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CSiM, a Center for Rural Health Stewardship, Joins I-TECH as Key Network Partner

The Center for Stewardship in Medicine (CSiM) has joined the International Training and Education Center for Health (I-TECH) Network as a partner, operating within the University of Washington’s Department of Global Health. CSiM is a collaborative of over 80 rural hospitals across nine states in the U.S. working together on stewardship challenges through education, quality and process improvement, and mentoring.

I-TECH and CSiM will mutually benefit from collective decades of experience tackling rural health challenges – including workforce shortages, staff who wear “many hats,” and disparities in services – in the U.S. and around the world.

“CSiM is a collaborative of physicians, nurses, laboratory professionals, and pharmacists working to bridge bi-directional knowledge gaps between academic medical centers and rural health care facilities,” said John Lynch, MD, MPH, co-director of CSiM. “Like I-TECH, we value collaborative, anti-hierarchical work that honors expertise and experience at all levels of the health care system, and from all sectors.” Dr. Lynch leads the center with Chloe Bryson-Cahn, MD, and Zahra Kassamali-Escobar, PharmD.

The CSiM team with guest speakers at the center’s conference in Spokane, WA, May 2023. Photo courtesy of CSiM.

CSiM works in antimicrobial stewardship and infection prevention, building sustainable quality improvement programs, and providing customized, long-term technical assistance to rural health facilities. The center’s main activities include leading the UW Tele-Antimicrobial Stewardship (TASP ECHO®) project, a telementoring program; coordinating Intensive Quality Improvement Cohorts; and providing resources and tools to support facilities in reaching their goals and improving the quality of healthcare.

“I-TECH and CSiM share a dedication to finding innovative and local solutions to provide ongoing education and mentoring to health care workers in resource-limited settings,” said Pamela Kohler, BSN, PhD, I-TECH co-director. “We are incredibly excited about the opportunity to learn from each other.”

Currently, CSiM has projects in Arizona, Idaho, Illinois, Louisiana, Maine, Montana, Oregon, Utah, and Washington and is exploring opportunities to extend its model globally.

“CSiM’s inclusive, team-based approach results in work that really matters to communities in need – particularly those in underserved, hard-to-reach, rural areas,” said Ivonne Ximena “Chichi” Butler, MPH, I-TECH co-director. “This approach makes it a perfect fit within the I-TECH Network.”

Center for Stewardship in Medicine (CSiM)

The University of Washington (UW) Center for Stewardship in Medicine, or CSiM (“see-sim”), is a collaborative of over 80 rural hospitals working together on stewardship challenges through education, quality and process improvement, and mentoring. CSiM  provides education, technical assistance, and personalized support to facilities and health care professionals to meet their stewardship needs.

In 2023, CSiM moved to the UW Department of Global Health and joined the International Training and Education Center for Health (I-TECH) as a partner.

CSiM works in antimicrobial stewardship and infection prevention, building sustainable quality improvement programs, and providing customized, long-term technical assistance to rural health facilities. The center’s main activities include leading the UW Tele-Antimicrobial Stewardship (TASP ECHO®) project, a telementoring program; coordinating intensive quality improvement cohorts; and providing resources and tools to support facilities in reaching their goals and improving the quality of healthcare.

Currently, CSiM has projects in Arizona, Idaho, Illinois, Louisiana, Maine, Montana, Oregon, Utah, and Washington and is exploring opportunities to extend its model globally.

Public Health Surveillance

I-TECH works in collaboration with key stakeholders, including communities, government entities, and the Centers for Disease Control and Prevention (CDC), to strengthen and implement surveillance programs focused on emerging disease threats, HIV recent infection, birth defects surveillance, and hospital acquired infections in sub-Saharan Africa. Eastern Europe, Asia, and South America.

In Malawi, I-TECH has supported the implementation of an active hospital-based birth surveillance system at four high-volume facilities in Malawi since 2016, and beginning in 2019, I-TECH began implementing recent HIV infection surveillance in April 2019.

In 2022, as part of the Integrated Next-generation Surveillance in Global Health: Translation to Action (INSIGHT to Action) project, I-TECH, the Peruvian Ministry of Health, the Universidad Peruana Cayetano Heredia, and CDC collaborated on a situational analysis to assess areas for potential strengthening of the Peruvian disease surveillance systems. In 2023, the INSIGHT for Action project launched the Triple Border Disease Surveillance Strengthening Program.

