The hulking torso of Winston Churchill catches edges of grey in the sunrise in Parliament Square, London. I feel nervous because I am not quite sure where I am going. I have a Google Map to guide me but my parochial Cape Town feet are coy on this Sunday morning. I am on my way to the Pre-Conference sessions of the 34th ISQua (International Society for Quality in Health Care) Conference at the QE11 Centre in London.

To a country girl, London is overwhelming. I look at Google Maps, I am in Broad Sanctuary – the road that supposedly leads to the conference centre where over 1500 delegates from 70 countries will soon gather. They are all leaders in healthcare and they have come here to network and learn more about improving quality and patient safety.

I feel a little ill. Not much breakfast. But then I spy a bank of ISQua flags billowing in the wind at the entrance to the QE11 and I feel, at last, the comfort of the familiar – even if it’s just ISQua logos blowing in the air.

It takes 45 seconds to register my attendance (a record in my experience) and I head for the coffee bar to examine the impressive 180-page programme covering the next four days (October 1-4, 2017).

The overall theme of the conference is “Learning at the System Level to Improve Healthcare Quality and Safety” but tucked under that headline is a mammoth amount of knowledge. There are various theme tracks, including, significantly, one for Lower and Middle-Income Countries (LMIC) – South Africa is one of these.

Over cappuccino, I thumb through the “book” and decide what sessions I am going to attend. It’s overwhelming: this is only the pre-conference material and there is so much to choose from!

I decide to attend the 9h00 to 15h40 session (with tea and lunch breaks between). It’s on the 4th floor. There are plenty of lifts, plenty of loos, plenty of smiling and delightful ISQua staffers to tell you where to go, but still there is anxiety.

In the lift is a tall man from Norway, a short woman from China, a large woman from Turkey and a statuesque beauty from India. You don’t know them but you know their names and where they come from because of their conference ID tags. You also know that you have something in common with them: you are sharing the global mission to make health care safer and better. 

I sit down in the Rutherford Room and start noticing some familiar faces, the veteran quality warrior, Charles Shaw, the crisply intelligent and articulate Wendy Nicklin (elected President of ISQua for the coming year), the energetic Stephen Clark, my CEO, Jacqui Stewart, Lena Louw of Australia – and many others.

Chatting at the Pre-Conference session (from left): Dr Lena Low, Executive Director of the Australian Council on Healthcare Standards (ACHS); Professor Ethelwynn Stellenberg Associate Professor of Nursing in Department of Nursing and Midwifery at University of Stellenbosch and COHSASA Board Member, Ms Jacqui Stewart, CEO of COHSASA and Dr Christine Dennis, CEO of ACHS.

The brain fest begins. Hours later with new knowledge spinning around in my head, I have conversations around the coffee table with more and more colleagues. It’s a waterfall of words and numbers; a monsoon of concepts.

One of the main themes emerging from these pre-conference sessions (and carried throughout the coming days as one of the major issues) is that the voices of patients need to be heard and acted upon in shaping standards and accreditation programmes. Patients need to be involved in the evaluation and delivery of health services. 


I get there early and wind my way through the trade exhibitors on the 3rd floor. There’s a decent cup of coffee to be had and the official opening ceremony is about to begin.

Left: The giant screen welcomes delegates to ISQua’s 34th annual international conference at the QE11 Centre in London. Right: Delegates wait for ISQua London to begin.

Peter Lachman, CEO of ISQua, outlines how to make the most of the ISQua conference and emphasises the role of social media – Twitter takes centre stage. In fact, Twitter is to become a bit of a nuisance for speakers who can’t seem to engage fully with delegates. Their heads are buried in their smart phones and they are tweeting…

The morning plenary again emphasises the importance of listening and hearing patient voices. Evidence is presented of how, when patients actively take part in their treatment, outcomes are better.

The rest of the day offers a menu of intriguing patient safety systems presented by a panel of stalwarts including Professor Charles Vincent (below left) and Professor Jeffrey Braithwaite (President Elect of ISQua, below right).

At lunch, delegates have a bewildering choice of extra information sessions and E-poster presentations. The corridors of the QE11 are abuzz with the duck and dive of delegates clutching bag lunches with an imaginative variety of walkabout food. The soup, on every day, is a firm favourite.

A love of films draws me to a session showing how cinema can affect patient safety culture and empathy. The British actress, Emma Thompson, wins the first-ever ISQua Film Award for her role as cancer patient, Professor Vivian Bearing, in the Emmy-winning 2001 film Wit. Ms Thompson was scheduled to accept the award but a last-minute change meant she could not receive it in person. It was an exciting, lively presentation and born out of a “mad” idea by president elect, Jeffrey Braithwaite and Riccardo Tartaglia.

