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Found in Translation: The Growing Improvement Movement in the Middle East

By Jesse McCall | Thursday, June 16, 2016

Found in Translation

As I walked into the Qatar National Convention Center in Doha last month for the 4th Annual Middle East Forum on Quality and Safety in Healthcare, a conference organized by IHI and the Hamad Medical Corporation, I was greeted by a 30-foot bronze sculpture of a spider called “Maman.”

While this may seem like an odd choice for the artistic centerpiece of a convention center, it was fitting for this event — spiders are clever, strong, and helpful. These qualities exemplify the individuals who come together at the Middle East Forum: The attendees are clever, the teachers and leaders are strong (in their dedication to improvement), and the conference staff are helpful.

Seeing Maman was just the first of a number of memorable moments during my most recent visit to Qatar.

Customizing Improvement for the Region

Now in its fourth year, the Middle East Forum has grown exponentially. More than 3,800 delegates attended this year from 18 countries, making it the largest Middle East Forum to date. It’s gratifying to see how many new people, from an ever-growing list of countries, attend every year.

More importantly, the event has evolved from a meeting designed and taught primarily by IHI staff and faculty to an event that the Hamad Medical Corporation (HMC) and the Hamad Healthcare Quality Institute co-design and co-teach with IHI. This conference is a powerful regional example of engaging local communities to best meet the needs of the local population.

The health care landscape in the Middle East is undergoing rapid transformation. The population is increasing. Expatriates flock to the region to support the rapid growth and development across all industries. Consequently, this year’s Middle East Forum addressed how to maintain or improve existing health care systems while facing continuing pressure on resources and increasing demand for services. Although IHI and our Qatari counterparts chose this focus specifically for the challenges faced in this region, many of the ideas and strategies discussed could apply in places around the world.

Building Local Improvement Skills

HMC has been an IHI Strategic Partner since 2013. They work on a few small-scale innovation projects and offer programs to teach quality improvement and patient safety tools to staff, but focus much of their energy on a system-wide collaborative to improve the quality and safety of care delivered in all eight HMC hospitals and the National Ambulance Service. With the practical application of improvement science over the last four years, HMC has seen notable improvements in their rates of ventilator-associated pneumonias, central line-associated bloodstream infections, catheter-associated urinary tract infections, and pressure ulcers.

Through their partnership with IHI, HMC staff have developed their improvement skills, and their knowledge and capability were on full display at this year’s Middle East Forum. HMC staff presented on the improvement work taking place across their system, including contextually specific adaptations to ISBAR and Early Warning Systems. They also described how they’re training staff to have culturally sensitive end-of-life care conversations with patients and families.

Perhaps most notably, the Middle East Forum provided sessions in Arabic for the first time this year. Four HMC quality and patient safety leaders, who have been working with IHI throughout the partnership, led sessions on “The Basic Principles of Quality Improvement in [the] Healthcare Sector.” I was proud to see colleagues I have worked with for years serve as esteemed faculty.

The Model for Improvement has been presented in many languages and formats around the world over the years, but — as far as I know — this was the first time its basic tools and methods were taught in Arabic at this scale.

As I watched from the back of a crowded conference room, it was clear that many attendees were engaged in learning that may not have been accessible to them until this session. They may have heard about quality improvement in English before, but learning these concepts in their first language brought a whole new level of understanding. As the Middle East Forum continues to grow, I hope that HMC and IHI can expand the number of multilingual sessions offered each year.

I’m amazed at how far this event has come over four short years. I’m also excited about the possibilities the future holds.

Jesse McCall is Senior Project and Regional Operations Manager for IHI's work in the Middle East and Asia-Pacific regions.

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