Monthly Archives: May 2012

Coordination challenges

By Lawrence Loh, MD MPH

We’ve talked a lot about the value of short-term medical trips and the benefits that the local community, the young professional volunteers, and the organizations themselves could potentially derive from coordinating such efforts. Such coordination is obviously challenging, though; with growing numbers of participants, there are always myriad opinions, ideas, and suggestions that would shape any such model.

Thus far, the biggest barrier faced in implementing a successful coordination model has been structural: a genuine lack of time and effective programs. A proposed website (as described in our previous post) involves significant technical knowledge and programming, as well as up-front aesthetic designs. At present we are in the midst of developing a prototype, but it will obviously need to be piloted by key stakeholders before being put into active service. Making this harder is the general lack of time – as young professionals passionate on the subject, we’re busy doing this off the side of our desks while working our regular day jobs.

Other challenges have been in reaching out and managing the expectations of all the parties involved. We are fortunate that there are so many different teams with differing histories, experiences, skill sets and ideas that are working in the community in question. It challenges us, however, to work with leaders and form consensus, trying to determine a process for what we need to do – how will we standardize protocols? Why have a real-time inventory, and how would we get people to participate? We also work alongside the local leadership to identify gaps and needs that can be fulfilled by projects run by the teams in tandem, and then work with the teams to figure out how best to broadly address these and implement them effectively.

The diversity of opinions and ideas, while valuable, can often times conflict with one another. Different folks have different priorities and different thoughts on the way forward, and of course, the local leadership have their needs and gaps to be met as well. The challenge is in ensuring that everyone feels a valued part of the team – because everyone is – and further to that, ensuring that key aspects of their vision are included in an overarching, shared vision that teams together can take ownership and pride in.

For the most part, though, such challenges are immensely rewarding – the exchange of information and opinions strengthens and galvanizes everyone’s efforts in the common cause. Perhaps the most important aspect of everything is despite the differences, the opportunity to speak and to keep things front of mind is a valuable intangible benefit in keeping everyone involved motivated and committed, eyes on the prize.

In this case, a challenge can be a strength – both in learning how to manage critical relationships, but also, towards improving things by asking the impertinent questions about how best to work together to produce those outcomes that we seek.

Dr. Lawrence Loh is Chief Medical Officer of The 53rd Week, and a physician in Toronto, Ontario, Canada.

So what would a website look like?

By Lawrence Loh, MD MPH

In our last post at the beginning of April, we started to talk a bit about what a potential coordination website would look like. Most of what we’ve come up with has been through informal discussion with lots of people – the local community we’re building the site for, the other teams that have significantly longer and diverse experiences participating down there, and what programmers feel is feasible. We’ve settled on a few common elements that are going to form the basis of our product.

The keystone of things will be a centralized calendar and contact database. After all, if we’re going to be working together and coordinating together, at a baseline we should know who everyone is, and where everybody can be reached at. Further to this, this calendar and contact system can one day form the basis for recruitment – trying to find specific young professionals who happen to have a week to come down and join a group for a week – with that group as part of the wider project going on. At the least, this will let everyone know who is who, when someone is heading down, and who to contact that might be on the ground right now or imminently.

Then comes the information sharing. And we had a long think and some very fruitful discussion with the other great people heading down there. From a disease perspective, it comes down to standardizing everything – protocols, program logistics, and information sharing. So we’d look to have team reports, that would be part of a record of what’s been done, but also serve as an information source for upcoming teams. We’d like to see some real-time inventory and tracking of projects that the teams are working on. We’d love to standardize protocols based on best evidence identified by teams (something to do while home and not on the ground there!) as well as experience. And of course, building a wiki of information on cultural customs, what to expect when heading down there, general tips and suggestions – filling into the idea of a virtual library of ideas that will eventually form a valuable knowledge base for anyone doing short or long term work in the community.

Then the biggest part of the interaction – a forum for discussion and communication. Teams can share ideas for new projects, plan how they’re going to go down, set goals, objectives, and indicators for how they’ll measure progress. They can give heads-up to teams heading down after them, or check-in with teams before them to see if there’s something that needs to be followed-up on. A continuous stream of information shared between teams, all on the same side, still individually autonomous, but using technology to push towards the same goal, with the local leadership always at the forefront of making sure things go.

And for those young professionals looking for a shot in, they can join a trip; read up on the locale through the virtual library and ask questions on the forum; source meds in their home community that are identified as in need on the inventory; head down on their trip with their team, and then come home and keep track of what they’ve started and participated in down there virtually until their next trip down in a year, or six months, or whenever.

In today’s busy day and age, it would mean that our valuable week down there becomes something more – it becomes part of solving the puzzle of work down there and turns our investment into something more valuable, part of a mosaic. It’s working together. And in our next post, we’ll talk about how we’ve started discussions with other folks, the general reception, and challenges we’ve faced in the development of our web platform.

Dr. Lawrence Loh is Chief Medical Officer of The 53rd Week, and a physician in Toronto, Ontario, Canada.