Board affiliate pilot: leadership and innovation—creating new opportunities to deliver better patient care

BackgroundLeadership and management have become a key facet of medical training. However, there remains enormous variation in the quality and effectiveness of medical leadership training. This article describes an innovative pilot programme that aimed to prove a new method of developing clinical leaders.MethodsWe undertook a 12-month pilot integrating a doctor in training onto our trust board in a role called the ‘board affiliate’. We collected qualitative and quantitative data throughout our pilot programme.ResultsQualitative data demonstrated a clear positive impact of this role on senior management and clinical staff. Our staff survey results increased from 47.4% to 50.3%. The pilot programme has had such an impact on our organisation that we have expanded the single pilot role into two positions.ConclusionThis pilot programme has demonstrated a new and effective method of developing clinical leaders.

Public engagement and crowdfunding for health research: A global qualitative evidence synthesis and TDR pilot

Background: Many exceptional researchers, especially in low-and middle-income countries (LMICs) face structural disadvantages in applying for research grants. Public engagement and crowdfunding make it possible for researchers to directly seek support from the public, by engaging large groups of people who make small contributions to support a project. This manuscript synthesizes global qualitative evidence and describes a WHO-TDR public engagement and crowdfunding pilot programme. Methods: We searched six databases for primary qualitative and mixed-methods research. We used a thematic synthesis approach and assessed our findings using the GRADE-CERQual approach. A crowdfunding approach to finance research studies was tested through a pilot programme, with a focus on infectious diseases of poverty. TDR Global mentors provided support for five finalists to engage the public and develop crowdfunding campaigns. Results: Nine studies were included in the qualitative evidence synthesis. Themes were developed into seven key findings, including the need for extensive public engagement, the potential for crowdfunding to open a communication channel between researchers and the public, key correlates of crowdfunding success and the risks of crowdfunding health research with associated mitigation strategies. The TDR pilot programme received 121 entries from 37 countries. Five LMIC-based researchers received training and joined a working group. Three researchers launched their crowdfunding campaigns, met their goals and received substantial monetary and non-monetary contributions. Conclusion: Public engagement provides a foundation for effective crowdfunding for health research. Our evidence synthesis and pilot data provide practical strategies for LMIC researchers to engage the public and conduct crowdfunding campaigns.

Creating and Testing an Online Platform for Language Learning in the Mexican Context

This chapter presents the results of a case study conducted in 2016-17 at the National School of Higher Studies in Morelia (ENES-M), Michoacán, Mexico, where a pilot programme was implemented at bachelor’s level for students learning English as a foreign language. The platform used in this study was composed of small digital units called Learning Support Units (UAPAs) first developed in 2011 to help students practice and develop their linguistic skills at two levels, basic and pre-intermediate. These selected UAPAs were hosted in a portal named Ambiente Virtual de Idiomas (AVI) (Language Virtual Environment) administrated by the Coordination of Open University and Distance Education (CUAED). Later, in 2015, it was proposed that a more complex and complete platform be designed and in 2016 the new UAPAs for levels A1, A2, B1 and some of B2 were developed and then piloted for further evaluation. As a result, the experimental groups exposed to a blended teaching reported higher scores in the post test than control groups that were taught with no use of technological elements, hence proving that blended-learning teaching is a good pedagogical option for university students.

Lowering drug prices and enhancing pharmaceutical affordability: an analysis of the national volume-based procurement (NVBP) effect in China

To cope with the increasing healthcare costs brought about by the universal health insurance programme, national volume-based procurement (NVBP) was implemented in China to reduce drug prices. However, the impact of NVBP remains unknown. We reported the effects of the NVBP pilot programme on medication affordability and discussed the challenges and recommendations for further reforms. A total of 25 molecules won the bidding in the NVBP pilot programme, and price cuts ranged from 25% to 96%. Medication affordability was measured as the number of days’ wages needed to pay for a course of treatment, and the medication was identified as affordable if the cost of a treatment course was less than the average daily wage. After the NVBP, the proportion of affordable drugs increased from 33% to 67%, and the mean affordability improved from 8.2 days’ wages to 2.8 days’ wages. Specifically, for rural residents, the proportion of affordable drugs increased from 13% to 58%, and the mean affordability improved from 15.7 days’ wages to 5.3 days’ wages. For urban residents, the proportion of affordable drugs increased from 54% to 71%, and the mean affordability improved from 5.9 days’ wages to 2.0 days’ wages. Implementing the NVBP substantially improved medication affordability. In future reforms, a multifaceted approach addressing all issues in the health system is needed to enhance medicine access.

COVID-19 infection among international travellers: a prospective analysis

ObjectivesThis report estimates the risk of COVID-19 importation and secondary transmission associated with a modified quarantine programme in Canada.Design and participantsProspective analysis of international asymptomatic travellers entering Alberta, Canada.InterventionsAll participants were required to receive a PCR COVID-19 test on arrival. If negative, participants could leave quarantine but were required to have a second test 6 or 7 days after arrival. If the arrival test was positive, participants were required to remain in quarantine for 14 days.Main outcome measuresProportion and rate of participants testing positive for COVID-19; number of cases of secondary transmission.ResultsThe analysis included 9535 international travellers entering Alberta by air (N=8398) or land (N=1137) that voluntarily enrolled in the Alberta Border Testing Pilot Programme (a subset of all travellers); most (83.1%) were Canadian citizens. Among the 9310 participants who received at least one test, 200 (21.5 per 1000, 95% CI 18.6 to 24.6) tested positive. Sixty-nine per cent (138/200) of positive tests were detected on arrival (14.8 per 1000 travellers, 95% CI 12.5 to 17.5). 62 cases (6.7 per 1000 travellers, 95% CI 5.1 to 8.5; 31.0% of positive cases) were identified among participants that had been released from quarantine following a negative test result on arrival. Of 192 participants who developed symptoms, 51 (26.6%) tested positive after arrival. Among participants with positive tests, four (2.0%) were hospitalised for COVID-19; none required critical care or died. Contact tracing among participants who tested positive identified 200 contacts; of 88 contacts tested, 22 were cases of secondary transmission (14 from those testing positive on arrival and 8 from those testing positive thereafter). SARS-CoV-2 B.1.1.7 lineage was not detected in any of the 200 positive cases.Conclusions21.5 per 1000 international travellers tested positive for COVID-19. Most (69%) tested positive on arrival and 31% tested positive during follow-up. These findings suggest the need for ongoing vigilance in travellers testing negative on arrival and highlight the value of follow-up testing and contact tracing to monitor and limit secondary transmission where possible.