In Kenya, the I-TECH Kenya office is working with CDC on implementing surveillance for hospital acquired infections (HAI) in low resource settings, with a focus on surgical site infection surveillance.

Program Highlights

Global Avian Flu Surveillance in Georgia
Migrating waterfowl from Asia, Africa, and Europe intersect in Georgia, which increases the potential for novel avian-origin influenzas to emerge ...
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Strengthening Public Health Disease Surveillance
The Integrated Next-generation Surveillance in Global Health: Translation to Action (INSIGHT to Action) project is a five-year cooperative agreement with the ...
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COVID-19 Sentinel Surveillance in Malawi
Despite establishing  COVID-19 monitoring measures within the existing routine national surveillance system and significant efforts to conduct testing, contact tracing, ...
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Triple Border Disease Surveillance in South America
Population movement, limited public health infrastructure, different country reporting systems, and poor environmental conditions increase incidence of certain infectious diseases ...
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HIV Drug Resistance Surveillance in Malawi
The World Health Organization recommends countries routinely implement nationally representative HIV drug resistance (HIVDR) surveys among people infected with HIV ...
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Global Health Security Agenda in Kenya
I-TECH Kenya’s Global Health Security Agenda (GHSA)-funded programs aim to advance the GHSA goals of preventing , detecting, and responding ...
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Field Epidemiology Training Program in Malawi
The Frontline Field Epidemiology Training Program (Frontline FETP) enhances the capacity of HIV and AIDS surveillance and strengthens health systems ...
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HIV Recency Surveillance in Malawi
The International Training and Education Center for Health (I-TECH), in collaboration with the Malawian Ministry of Health (MOH) and the ...
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Birth Defects Surveillance in Malawi
Malawi is one of first countries in Southeast Africa to respond to the World Health Organization’s call for robust birth ...
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National COVID-19 Emergency Response in Malawi
In collaboration with the Malawi Ministry of Health (MOH) and Centers for the Disease Control and Prevention (CDC), I-TECH has ...
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Global Health Security Agenda in Kenya

I-TECH Kenya’s Global Health Security Agenda (GHSA)-funded programs aim to advance the GHSA goals of preventing , detecting, and responding to disease threats to health security.

For the past 8 years, I-TECH Kenya has had a cooperative agreement with US Centers for Disease Control and Prevention (CDC) to work closely with the Kenya Ministry of Health (MOH) on multiple projects related to health security. The key objectives of these activities are preventing and reducing the likelihood of disease outbreaks, improving the efficiency and accuracy of the detection of communicable diseases, strengthening surveillance capacity and national and county levels for a rapid and effective response, enhancing Infection Prevention and Control (IPC) practices to prevent the emergence and spread of pathogens and antimicrobial resistant bacteria.

Prevention

Use IPC practices to combat antimicrobial resistance (AMR) and other microbial threats:

  • Building capacity for IPC in health care facilities is a critical part of disease outbreak and AMR preparedness and prevention. In Kenya, I-TECH has partners with the CDC National Center for Emerging and Zoonotic Infectious Disease and Kenya MOH to support two model hospitals in developing capacity for quality improvement measures for strengthening evidence-based IPC practices, infrastructure, and tools including hand hygiene, waste management, injection safety, surgical site infections, and antimicrobial stewardship. As part of this IPC work, I-TECH created and piloted e-learning modules for IPC. The modules aim to build clinical skills and technical knowledge in infection prevention and control and antimicrobial stewardship among health care workers in low-resource settings, and have now been adopted by WHO.
  • With the onset of the COVID-19 pandemic, I-TECH Kenya was able to play a leadership role in the country in assessing and improving facility readiness at the national and local level to handle COVID-19 cases and maintain the health care workforce.
  • Current IPC activity is focused on surveillance for surgical site infections, an important cause of hospital acquired infections (HAIs).

Disease Prevention through Immunization Program Strengthening:

  • I-TECH collaborated with the Kenya MOH, CDC Global Health Protection Division, and the CDC Global Immunization Division, to build and roll out an online mobile platform for capturing immunization data at the point of care.

