Georgetown University HSQA Jordan Hiring for Jordan NeoTeam — Neonatologist and NICU Nurse at Amman, Jordan Full Time

Background

The U.S. Agency for International Development’s Health Services Quality Accelerator Activity (USAID HSQA Activity) is a five-year initiative (August 2021 to August 2026) to sustainably improve equitable reproductive, maternal, newborn, and child health (RMNCH) services and outcomes in Jordan. The HSQA Activity implements innovative approaches to improve quality and strengthen delivery of integrated health care, primarily in the public health sector. The Activity uses the evidence-based point-of-care quality improvement (POCQI) approach to support incremental improvements in the quality of RMNCH services. URC manages this program in Jordan and Georgetown University is a partner.

The Golden Hour Pilot and Expansion  

The Golden Hour includes six interventions to be administered effectively during a newborn’s first hour of life. Two of these interventions are lifesaving: resuscitation and temperature maintenance. The remaining four interventions are important for bonding, promotion of breastfeeding and long-term child health. They include immediate drying of the baby after birth, delayed cord clamping, skin-to-skin contact for at least 60 minutes, and breastfeeding. In August 2022 the HSQA Activity trained trainers and subsequently launched a pilot of the Golden Hour concept in three hospitals In October 2022 which will expand to an additional 17 hospitals in October 2023.

A separate initiative will begin in 2024 to focus on life-saving techniques for the small and sick newborn (SSN) This includes, resuscitation, prevention of hypothermia, respiratory support, safe use of oxygen, prevention of infection, feeding practices and use of maternal breast milk, maternal/family involvement, and transport.

The Jordan NeoTeam (JNT)

The Activity seeks to enhance the quality and support provided to the Golden Hour and Small and Sick Newborn initiatives by hiring two Jordanian consultants: a neonatologist and a NICU nurse to support both The Golden Hour (which includes the Neonatal Resuscitation Program) and Small and Sick Newborn interventions. These individuals will visit, observe, coach and train health care providers in the 20 MOH and RMS hospitals that are part of the HSQA Golden Hour and Small and Sick Newborn initiative. They will collaborate with the Activity’s Service Delivery/Quality Improvement team.

Observation: Prior to assuming day-to-day duties in Jordan, the successful candidates will participate in a four-week observation at MedStar Georgetown University Hospital in Washington, DC. The goal is to observe quality of care practices in a tertiary referral hospital in the United States and apply that to maternal and neonatal care in Jordan.

Both the doctor and the nurse will observe all aspects of care of term and premature newborns including delivery room care, initial resuscitation, respiratory management, infection prevention, intravenous fluid management, nutritional management including safe use of maternal breast milk, transport, and family-centered care.  

While the physician cannot provide hands-on-care and procedures he/she will participate in rounds, watch procedures and processes of care in the labor and delivery room, operating room, and the NICU. He or she can also observe ambulance transports, participate in the training program, simulations, attend quality improvement meetings, and discuss how these procedures apply to the MOH and RMS systems in Jordan. 

The nurse cannot be involved in hands-on-care or procedures but will shadow one nurse at a time to cover and understand all aspects of that nurse’s patient load. Over the course of the month, they will have opportunities to observe delivery room care, C sections, resuscitations, bedside management of a range of cases including extremely premature newborns, critically Ill term newborns, pre- and post-surgical patients, “feeding-growing” newborns in the intermediate care nursery, and transports.   

Responsibilities in Jordan. After the observational tour, the JNT will return to Jordan to work as part of the HSQA program. They will debrief with the HSQA and share their experience with HSQA staff, noting differences in the practices observed and the practices with which they are familiar in Jordan. They will then begin working with the Quality Improvement Officers to review processes of care in the Golden Hour and Small and Sick Newborns (SSN) initiatives. They will be responsible for monitoring practices through auditing/observation. coaching, training, and improving the quality of care in the 20 MOH and RMS hospitals in the GH/SSN initiatives. Specifically, they will:

