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My Emerging Leader Journal
by Roula Gharios Zahar

Stage One - Dublin, Ireland

Saturday 5 March, 2016

Welcome World!!

The tension was mounting as the departure day approached. Was I the right person to do this? Will I meet the expectations? 
While I still do not have all the answers, I know for sure that I have friends that will gladly answer my questions.

The first week of ISQua’s Emerging Leader Program proved to be beyond all I wished for. Here I was, meeting quality experts who were eager to help, to provide the knowledge, support and skills. ISQua opened all the doors with a magic wand. In depth knowledge about accreditation, HIT, quality improvement and patient safety was all at hand.

During my visit to HIQA (Health Information and Quality Authority) in Dublin, I was able to understand the complete quality cycle that the organisation relied on. I had the opportunity to meet people from the different directorates with different roles. 

At ISQua, I was able to experience quality from a different perspective with a broader view on the International Accreditation Program and the technical aspects of standard and program development. Whilst at St James's Hospital, I had a more hands on experience with barcode tracing systems and hemophilia medication supply chain management.

My overall impression while listening to the problems evoked, was a deep feel of familiarity. Health workers and organisations are a kind of big family or clan facing the same problems wherever they are. Hence, we can benefit from the knowledge of others and accomplish substantial leaps.

IT all sounded like a welcome to the world, an invitation to an incomparable journey whose destination will be a better world of quality, safety and care."

Stage 2 - Edinburgh, Scotland

Saturday 12 March, 2016

Armed with cunning self-confidence after a rewarding first week, I marched through Cowgate Street to discover and immerse in the delights of Health Information Technology research. 
Another warm welcome and incomparable experience awaited me. 

The Institute of Health and Science Informatics at the University of Edinburgh is a fascinating temple of science and knowledge of 250 researchers innovating and improving healthcare through the use of IT. UoE is believed to be one of the main research hubs in the world, and it stands up to its reputation. I was given the chance to discover the various programs under study: MDT evaluation, ePrescribing, telemedicine, various user apps and learn about implementation of health management software. Researchers were incredibly generous in sharing their knowledge and expertise. I would like to thank professors Aziz Sheikh, David Robertson, Jamie Coleman, Brian McKinstry, Robin Williams, Drs. Lucy McCloughan, Hajar Mozaffar, Katherin Cresswell Saturnino Luz and Colin Simpson  for the time they took out of their busy schedules to guide me an initiate me to the wonders of health IT research. IT in health is still problematic in most areas in the world and research plays a major role in promoting the efficient use of IT for improving health. Learning about the British healthcare system provided precious insights about healthcare organization. I hope to use this inspiring experience to serve quality improvement in healthcare in my country.

Upon leaving, a feeling of nostalgia pinched me as I felt I was being separated from valuable acquaintances. “Hajar, Abbey, Lucy and Athar I really hope to see you again”. 


Stage 3 - Paris, France

Saturday 19 March, 2016

The third phase of my Programme was in Paris at the Haute Autorité de Santé (HAS). It was an overview of quality and patient safety in French hospitals. The HAS is one of the world’s largest accrediting bodies with over 400 surveyors. There are approximately 2,500 hospitals in France and each of them is accredited once every four years. The process is at its 4th iteration and is presently concentrating on a risk assessment survey methodology. 

The visit was focused on my main interest- accreditation- and was particularly interesting since the HAS are overseeing the accreditation process of Lebanese hospitals. It was an opportunity to discuss Lebanese accreditation and ways improve its efficiency with the people in charge.

I also had the opportunity to review several patient safety tools and to have an in-depth view of national indicators used in line with the national health strategy.  The French healthcare system and accreditation history bares similarities and differences with other systems that are very interesting to investigate in light of their actual status and performance. This was a perfect example of the remarkable outcome from the association of quality, patient safety and accreditation with health policy implementation. 

The magnificent Saint-Denis Cathedral is 2 km away from the HAS headquarters in the north of Paris, It is the shrine of French Kings and while visiting, one can capture a great deal of France’s glorious history. It’s a treasure that I was lucky to discover thanks to the advice of my fabulous hostess and mentor, Ms. Fabienne Menot. 


Stage 4 - Boston, United States of America

Saturday 2 April, 2016

My fourth week was at Brigham and Women’s hospital in Boston. It was rewarding on many aspects: knowledge, leadership, and opportunities to name a few. It allowed me, in particular, to observe the effective interaction between research and practice.

At BWH, scientists collaborate closely with operational managers to plan, implement, verify and improve care in medical, nursing or quality fields. I had the occasion to learn about innovative and highly reliable tools for quality and patient safety, experiment their actual implementation, notice the leadership skills involved, and finally find opportunities for transferring, knowledge and improvement skills back in Lebanon. The most unforgettable concept in practice was the transparency and safety culture the Leaders were keen to adopt and impose on the operational ground. 

Moreover, the timing of my visit was ideal to learn and discover the challenges of HIT implementation; BWH is the first among PeC partners– a partnership between 7 hospitals- to implement a newly acquired HIT commercial system. The main objective of this colossal program is to facilitate the communication and standardization of data among partners to improve care and coordination. Problems encountered and solutions on the way were a valuable wealth of knowledge on IT implementations; in short it was a real life lab. 

Boston offers an indulgent atmosphere for the voyager and numerous places and museums to visit, such as the beautiful garden of the Gardner’s museum, a haven of peace and inspiration. The public library attests of Boston’s vocation as a knowledge and education hub. It has a monument to Gibran Khalil Gibran, the famous Lebanese writer and philosopher.