Session Summary - A Vision Worth Pursuing

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Apr 30, 2012
by Louise Hallman
Session Summary - A Vision Worth Pursuing

The Health and Healthcare IV session may have ended, but the journey will still continue

View of the Untersberg mountain across from Schloss Leopoldskron, home of the Salzburg Global SeminarThe Session ‘Health and Healthcare Series IV: Making Health Care Better in Low and Middle Income Economies: What are the next steps and how do we get there?’ came to an end in Salzburg, Austria on Friday, April 27, with a lecture from session chairman Dr. M. Rashad F. Massoud.Dr. Massoud reiterated again that the week-long seminar had been the “beginning of a journey, not the end” and that the final day would prove the most important with the writing of the Salzburg Seminar.Summarizing the week’s discussions, Dr. Massoud highlighted the five key challenges that had emerged – inadequate human resources, community involvement, poor planning, the difference between patients’ preferences and their needs, and the differing perceptions of quality among providers, policymakers and the public – as well as reiterating concerns about the confusion that exists and the need for a common terminology in the area of quality improvement in healthcare.Dr. Massoud also emphasized the need for accurate and correct documentation to enable thorough knowledge and know-how sharing.“Knowledge sharing was a major theme and this is not only about what interventions are known to work, but about the know-how on how to implement these interventions in real life; that is a whole other area of knowledge, equally important, if not even more important than the content knowledge itself,” he said.Focussing on the latter half of the week, Dr. Massoud asserted the importance of addressing research and evaluation methods in quality improvement, stating that research is critical in supporting improvement techniques and that widely available, cost-effective, simplified data is vital for the future of quality improvement in lower and middle income countries and on a global scale.
He went on to speak about the role of quality improvement as a means for strengthening healthcare systems, as well as the need for strong, visionary leadership.“Leadership is one of the most critical ingredients for success of this work – we know that – however leadership is very vaguely defined,” Dr Massoud explained.“One of the things that came up here was the need to implement work at all levels of the systems, involving leaders at the different levels, be them national, regional, provincial, district levels, community levels, all of whom need to get together to be able to do this. And nurturing leadership at all of the levels is a key component.”He particularly highlighted the need to target leaders who are tightly connected to their communities.Concluding, Dr. Massoud repeated the previous day’s “eight drivers” for sustaining execution – community and patient demand, health managers and providers and professional societies, data systems, capacitation of frontline health practitioners, managers and systems leaders in quality improvement methods, political “buy-in” of the quality improvement approach, support from external funders, external and internal quality improvement experts, the evidence base for using quality improvement methods – and their individual and combined importance in improving the quality of healthcare.Finally, Dr. Massoud presented his “learning agenda” for each of the identified interlinked constituencies;

  1. Communities and Patients: Understand their rights, and their role in driving the health improvement agenda.
  2. Technical Advisors: Promote quality improvement as a method for improving health outcomes as well as accurately collect, synthesize and disseminate the data needed to promote the learning agenda for quality improvement.
  3. The Leaders of the Health Systems: Be informed on how effective quality improvement efforts are in improving outcomes, what processes lead to those improvements and how much it cost, in order to promote the agenda for including quality improvement in national strategies.
  4. National and Global Academic Community: Promote quality improvement as a legitimate mechanism for improving health outcomes on a large scale. Impact data has the greatest influence, followed by cost effectiveness.
  5. Global health policy makers: Be informed on a simplified description of the quality improvement model, the key arguments in favor of its use (better outcomes, cost-effectiveness, improved return on investment), and improved efficiency of health systems.

Dr. Massoud finished by re-sharing the vision panelist Jim Heiby, Medical Officer and Contracting Officer's Technical Representative, USAID Health Care Improvement Project, Washington, DC, who had earlier in the week proposed the ‘Dream Quality Improvement Database’.“Where would we be if that were to exist? I think it’s a vision that’s worth pursuing,” added Dr. Massoud.