Nov 2, 2012

Food for Thought at ISQua, Geneva

Got back last week from the International Society for Quality in Health Care's 29th International Conference in Geneva. I was there to present a paper on our experience with using clinical decision support tools in electronic health records to help children maintain healthy weights. 

Over 1200 people from 66 countries attended the meeting. A personal highlight for me was listening to Margaret Chan, Director General of the World Health Organization (WHO) speaking at the opening plenary. The magnitude of her stature in the world of global health is inversely proportional to her actual height. In fact, she began her talk by peeking up from
behing the podium and asking, "can you see me".

I learnt from Chan that health care faces a shortage of 4 million clinicians. Referring to the "young discipline" of patient safety, she said that unsafe injections alone result in 1.3 million deaths worldwide, costing $535 million in direct medical costs, and an astounding loss of 26 million years of life.

While most teenage girls in my day dreamt about scrunchies, clothes with shoulder pads or the latest George Michael audio cassette tape, my dream was to visit the WHO. Yes, I know ... I was quite a serious kid.

This aspiration finally came true. The conference offered a site visit to the WHO where staffers presented highlights of some of their programs. One eye opening fact that sunk in after the site visit was the evolving reality of global public health funding. For instance, did you know that if the Gates Foundation were a country, it would be the 3rd largest funder of the WHO?

Another stark fact is that political will is a key driver in solving our pressing global health problem. For example, polio was eradicated in India last year - an undertaking previously thought by many to be impossible. But top down state and national government support showed the world that it could be done. Now we are left with just 3 countries where polio remains endemic - Pakistan, Afghanistan and Nigeria. Addressing security concerns to enable health workers deliver vaccinations has been a continuing challenge in these countries.

The terrifying part is that all of our work could be shattered in an instant by complacency. Last year we saw ongoing polio outbreaks in several countries due to international travel. Our vulnerability is evident by modeling that shows that failure to eradicate polio could cause a worldwide resurgence of polio within 10 years.

Perhaps the most significant thing I realized at the meeting was that (in Margaret Chan's words) "solutions don’t need to break the bank". For example a quality improvement intervention to prevent central line associated blood stream infections in Michigan, supported by a $450,000 grant from the Agency for Healthcare Research and Quality, saved 1,500 lives and $100 million annually across the State of Michigan. Peter Pronovost, the researcher from Johns Hopkins who led this study, as well as Carolyn Clancy, the Director of the Agency for Healthcare Research and Quality, a funder of this study, reinforced this point during their respective keynote presentations.

All in all an amazing learning and networking experience. I left the conference with a happy and energized buzz. Perhaps 4 days of espresso and chocolate had something to do with it too.

- Ulfat Shaikh

Margaret Chan, Director-General of the WHO, speaking at ISQua

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