On September 1, I started as Chief Executive of ISQua. There is excitement, of course. But the feeling I am holding onto most strongly is curiosity.
For much of my professional life, I have had the opportunity to work alongside people trying to improve health and healthcare. That journey has taken me into health systems and communities across the globe – from large academic hospitals to primary care teams, national and regional health systems, governments, community organisations and places working with extraordinarily limited resources.
I have learned a huge amount alongside system leaders committed to better. I have seen remarkable examples of what is possible when people come together around a shared purpose. And I have also seen, at times, the distance between what we know and what people actually experience when they seek or provide care – including the associated suffering and costs.
One of the greatest lessons I’ve gathered from those experiences is a simple one – context matters, no single method provides a simple solution, and no one has all the answers.
That is why I have planned my first months at ISQua to begin with listening and learning.
Listening to our team, Board, members and Fellows. To our partners and the organisations we accredit. To patients and people with lived experience. To those who have built ISQua over many years, and those encountering our community for the first time. With keen interest also in colleagues working in parts of the world whose experiences and knowledge have too often been underrepresented in global conversations about quality.
I want to understand what people most value about ISQua, where we make a distinctive contribution, where we could do better, and what our community needs from us next.
I am approaching these conversations openly, with a learning spirit.
Inevitably, I do have some questions of my own.
Our shared, current healthcare quality and safety movement has achieved an extraordinary amount. Many of the ideas that shaped our field – patient safety, improvement science, person-centred care, accreditation, measurement, systems thinking, coproduction – have fundamentally changed how we think about healthcare.
And yet, enormous gaps remain.
Too many people continue to experience avoidable harm. Too many communities experience unacceptable differences in access, experience and outcomes. Too many people working in healthcare are exhausted. And too much of what we already know about improving care still fails to reach everyone who could benefit from it.
Meanwhile, the context around us is changing rapidly.
Artificial intelligence is beginning to reshape healthcare and our societies. Climate change is creating new threats to health while testing the resilience of health systems. Populations are ageing. Resources are constrained. Conflict and displacement affect millions of people. Trust in institutions is fragile in many places. And political and social polarisation can make collaboration across boundaries increasingly difficult.
These challenges raise important questions for our field, including…What does quality mean in this changing world? What must we preserve? What must we rethink? What new capabilities do health systems need? And what role should a truly global quality community play?
Discovering the answers to these together is part of the work ahead.
One of the gifts I’ve valued over the past two decades has been to better understand an ongoing, latent opportunity in this work – building community, and networks of learning and impact that leverage the wisdom of those closest to the work.
Healthcare quality hasn’t advanced because one organisation, approach, profession or country possessed all the answers.
Progress happens when people share ideas generously, are open to a myriad of methods, test them in different contexts, learn from failure as well as success, and help one another turn knowledge into better care.
ISQua has embodied that idea for decades. At a time when there are powerful forces pulling people apart, I believe we should double down on it.
Imagine the potential of an even more connected global community of people committed to quality and safety: patients learning alongside clinicians; improvers alongside policymakers; researchers alongside practitioners; accreditation organisations alongside health systems; and colleagues in every continent learning with and from one another.
Not simply as a community of shared interests, but as networks of learning and impact – networks that help good ideas travel, support people to adapt them thoughtfully to local context, accelerate collective learning, and make it easier to move from knowledge to action.
Not because every context is the same. Precisely because it isn’t. Our differences create opportunities for learning.
And perhaps one of ISQua’s most important roles is to continue to build bridges: finding knowledge wherever it exists, creating spaces where people can learn from one another, elevating voices that are not heard enough, and helping ideas travel across boundaries while respecting the contexts into which they travel.
That means thinking beyond traditional notions of membership or professional networking. It means asking questions such as how our community can become a living global learning system – one in which people and organisations are connected not only by what they know, but by what they are trying to improve, the challenges they are facing, and the impact they are seeking to create.
The direction can be packed with ambition, including the generation of more knowledge about quality, as well as closing the gaps between what we know and what people experience.
Over the coming months, I will be asking many of you for your time to reflect back, and to look ahead to the coming five years – thanks in advance for that generosity.
And as it happens, I won’t have to wait very long to meet many of you.
At the end of September, more than 1,500 members of our global community will come together in Dublin for ISQua’s International Conference. As an incoming CEO starting only a few weeks beforehand, I can think of no better way to start.
I am looking forward to the formal programme, of course, but perhaps even more to the conversations around it: over coffee, between sessions, walking through the conference centre and around Dublin. I want to hear what brought you into this work, what you are learning, what is keeping you awake at night, and what you think our global quality community could accomplish together.
In many ways, Dublin can be a living expression of the kind of community I hope we continue to strengthen: people coming from different countries, professions, experiences and perspectives, united by a shared commitment to better and safer care, and willing to learn generously from one another.
So, if you are coming to Dublin, please come and say hola. I want to learn about what you are proud of and what frustrates you. What ISQua should protect fiercely and what we should be willing to change. Where you see the biggest gaps in quality and safety, where you see hope – and who else I should be listening to.
I will inevitably arrive at some conversations knowing very little about your particular context. I hope you will teach me.
My commitment is to listen with curiosity, to ask questions, to share what I am learning, and to help connect people and ideas across our community.
Because I’ve learned over time that the most meaningful improvements rarely begin with someone arriving with the perfect solution. They begin with people coming together around something they care deeply about, being curious enough to learn from one another, and courageous enough to try something different.
The challenges facing healthcare are significant. But so too is the collective knowledge, experience, kindness and determination contained within this extraordinary global community.
Our shared opportunity is to connect that strength more deliberately – to help close gaps faster, spread what works more intelligently, and support one another in creating better and safer care.
And perhaps that is part of the invitation for the years ahead – to bring our different perspectives, experiences and capabilities closer together around a common purpose; to learn across the boundaries that too often separate us; and to turn our collective knowledge into meaningful improvements in health and care for people everywhere.
No organisation or individual can achieve that alone. But as a global community, working with generosity and shared purpose, I believe we will build a bridge to better, to progress.
I look forward to starting many of those conversations in Dublin – and to discovering together what is possible.
Pedro Delgado
Chief Executive Officer
ISQua
