Workshop to develop a new ISQua Green Paper on high quality and environmentally sustainable healthcare

39th International Conference of ISQua in Seoul, 2023

‘Technology, culture and co-production: looking to the horizon of quality and safety’

in the run-up to the 39th International Conference of ISQua in Seoul, 2023

 ‘Technology, culture and co-production: looking to the horizon of quality and safety’

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Workshop to develop a new ISQua Green Paper on high quality, environmentally sustainable healthcare

The horizon of quality and safety in healthcare is rapidly becoming obscured by one of the biggest threats to public health: the escalating ecological crises. It is not just the global warming of the planet, it is also the loss of biodiversity and the widespread pollution of the air, the water and the soil that seriously affects our health in multiple ways. Recent climate science demonstrates that several vital planetary boundaries are being breached, even to the extent that this cannot be reversed. The scientific evidence is unequivocal: the natural systems that support all life on earth are in clear and present danger.

As healthcare professionals we are confronted with the consequences. No matter where we live, we will observe an increase in health complaints and diseases that directly or indirectly arise from environmental or climate causes. We already see more cardiovascular diseases, respiratory diseases, infectious diseases, cancer, mental health problems attributable to environmental degradation. Of course the incidence, prevalence and severity vary with where you live on the planet; extreme weather events like flash floods, storms or heatwaves are more likely to occur around the equator. Low-resource countries with fragile health systems will suffer harsher consequences. Same for vulnerable people in both low- and high-income countries: mothers and babies, children, the elderly, and patients with chronic disease. Social determinants of health play a compounding role – as those with less income, education, housing or work opportunities are less able to cope with the climatic “shocks”. The environmental determinants of health put people in a precarious situation: those who live in coastal areas will have to flee from the rise of the sea-level. Food insecurity, conflict and forced migration crawl upon the lives of millions. The impact is enormous. The cost as well.

So what can health professionals do when we realise that our health depends on the health of the planet? Unfortunately, the health sector contributes substantial greenhouse gas emissions, pollution, waste. If global healthcare were a country it would rate as the fifth most polluting country in terms of greenhouse gas emissions. Do we have a moral obligation to ring the alarm bell and prioritise to work on ‘greenifying’ our clinical routines and models of care? We have the ability to prevent (mitigate the causes of climate change), treat (adapt to what cannot be prevented) and advise patients and colleagues to promote health (raising awareness on the health impacts). If we look at our products, processes and services we see many opportunities for making healthcare more sustainable.

ISQua was one of the first scientific and professional healthcare organisations to explicitly address this global challenge and take action accordingly. The ISQua Declaration on Climate Change at Cape Town in 2019 was very clear: working towards sustainable healthcare is part and parcel of our mission to improve health worldwide. Simply because green care is better care. Because we don’t want healthcare to harm people. This effort is perfectly suited to the quality improvement (QI) lens. We can use the same concepts, tools and approaches. Think of accreditation, co-production, theories of change, the use of PDSA cycles (plan-do-study-act), process mapping, or de-implementing low-value care.

ISQua is leading the charge at this year’s international conference in Seoul. Dr Adi Vyas and Dr Hans Ossebaard will lead a Workshop (Monday 28th August 2023 from 12:45 to 13:30) dedicated to how we can redesign our health systems in order to be in harmony with the natural environment. We are developing an ISQua Green Paper on this theme and we would like to consult and engage with the ISQua membership at the Workshop. We will address subjects like:

  • how to equip ISQua members with knowledge on the threats to health from climate change, and to the solutions to address this from quality improvement and patient safety perspective;
  • setting out the position of ISQua on the role of health systems in responding to the eco-crises;
  • advocating for environmentally sustainable (green) interventions to transform health systems;
  • strengthening quality and safety in healthcare through the lens of environmental sustainability.

ISQua wants to take pole position in what is nothing less than a transformation in already revolutionary time in the Anthropocene.

  • Join us at the Workshop, come share your experiences in order to brighten up our horizons and work together for a better world.

Adi Vyas / [email protected]

WHO Collaborating Centre for Climate Change and Health Impact Assessment, Curtin University, Australia

&

Hans C Ossebaard / [email protected]

National Health Care Institute | Athena Institute, Vrije Universiteit Amsterdam, Netherlands

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Nourhan Kawtharani


Nourhan, a quality and safety coordinator with eight years of experience in ambulatory healthcare in Lebanon, aims to deepen her understanding of the systemic and holistic approach to healthcare through this fellowship.

She aims to identify gaps and develop tailored interventions that address specific contexts rather than applying general solutions. Engaging with diverse professionals and perspectives during this educational journey will expand the application of these concepts across different cultural settings.

