Quality (133) Lessons from the 37th International Society for Quality in Health Care Conference, 8-11 July

14 July, 2021

The ISQua 37th International Conference 2021, initially scheduled to hold in Florence last year but converted to a virtual conference, held between the 8th and 11th of July 2021 with about 2000 persons in attendance. The theme of the conference was “emotions, inspiration and creativity: pathways to global health quality”. It featured plenary sessions from great speakers including Melanie Calvert, Walter Ricciardi, Pascale Carayon, Glyn Elwyn, Valerie James, Sylvie Mantis, Boel Andersson Gare, Trish Greenhalgh, Rene Amelberti, Charles Vincent, Sumaia Al-Ariki, Frances Mortimer, Ron Wyatt and Yvonne Coghil. We also had sessions from WHO (GPSN & GLL for QUHC), NAHQ, Good Governance Institute. Speakers from more than 50 countries also had the opportunity to present their works. As always with the ISQua conference, there were so many lessons to learn. I am glad that this year’s conference sessions are recorded and made available, there’s still so much to learn from some of the sessions I wasn’t able to join during the conference. ISQua has also decided to make the videos available to anyone who might be interested for a token. Meanwhile, I will be sharing some of the lessons for each day here over the next few days. My key lessons of the first conference day are:

Melanie Calvert, the recipient of this year’s HAL career prize for an individual on patient-reported outcome, discussing the need for understanding of the various terminologies used in measuring patients’ care: patient experience, patient satisfaction, patient-reported outcomes, and co-production. Patient-reported outcome measures are extremely useful to understand both the ill-health and the care services as received by the patients. It helps to prioritize the things that are most important to the patient, and build the care process around these things. She also discussed the current fragmentation of these tools across different units, institutions and program areas, and the need for harmonization, both generic measurements and disease-specific measurements.

Several other speakers also talked about patient-centered care, and how COVID-19 has driven this home more than ever before. In the words of one of the presenters, “it is not [always] about being polite or gentle, it is about listening to learn, to understand the recovery priorities and goals of the patient”. Patients are active partners in their care, they spend most of the time (over 97% of time) taking care of their health. The asset that they bring on board needs to be recognized and explored.

Isabelle Castro talked about “power” as it relates to healthcare and how it has transitioned over the generations. First, we started with powers belonging to the public managers (keeping power) who decides how the healthcare system runs; then moved to understanding the need for power to be shared with the receivers of healthcare through patient participation, engagement, feedback, and quality improvement. However, the world is rapidly moving towards the third power wave - ceding powerr to the patients, understanding that the patient is first and foremost responsible for his/her care and co-producing this with the patient.

Having experienced and benefited a lot of MOOCs over the past few years, I have always considered how best to evaluate the impact of MMOC, especially in healthcare quality improvement. Tricia Woodhead gave a great presentation on this, how to explore both the Kirkpatrick and RE-AIM models that I found very useful. I found the link to the full work, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008416/, I think it’s worth checking out.

The final lesson that I’d like to share is the presentation on “the role of leadership to tackle formidable health systems challenges”. The speaker described the changing health systems landscape as preparing for the “perfect storm”. A "perfect storm" is an expression that describes an event where a rare combination of circumstances will aggravate a situation drastically. He believes that because:

People live longer and have fewer children

People migrate within and between countries, and cities grow bigger.

Non-communicable diseases dominate the disease burden.

Depression, heart disease and cancer are leading causes to healthy life years lost.

Infectious diseases, such as SARS-COV, HIV, tuberculosis remains a challenge to control.

Antibiotic-resistant organisms are emerging.

Health systems face rising costs.

Primary health care systems are weak and lack preventive services.

Public health capacities are outdated.

Yet, he believes that despite the challenges, building healthcare leaders guided by all of Jim Collins 5 levels of leadership can help prevent/survive the “perfect storm” that is coming. These levels are:

- Developing highly capable individuals who make productive contributions through talent, knowledge, skills and good work habits

- Grooming contributing team members who contribute their individual capabilities to the achievement of the group objectives and work effectively with others in a group setting

- Organizing people and resources toward the effective and efficient pursuit of predetermined objectives

- Catalyzing commitment to and vigorous pursuit of a clear and compelling vision, stimulating higher performance standards, and

- Building enduring greatness through a paradoxical blend of personal humility and personal will.

Two things have occupied my thoughts from the lessons from the day that I’d like to share with the group:

In countries where out-of-pocket expenditure is responsible for the bulk of healthcare financing, how useful is Patient-Reported Outcome Measures in monitoring response to healthcare services? Does anyone in the group have experiences/outcome of research they’d love to share?

Regarding the power curve in the health sector, how well would you say your local, district/state, regional or national level has transited to ceding power to the patients? What has been the experience in your setting?

Balogun Stephen Taiye MBBS, MPH, CSSGB, SMC, PMP, FISQua

ISQua Expert, ISQua Ambassador, Lucian Leape Patient Safety Scholar,

WHO Global Patient Safety Network (GSPN) Member

HIFA profile: Balogun Stephen Taiye is a Medical Officer/Quality Improvement Team Leader at the Olanrewaju Hospital in Nigeria. He is also currently a post-graduate student of Public Health and Business Administration. Professional interests: patient safety, healthcare quality improvement, reproducible research, data collection and analysis. He is a HIFA Country Representative for Nigeria and was awarded HIFA Country Representative of the Year 2016.

www.hifa.org/support/members/balogun-stephen

www.hifa.org/people/country-representatives/map

Email: stbalo2002 AT gmail.com