Reflections on ISQuA 2022, Brisbane

The International Society for Quality Assurance (ISQuA) in Healthcare held its first in-person conference for three years at Brisbane last month – GGI consultant Joe Roberts was there.

This year’s ISQuA conference revolved around several broad themes which are at the forefront of all our minds in health and social care: co-production with patients, patient safety, dealing with healthcare emergencies, workforce challenges, digital innovation, and integrated care.

These topics were covered both in plenary sessions at the start and end of the day, and in smaller seminars where delegates presented work which they had done in their own healthcare services to address these issues.

I found the small seminar sessions the most interesting – they linked the big and small pictures and provided practical examples of how individuals and clinical teams had improved quality and tackled long-standing problems.

We heard how the emergency department of an Australian hospital had applied quality improvement methodology to improve patient flow through the hospital and get ambulances back on the road quicker. And how another hospital had implemented a more robust approach to investigating and learning from serious incidents. There was much to learn and much that could be emulated elsewhere.

Conversations during coffee breaks or over lunch with other delegates could be just as informative as PowerPoint slide decks and question-and-answer sessions in the conference hall.

Same challenges

With many nations and every continent represented at the event, it struck me that wherever we are (the UK, Australia, Brazil, Japan, Canada, United Arab Emirates….) and whatever type of healthcare system we have (public, private or social insurance-based) we face similar challenges. These include staffing shortages in key clinical roles, waiting lists for elective treatment, exceptionally high demand for acute care, and the psychological impact on healthcare workers of working through two years of a global health emergency.

Of course, these pressures bear more heavily in some places than in others and healthcare systems which were already struggling before the arrival of COVID-19 in spring 2020 often feel them more keenly.

While we undoubtedly have much in common, there are also important differences between countries. These were evident in a half-day session dedicated to inspection and accreditation.

I was surprised that in some countries quality accreditation of healthcare organisations remains voluntary; this is very different from England, where all health and social care providers are required by law to register with the Care Quality Commission, which has extensive enforcement powers.

Climate change featured prominently on the conference agenda – both in terms of its impact on health, and the vast carbon footprint of healthcare. An epidemiologist outlined the multiple physical and mental health impacts of heatwaves and climate-related natural disasters such as floods and wildfires, not all of which are obvious, and some of which take a long time to manifest themselves.

Other speakers revealed the environmental impacts of the healthcare supply chain, anaesthetic gases and the reliance on single-use products.

Good work is being done by healthcare systems at the national level to safeguard our environment – the NHS was commended for its ambitious net zero objectives – and the local level too, with myriad initiatives such as planning team rotas to minimise travelling distances, or tree planting on hospital sites.

However, there was also some frustration that with many healthcare organisations facing long waiting lists and financial deficits, action to protect the environment may be seen as ‘nice-to-do’ rather than ‘must-do’. Session presenters spoke with real passion, leaving no doubt that with global temperatures ever-rising, this is both a moral and a practical imperative.

Flying the GGI flag

On the final day, I flew the flag of GGI with one of our co-founders, Dr John Bullivant, who has developed an e-learning package covering the basics of clinical and corporate governance.

We demonstrated the package and introduced GGI’s range of maturity matrices to a group of current and aspiring executive directors. While developed originally with Britain’s NHS in mind, the principles underlying these matrices should be applicable anywhere, and were received with interest.

The conference was a great opportunity to learn and share good practice. For me, the most important learning was about ‘planetary health’ and what healthcare organisations need to do to protect our planet and ensure a healthy, liveable environment for future generations.

The action I took away was to think about what I, and GGI, can do to make a difference.

Finally, I also had the opportunity to explore the riverside city of Brisbane at the start of an Australian spring. It is well worth a visit! American-style steel-and-glass skyscrapers stand cheek-by-jowl with traditional wooden-framed Queenslander houses with their tin rooves and elaborate ironwork, and the city has a down-to-earth feel. Lush green mountains and golden beaches are just a bus or train ride away.

Thank you, Brisbane!