It was with the remarkable Italian renaissance city of Florence in mind, that The International Society for Quality in Health Care (ISQua) bestowed the title “Emotion, inspiration and creativity – pathways to global health quality” on our 37th international conference. We intended that with our delegates coming together in a place so steeped in history, art and culture that our professional interactions and deliberations would be uplifted; inspiring fresh commitment to the pursuit of improved safety for patients and the quality of care worldwide.
We never made it in person to Florence: the pandemic intervened. However, I am confident that we reached new heights of sharing and understanding at our virtual conference. More than 1,050 delegates from 83 countries attended, presenting plenary addresses, sessions, keynote talks and displaying e-posters. We all spent many informative hours participating in forums and discussions. Even as a virtual event, many of us met new colleagues, built on our existing networks, and bolstered longstanding relationships.
Quite simply, we caught up with friends, ISQua Members, Academicians, Experts, Fellows, and stakeholders after more than 18 months of some of the most challenging times of our working lives. There were lots to talk about, absorb, and learn.
Italians know about these challenges as much as anyone across the world. In the early weeks of the pandemic, they were in the epicentre of it. Throughout the conference, we were greatly motivated by the examples of sheer persistence and courage that the whole Italian health system set for the world.
Across the ‘floor’ of the virtual conference, we benefitted from new insights, research, discussion, and persuasive ideas from colleagues. Together we explored ways to better implement pathways and strategies to improve patient safety globally.
Our conference opened with Professor Francesco Venneri from the Italian Network for Safety in Healthcare (INSH) and Mr Dario Nardella, Mayor of Florence. Both offered not only warm words of welcome but also understanding and empathy for the challenging times faced by all delegates.
We celebrated the recipient of this year’s Health Assessment Lab / Medical Outcomes Trust John E Ware, Jr and Alvin Tarlov Career Achievement Prize in Patient-Reported Outcomes Measures. Our congratulations go to Professor Melanie Calvert, Professor of Outcomes Methodology, University of Birmingham, UK. We are encouraged by all you do to enhance care for patients.
The Peter Reizenstein Award for Best Paper Published in the International Journal for Quality in Health Care (IJQHC) in 2020 was awarded after a rigorous nomination and voting process for the paper “The 40 Health Systems, COVID-19 (40HS, C-19) study”. Along with my co-authors, Dr Yvonne Tran, Professor Johanna Westbrook, and Dr Louise Ellis from the Australian Institute of Health Innovation, I was honoured to accept the award and I wish to complement the consistently high standard of academic research published in IJQHC.
After the inspiring scene-setting from our Italian hosts, we learned a great deal from the many informative and erudite plenary sessions. The range and depth of accompanying presentations, talks and workshops was impressive. Knowing full well I cannot hope to do justice to everyone who presented and that each participant followed his or her own learning journey and hence had their own unique experience, I hope to capture a flavour of the pathway I moved through, in what follows.
Professor Walter Ricciardi from Italy roused us all with his discussion on the role of leadership to tackle the ‘perfect storm' of health system challenges: ageing populations, global migration patterns, chronic ill-health, and economic constraints. All of us would have recognized our own version of these challenges our own country, health system, and in the global context as we listened to this compelling address.
Dr Ron Wyatt, US, and Ms Yvonne Coghill, UK, each evocatively spoke about rising inequality in the health system caused in part by racism. This has been declared a public health crisis in the US. We must display resolve to tackle such problems, every single day, in every country.
In the 10-minute oral presentations, there were multiple examples of excellence. We heard from Taiwan’s Dr Juang Wang-Chuan on implementing holistic inpatient decision support services based on machine learning and Brazil’s Dr Maria Magalhaes, Dr Mansur Nacime and Dr Barreto Paloma on their research conducted across 10 Brazilian public hospitals on a strategic organizational learning model for improving compliance of Safety Operation Procedures (PSO).