• work together to visit each of the 20 participating hospitals each month. They will observe health care practices and complete observational checklists, interact with all hospital personnel to ensure appropriate GH and SSN practices. This includes hospital administrators, data management personnel and managers, staff obstetricians, gynecologists, pediatricians, neonatologists, health educators, midwives, and nurses in labor and delivery, the neonatal intensive care unit, and antenatal care clinics. They will also train and support the hospitals Quality Assurance and Patient Safety officers and monitor the accuracy of procedure logging and data entry and consistency of tracking and monitoring activities. 
• work as part of the HSQA Quality Improvement team supporting key Activity outcomes. The JNT will participate in all HSQA Quality team meetings and HSQA staff meetings and participate in regular phone calls with Georgetown’s NeoTeam and serve as an intermediary between the GU and Jordan HSQA Teams. 
• support writing of HSQA quarterly reports, interact with USAID, the Ministry of Health, other stakeholders and technical committees and participate in other HSQA quality and planning activities related to newborn care.
• participate in conducting the introductory HSQA/SSN training as well as support preparation and follow up.

Term

The positions require a two-year commitment. 

Experience

Neonatologist. Ideally, the neonatologist or pediatrician will 

• have at least four years of experience working in a level three neonatal intensive care unit in a large hospital in Jordan, i.e. at least 16 incubators caring for babies from 25 or 26 weeks gestation, C-PAP and respiratory support, and central lines.
• be proficient in Arabic and in English.
• be eligible to receive a visa for entry into the United States. A current US tourist visa is desired but not required.
• be comfortable with and enjoy teaching other professionals.

NICU Nurse. The NICU Nurse will 

• have at least four years of experience working in a level three neonatal intensive care unit in a large hospital in Jordan as defined above.
• be proficient in Arabic and in English.

• have experience working with a multidisciplinary team. 
• be comfortable with and enjoy teaching other professionals and providing patient education.

Experience in a leadership role is preferable but not mandatory.  

Candidates having these qualifications are preferred. Training may be provided for candidates lacking all these qualifications.

Terms of Employment:

The NeoTeam will be hired as consultants to Georgetown University. They will need to comply with all requirements related to USAID government standards and will be required to sign a two-year contract with Georgetown University. The Neo team will need to provide health clearance and immunization certificates to MedStar Georgetown University Hospital, and also sign a confidentiality agreement for maintaining patient privacy. 

The NeoTeam’s primary report will be Georgetown’s Dr. Jayashree Ramasethu with secondary HSQA coordination with HSQA Clinical QI Advisor and DCOP.  

Employment Status

The NeoTeam will be hired as contractors under Georgetown University’s sub agreement. This will enable them to continue part-time work in private clinics or other consulting efforts.

• They will be required to demonstrate they are contractors. One way to do this is  through a Linked In profile. 
• While contractors cannot be required to work in the HSQA office, they will have desks available for their use within the HSQA office and will be included in HSQA Quality Team meetings and other HSQA meetings. 
• As contractors they will need to have their own health insurance and work with their own mobile phones. Business phone calls are items that are reimbursable.

Benefits:

• Georgetown will provide travel/medical evacuation insurance during US travel, 
• During the US visit, the NeoTeam will live with local families and some meals may be provided. The JNT will receive reimbursement during their trip to Washington, DC for local business travel, incidentals, and meals. Reimbursement of travel expenses will be provided during US and Jordan business-related travel according to US government standards.
• Transportation for hospital visits in Jordan will be provided through the HSQA transportation fleet. 

Deliverables:

Consultants will be paid monthly based on receipt of the following deliverables:

• A trip report summarizing the observation tour and an assessment of quality procedures observed and the differences from observed practice in Jordan. 
• An annual strategy addressing the challenges and opportunities within all hospitals and plan for addressing them. This will be done in collaboration with the HSQA Quality team.
• Weekly submission of field visit report along with the  hospital observational checklists with visits planned for the following week.
• Monthly report describing training activities, visits to and the progress of each of the 20 hospitals, challenges to address for each hospital, hospital successes, innovations, and insights for practice change, coaching and on the job training provided.
• Summary reports of USAID, MOH, and key stakeholder meetings attended.
• Debrief summaries on GH and SSN trainings.
• Monthly invoices due on the 5^th of each month.