2. LRC Experience in Implementing Clinical Practice Protocols for Quality Improvement Lala Alieva Joint City Hospital #6 Baku/Richmond Partnership Date:10/07/03

3. Established in April 2000 With the overall goal to improve the health status of the Binagadi District population, including IDP/refugees, through community-based Primary Care services The Binagadi District Health Administration in Baku, Azerbaijan Virginia Commonwealth University, Richmond, VA The Partnership

4. Area:174 sq km Population: 209 300 Health care settings13 Health care settings in IDP/refugee communities12 The Binagadi District

5. ESTABLISHED IN FEBRUARY 2001 AT JOINT CITY HOSPITAL #6 LAN INCLUDING 3 PCs AND INTERNET ACCESS TV AND VIDEO EQUIPMENT, OVERHEAD PROJECTORS PRINTERS AND COPIERS TEACHING MATERIALS ROOM FOR WORKSHOPS AND TRAININGS LRS History and Facilities

6. Choosing Standards Information Search Analysis Choosing the most acceptable Clinical Practice Implementation of a new standard Evaluation of outcomes Strategy

7. Medline Pub Med Cochrane Library Ovid National Medical Library Russian Health Server Electronic Medical Library The International Medical Practice Journal Search Engines and Databases

8. General Practice Hypertension Gastric and Duodenal Ulcer Bronchial Asthma CPGs

9. PEDIATRICS Infectious Diseases. Immunization Rheumatic Fever Bronchial Asthma CPGs

10. GYNECOLOGY Use of prostaglandins in the treatment of atonic and hypertonic hemorrhages Use of combined Femoston and Klimaktoplan therapy to mitigate manifestations of the climacteric syndrome Treatment of women with immune-incompatible pregnancies CPGs

11. ANESTESIOLOGY Beta-Blockers dozing principles in the most acute stage of myocardial infarction Action Algorithm for complicated (unsuccessful) intubations Revised methods of prolonged spinal and epidural anesthesia during surgeries on lower extremities and small pelvis CPGs

12. SURGERY Use of antibiotics and antiseptics in abdominal surgery Use of hyperthermia for peritonitis Wide use of tension methods of repair in hernioplastics for patients with giant hernias of different localizations CPGs

13. A 30% decrease in the number of patients hospitalized for arterial hypertension; A 20% decrease in the number of patients hospitalized for aggravations of gastric and duodenal Ulcer; A 15% drop in the number of complicated deliveries; Controlled bronchial asthma status achieved in 70% of the BA patients; A one-third decrease in the number of complication and mortality cases in Joint City Hospital #6 Intensive Care Unit. About 65% of physicians and health workers surveyed said that the use of new clinical practice guidelines had assisted them in making the treatment more efficient. The percentage of patients assessing the quality of medical care that received as good and very good increased from 20% to 65%. Outcomes