Dr Frances Mortimer, UK, and public health officer Dr Sumaia Al-Ariki discussed a challenge at the top of all our minds—how to maintain quality and safety in periods of great stress, be it a pandemic, a national disaster, war, or a terrorist attack. The big question asked was: “How do we stay safe, effective and person-centred in all situations?” Dr Al-Ariki provided an account of the crisis in Yemen where around 21 million people are in urgent need of humanitarian assistance, including 11 million children. Only half of the country’s health facilities are operating and there are no doctors in 67 of Yemen’s 333 districts. The largest humanitarian crisis we could imagine is raging there right now.
We also heard from Professor Joanne Travaglia, Australia, how marginalized or minority groups within society may be at higher risk of iatrogenic harm. Professor Travaglia’s cross-cutting theme applied the lens of social epidemiology to inform a review of the incidence of harm. This thought-provoking presentation discussed the intersectional and therefore compounding nature of vulnerability; it considered how biologically-based expressions of social inequality (e.g., poverty), layered over with discrimination, lead to an increased risk of harm.
Our human factors colleagues did what their expertise always does and challenged us to think differently. Professor Pascale Carayon, US, provided a human factors and systems engineering perspective on addressing quality chasms. Associate Professor Robyn Clay‐Williams, Australia, focused on emergency departments and the human factors and ergonomics that contribute to resilience in these specialized environments.
Professor Trish Greenhalgh, UK, amongst the most innovative researchers internationally of all those in health services investigations, provided a new conceptual framework for planning and evaluating remote consultation services. The expansion of consultations via phone or video and the promotion of websites for self-management was pandemic-induced but has since been adopted by the UK’s National Health Service (NHS) as the default way forward. Professor Greenhalgh discussed the political, organisational, technical, relational, and clinical challenges.
Changing pace and focus, Drs Ifeoma Tony‐Monye, Sandra Esin, Derick Nwosu and Joseph Enegela shared insights from Nigeria’s program to improve the quality of care for patients enrolled in HIV care and treatment facilities through the introduction of a bi-annual performance review. The study showed no significant improvement in the quality of HIV service delivery from the intervention; and from a quality point of view, demonstrated the complexity of such interventions as well as the importance of ongoing evaluations. Important messages, indeed.
Looking back at all the sessions I managed to cover over four days of fantastic knowledge dissemination, I was heartened by the scope of the ISQua endeavour, the tenacity of individuals to pursue excellence, and the responsiveness of our ISQua networks to provide wonderful education and learning opportunities to all who come seeking answers.
While the COVID-19 pandemic prevented us from meeting in person, we must acknowledge the enormous effort of the organizing committee and all contributors to making this virtual meeting truly fulfilling. Dr Riccardo Tartaglia, co-chair of the Program Planning Committee, and indeed the whole committee, were marvellous. I also make special mention of the dedicated ISQua team in Dublin who have a huge reach across the globe in supporting the Board and ISQua members and stakeholders to promulgate our message.
Being a scientist at heart, I cannot resist data, and I think readers will also appreciate the following statistics:
- 1,050 delegates attended
- 83 countries were represented. Australia had the most delegates with 97, closely followed by Taiwan with 87 registrants, Italy, 73, the United States, 68, with Ireland, 65, rounding out the top five
- 160 short oral presentations were delivered
- 55 longer expert sessions were run
- 137 scholarships were awarded – the most ever
- 344 Posters were accepted
Many people provided feedback through our conference survey. We appreciated the support and have taken on board the suggestions. We were encouraged that 85% of respondents found the virtual experience to be value for money and 90% would recommend a virtual conference to their colleague.
Many of us who attended the conference know firsthand the impact the pandemic has had on the safety and quality of health care in our hospitals and communities. We thank everyone who participated for taking the time to attend the conference, share your insights and encourage others.
It is with enormous anticipation I look forward to the 38th international conference in Brisbane, Australia, scheduled to be held from 17-20 October 2022. We sincerely hope to see everyone associated with ISQua in person.
A call for papers will be out in October 2021. Rest assured, our team will once again work tirelessly and creatively, to bring you ISQua 2022.
Professor Jeffrey Braithwaite, BA, DipLR, MIR, MBA, PhD, FIML, FACHSM, FAHMS, FFPHRCP (UK), FAcSS (UK), Hon FRACMA
ISQua President