Detection

Laboratory Information Systems Strengthening:

  • In Kenya, I-TECH collaborated with the MOH and National Public Health Laboratory Services to enhance and strengthen laboratory information systems at the facility and national levels to improve timeliness and efficiency of testing and reporting results, specifically for AMR testing.

Response

Disease Surveillance and Response:

  • I-TECH supports the Kenya MOH Surveillance Unit in the rollout of trainings for health care workers to routinely and consistently use the real-time surveillance reporting system in Kenya.

Global Health Security

The COVID-19 pandemic has highlighted the critical importance of strong national disease surveillance systems that can detect disease threats in a timely fashion and provide actionable information for public health action. I-TECH focuses on preventing the likelihood of disease outbreaks, improving the efficiency and accuracy of the detection of communicable diseases, strengthening surveillance capacity for rapid and effective responses, and enhancing infection prevention and control practices to prevent the emergence and spread of pathogens and antimicrobial resistant bacteria.

In response to the COVID-19 pandemic, I-TECH provided technical assistance on the prevention and control of COVID-19 that ranges from training healthcare workers and facilities in infection prevention and control best practices to supporting the development of national policies and standard operating procedures. Throughout the COVID-19 pandemic, I-TECH has worked with Ministries of Health and other local stakeholders to ensure that laboratories, health facilities, clinics, and providers are being trained in and implementing procedures to prevent and control the spread of COVID-19.

Program Highlights

Global Health Security Agenda in Kenya
I-TECH Kenya’s Global Health Security Agenda (GHSA)-funded programs aim to advance the GHSA goals of preventing , detecting, and responding to disease threats to health security. For the past 8 years, I-TECH Kenya has had a cooperative agreement with US Centers for Disease Control and Prevention (CDC) to work closely ...
Read More
Strengthening Public Health Disease Surveillance
The Integrated Next-generation Surveillance in Global Health: Translation to Action (INSIGHT to Action) project is a five-year cooperative agreement with the US Centers for Disease Control and Prevention to assess and strengthen global public health surveillance systems using a One Health approach. The INSIGHT project leverages the capacity building strengths of ...
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Prevention, Care, and Treatment of Diseases

I-TECH has a wealth of experience and expertise in planning, developing, and implementing projects focused on prevention, care, and treatment of infectious diseases, particularly HIV and opportunistic co-infections such as tuberculosis (TB) and sexually transmitted infections.

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Kenya

Since 2005, I-TECH has drawn on expertise from the University of Washington and the University of California, San Francisco, to support the Ministry of Health (MOH) in advancing priorities in the areas of health information systems (HIS), HIS leadership and governance, Global Health Security (GHSA), and evidence-based Infection Prevention and Control (IPC) practices.

I-TECH Kenya’s programs aim to improve the quality of patient care and enable health care facilities to meet their health information, data collection, and reporting needs. I-TECH Kenya’s GHSA funded programs aim to advance the Global Health Security Agenda through strengthening information systems and reporting, and improving IPC in health care facilities.

In all efforts, I-TECH Kenya works closely with the MOH and local partners to develop and implement programs that can be successfully transitioned to local ownership, ensuring sustainable progress toward Kenya’s long-term health goals.

Program Highlights

Global Health Security Agenda in Kenya
I-TECH Kenya’s Global Health Security Agenda (GHSA)-funded programs aim to advance the GHSA goals of preventing , detecting, and responding to disease threats to health security. For the past 8 years, I-TECH Kenya has had a cooperative agreement with US Centers for Disease Control and Prevention (CDC) to work closely ...
Read More
Health Information Systems in Kenya
In 2012, I-TECH designed and developed an electronic medical records (EMR) system, KenyaEMR, to support the care and treatment of HIV/AIDS. KenyaEMR is built on the OpenMRS platform. I-TECH supported the implementation of KenyaEMR in over 300 health facilities throughout Kenya—one of the largest open source EMR rollouts in Africa ...
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HIS Leadership and Governance in Kenya
As a key member of the Kenya electronic medical record (EMR) system technical working group, I-TECH works to implement and standardize the EMR systems used in the management of national HIV and AIDS care and treatment data. Similar efforts have focused on ensuring that different electronic systems can communicate with ...
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