Nourhan emphasizes the importance of promoting a culture of continuous learning and improvement within healthcare institutions, considering it a vital leadership responsibility to integrate quality and safety initiatives into the organizational culture.

Nourhan's commitment to patient safety and quality management includes sourcing practical resources and transforming insights into actionable knowledge to drive continued progress in healthcare practices and outcomes.

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Elom Otchi


Elom is passionate about improving quality of care and patient safety outcomes.

In view of this, he has had the opportunity to work in various capacities with various organisations including AfIHQSA, WHO, UNICEF and others undertaking research, supporting the development of national quality policies and strategies, facilitating the establishment of quality governance systems across all the levels of the health sector and building capacity of national and sub-national quality leads/teams to institutionalize the practice of quality and patient safety across the continent.

He has also worked extensively across all levels of care in the health sector of Ghana, including leading the Quality & Patient Safety program in its largest teaching hospital.

I would like to use this Fellowship as a learning platform and an opportunity to acquire the requisite knowledge, skills and competencies to complement ongoing efforts by like-minded individuals and organizations to continuously advance improve the quality and patient safety in Ghana and the continent.

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Stephen Taiye Balogun


Stephen is a Senior Programme Officer at the Institute of Human Virology in Nigeria as well as Country Representative for Health Information for All (HIFA).

Stephen plans to use this opportunity to maximise his impact by championing the cause of patient safety and quality in Nigeria and across Africa.

Stephen says "Quality and safety is a major wheel through which universal healthcare coverage can be achieved. The goal is to be a bridge in the gap between the International Quality Improvement and Patient Safety community and my country to ensure rapid spread, adoption, implementation and practice."

We are looking forward to working with both Stephen and our 2020 winner Rhoda Kalondu over the next year.

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Dr Rhoda Kalondu


Rhoda is the Head of the Patient Safety Unit at Kenyatta Hospital in Nairobi and wants to use this Fellowship to learn how to establish a culture of safety and develop systems for assessment and analysis at her institution, and more widely. As well as this, Rhoda intends to develop and execute an intervention to improve patient safety in Kenyatta National Hospital.

It is one thing to institute measures and processes for improvement, but quite another to change the culture of an environment. Rhoda's ambition to lead others in this change inspired the panel.

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Dr Subhrojyoti Bhowmick


I am an MBBS graduate from Calcutta University with a Gold Medal in Gynecology & Obstetrics.

I have completed M.D in Pharmacology from IPGME& R, Kolkata and have over 12 years of experience in the field of Clinical Research, Pharmacovigilance and Medication management in Hospitals.

I have completed certification in Clinical Research Administration & Project Management from Stanford University, USA and in Patient Safety from Johns Hopkins University, USA.

I am an Assessor for National Accreditation Board for Hospitals & Health care providers (NABH), India assessing hospitals for medication safety and clinical quality standards and NABH Assessor for Ethics Committee Accreditation program in India as well.

I serve as the Chairperson, Institutional Ethics Committee of Health Point Hospital, Kolkata and am associated with 2 other Hospital ethics committees as a member.

I finished my Fellowship in Healthcare Quality from the International Society of Quality in Healthcare (ISQua) from Ireland in 2017.

I have published several research articles and have also authored a chapter on “Regulations governing Clinical Trial” in the book “Fundamentals of Clinical Trial & Research”.

I am a peer reviewer for prestigious international journals like the British Journal of Clinical Pharmacology, CNS Drugs and Drug Safety case reports.

I am the recipient of the UK Seth Oration Award for Best Clinical Pharmacology paper by the Indian Pharmacological Society in 2009 and the “Most promising Healthcare professional in Patient Safety in India” award by the Asian African Chamber of Commerce and Industry in October 2018.

Recently in April 2019, I received the Young Quality Achiever award by Consortium of Accredited Healthcare Organizations (CAHO), India for 2019 for my work in the field of medication safety and clinical research.

I have a keen interest in teaching and am visiting adjunct faculty of Pharmacology at KMC, Mangalore, India and for Healthcare technology at MAKAUT, Kolkata, India.

I was associated with Stanford University School of Medicine, in the USA as a Senior Clinical Research Associate from 2015 to 2017 and have certification in Biostatistics, Evidence-based Medicine and Medical Writing from Stanford University.

Currently, I am working as the Clinical Director of Academics, Medical Quality and Clinical Research at Peerless Hospital and B K Roy Research Centre, Kolkata.

I am very happy and thrilled to receive the prestigious ISQua Lucian Leape Patient safety Fellowship Award for 2019 and I look forward to honing my skills further in the field of healthcare quality and patient safety through my experiences during this fellowship.

I sincerely believe that successful completion of this fellowship will help me evolve as a more confident Patient safety leader in India who in turn can provide significant inputs on policy changes through NABH for the Indian healthcare system.

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