A Farewell Message from Carsten: Five Years at ISQua 

The 30th April was my last day as the CEO of ISQua after five amazing years. It has been a privilege to lead the office staff, a bunch of lovely and dedicated people, during one leg of the journey of healthcare quality support and promotion, which began more than forty years ago and will hopefully continue for at least another forty years. 

During those five years, we have, together, achieved a lot to be proud of. 

From the very beginning of its existence, the annual conference has been a crown jewel for ISQua, a place for the ISQua community to come together, share knowledge and experience, and network. In my first year, the conference had to be virtual, but after that, I have had the pleasure of, together with the Board and the team, welcoming the ISQua Community to four international conferences across four continents. All of them amazing experiences. 

In addition to the international conference, we have been a knowledge partner for two regional conferences over the last 12 months, with a third in the planning stage. This has proved to be a great way to extend our reach, leverage the strengths of, and strengthen our bonds with, our regional partners. 

A new model for the ISQua Fellowship has been established and consolidated, ensuring that the Fellowship remains accessible and affordable, but also scalable and up-to-date. The total number of Fellows has grown from approximately 650 to almost 2000. 

In addition to the longstanding Community of Practice in Latin America, we have launched two new Communities, one in Africa and one in North America. The driving forces behind those communities are, of course, the local steering committees, and it has been very satisfying to support them. One memorable moment was the vibrant session of the African Community of Practice at the Sao Paulo conference. 

ISQua’s International Accreditation Programme, the IAP (“Accrediting the Accreditors”), has now been in existence for more than 25 years. The client base has continued to grow as new countries have taken up accreditation. 

The Principles for the Development of Health and Social Care Standards, which set the quality criteria for the development of healthcare accreditation standards and outline what issues they should address, have been updated to include in their 6th edition important new quality domains, notably environmental sustainability and digital health, while stressing the importance of workforce wellbeing and updating well-known requirements related to safety and clinical effectiveness. 

After 25 years, it has, despite several revisions, become time for an in-depth review of the IAP to transform it so that it will remain relevant, reflect the transformative changes that healthcare is going through, and leverage the opportunities offered by new technologies to make accreditation less burdensome and more focused on outcomes, rather than mere process compliance. As a first step, we, in 2025, commissioned a Strategic Paper: “The Future of Health and Social Care Accreditation” for the Board to outline the challenges and opportunities as seen by stakeholders, other industries and the literature. Based on these findings, the authors of the report listed fourteen recommendations for the future. We are now ready to take the next step and begin the work to translate these recommendations into a new accreditation model. This work is just about to commence. 

We are often asked about the evidence for accreditation. To give an evidence-based answer, we partnered with the Australian Institute of Health Innovation at Macquarie University, Sydney, led by former ISQua President Prof Jeffrey Braithwaite, to create an AI-facilitated literature summary. The first edition, covering the literature from the start of the PubMed database to 31st December 2023, is freely available on our website; and the plan is to update it regularly – the first update is under way. 

ISQua is interested in partnering in consultancies, mainly as a knowledge partner. Currently, we are partners in Support4Reslience, an EU Horizon project led by a team from the University of Stavanger with the aim of creating a toolbox for leaders in elderly care to establish and maintain a resilient work environment – an exciting experience, very much aligned with ISQua’s mission. 

ISQua’s two peer-reviewed journals are thriving. The “original” ISQua journal, The International Journal for Quality in Health Care, is among the leading journals in the field. Its younger sibling, The International Journal for Quality in Health Care Communications, an open-access and implementation-focused journal, provides further opportunities to share and learn. 

An important way for ISQua to summarise and make available the knowledge and experience in its network is by publishing White Papers, which are free resources available for everyone on our website. During my tenure, we have published: 

  • Clarifying the concept of external evaluation. 
  • Person-Centred Care Systems: from theory to practice. 
  • Green Care is High Quality Care: The ISQua Green Paper and Call to Action for Environmentally Sustainable and Climate Resilient Health Systems – with a follow-up paper under way. 
  • Safe Care is the Right Care: The ISQua White Paper on Patient Safety for Healthcare Organisations. 

The Patient Safety White Paper was authored by members of the Patient Safety Task Force we established at the suggestion of the WHO. It has been a pleasure to see the interest this paper has generated – we know that a considerable number of hospitals have taken it up to guide their safety implementation work. 

It has become important for ISQua to include the Patient Voice in its activities. The Person and Family Centred Advisory Council, which was newly established when I commenced as CEO, is now well-established and has made considerable contributions, not the least by providing a strongly articulated patient perspective to the annual conference. 

And last, but not least, we have been able to secure an accumulation of financial reserves, which will serve as a solid foundation for the work over the coming years and will allow for investments to improve the services we provide. 

I would like to thank the ISQua staff, the ISQua Officers, all Board Members, Honorary Advisors, ISQua Members, Members of the Patient and Family-Centred Advisory Council, Fellows, Experts, the Academy, and Partners for their tireless support of ISQua and its mission. Any success we have achieved is a result of your commitment and efforts. 

Finally, I would like to welcome my successor, Pedro Delgado. I am sure ISQua will remain in good hands and, under his leadership, will continue to find and pursue new ways to enable us to meet our mission to inspire and drive improvement in the quality and safety of healthcare worldwide. 

And, while I am leaving this post: Once a member of the “ISQua Family”, you will, forever, remain a member of that family – so will I. 

Carsten Engel

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Dr Rhoda Kalondu

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Dr Subhrojyoti Bhowmick

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