global health initiatives 

Chandigarh, India 2012

Post Graduate Institute for Medical Education and Research (PGIMER)

In May of 2012, Dr. Jonathan Chen led a group to the Post Graduate Institute for Medical Education and Research (PGIMER) center four hours northwest of New Dehli, under the auspices of Children's Heartlink, a humanitarian organization based in Minneapolis that had overseen the group's prior trip to Changchun, China. In addition to Dr. Chen, the team included Dr. Alejandro Torres, a pediatric cardiac catheterization specialist; Dr. Patrick Flynn, a pediatric echocardiography specialist; Thomas Orr, a pediatric perfusionist; Dr. Ralph Slepian, a pediatric cardiac anesthesiologist; Jillian Kirkpatrick and Dan Hogan, pediatric ICU nurses; Suzanne Cota, a pediatric nurse practitioner, and Dr. H. Michael Ushay, a pediatric intensivist.

Focusing on Education and Training

Unlike in prior trips, PGIMER is a fairly high-volume center, performing nearly 1000 open heart procedures (of which 300 are congenital heart operations), and several thousand interventional cardiac catheterization procedures annually. In addition, PGIMER is one of the premier locations for postgraduate education in India. The visit from the NYP group was the first full team assessment sent on behalf of Children's Heartlink to establish the need and potential for partnership in the future.

Accordingly, in this trip, the team focused more on education and teaching than on hands-on technique and clinical skills. Advanced echocardiography was a main focus among the cardiology and cardiac anesthesiology faculty, while fundamentals of perioperative congenital heart care, and quality and safety were the emphasis of the nursing education. Partnership with the nationwide perfusion (heart-lung bypass techniques) credentialing association is ongoing, and a key interest for PGIMER and the other sites in India whose work is overseen by Children's Heartlink.

"Crash Course Introduction" to Different Modes of Healthcare Delivery

Future trips to PGIMER will likely focus primarily on organization management, with the hope that a 'heart center'-type (Western) model may favorably synthesize coordinated care across disciplines (e.g., nursing, cardiology, cardiac surgery, intensive care medicine). Said Dr. Chen:

Always part of these trips is an amazing crash course introduction to the modes of delivery of health care around the world. In many ways, our challenge as 'consultants' is to balance our expectations with what may or may not be feasible abroad. While this conundrum can often be the source of great angst, it is also one of the true intellectual rewards of our trips these intellectual exercises surely make us better doctors and nurses, and open up new avenues that inform and refine our clinical practice at home.

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