At the end of the day, delegates headed out to the Museum of Transport in the Covent Garden Piazza (above left) and from there via the famous London Black Cabs (if they could afford it) to chat some more with colleagues at late-night dinners around London (above right). 


My CEO, Jacqui Stewart, is up with the birds to take part in a debate about whether to use more, or less, indictors to measure improvements in the complicated universe of health care. Her team – Jason Leitch and Rashad Massoud – win the argument for less.

More tea, more coffee, more meals, more chats – a day of whirling information, exciting discoveries, contentious arguments and a few damp squibs. But the standout talk for me in the day is Sir Liam Donaldson chairing a panel to introduce the WHO’s Third Global Patient Safety Challenge: Medication without Harm. 

Unsafe medication practices and errors in administering medication are a leading cause of avoidable harm in healthcare systems around the world. These errors cost more than US$42-billion each year globally. The panel discusses how to change this narrative and who would be involved in making the change happen.

Although I run out of time to participate, I notice and speak to those who are manning a very interesting “exhibition”. Entitled “A Mile in My Shoes”, participants are invited to step into someone else’s shoes and embark on a 90-minute imaginative audio journey into their world. The Empathy Museum teamed up with the Health Foundation to develop a collection of stories from those working in health and social care and they produced a wide range of experiences which one can choose by selecting a shoe-story.


After lunch, I whip upstairs to the St James Room on the 4th floor where COHSASA CEO, Jacqui Stewart (above left) is chairing a session on Sustainable Quality Improvement for LMIC. CEO of ISQua, Peter Lachman (above right), presents a fascinating initiative in Mozambique where the Ministry of Health has teamed up with the Irish health service (a North-South partnership) to develop a national quality improvement programme. The drive for quality has come about due to a realisation that Sustainable Development Goals (SDGs) cannot be achieved in resource-poor countries without improving the quality of health services. One of the participants, Jonas Chambule, of Mozambique who could not be present is linked up using video conferencing. The marvels of modern technology!


During the plenary session in the morning, delegates are introduced to the ISQua’s 35th conference due to be held in Malaysia’s capital city, Kuala Lumpur in 2018. The country has mounted an impressive welcome exercise to entice delegates there and their exhibition stand draws many of the curious to begin forming an appetite to attend the 2018 conference. In the plenary session, two countrymen sing a “Welcome to Malaysia” song to all the gathered delegates: there is no doubting the sincerity of their sentiment…

There are 20 people manning this stand – some from the Malaysian Society for Quality in Health (COHSASA’s counterpart in that country). They hand out pamphlets, brochures, key rings and maps to interested by-standers and ensure a successful promotion of the ISQua conference at the Kuala Lumpur Convention Centre from 23-26th September 2018. The theme of next year’s conference is Heads, Hearts and Hands: “Weaving the Fabric of Quality and Safety”. Call for papers opened on 4th October 2017 and close on 12th February 2018 – so get those papers in!

That afternoon, I head for a panel discussion in the Westminster room on the 4th floor. This is the distracting view:

The session under the general theme of “Sustainable Quality Improvement for LMIC” is entitled, “Sustainability of Quality Improvements in Public and Private Sectors in South Africa”. The speakers are Jacqui Stewart, Shivani Ranchod and Gareth Kantor. The presentation outlined the challenges facing both private and public sectors in the RSA, particularly the challenges associated with sustaining quality initiatives and suggestions on how to strengthen the sustainability.

Some of the South African panel members at ISQua; above left: Ms Shivani Ranchod and above right Anaesthetist Dr Gary Kantor, Co-founder of Best Care Always, and consultant to Discovery Health and Insight Actuaries.

As the conference ends, delegates are wired but tired. Some have left the QE11 centre which is a pity because Jishnu Das from India presents an eyebrow-lifting paper on studies in India, Kenya and China which reveal new insights into the care the poorest receive at clinics.

This final plenary session is chaired by COHSASA CEO, Jacqui Stewart, who – realising that people have conference fatigue – keeps it short and to the point. Many appear very grateful for that. With a brief summary of the conference the ISQua President Wendy Nicklin bids everyone farewell and safe travels. As everyone files out of the large hall, there is a flatness in the afternoon, a sudden realisation that rent cheques and root-canal work – the everyday banality of reality – wait outside. 

But hold it right there… here is a happy band – the tireless, ever-polite, ever efficient ISQua staff who made the conference so seamless, convenient and accessible. Their smart blue uniforms were everywhere – not a corner, not the tiniest of side rooms was not covered by their waiting hands and willing attitude to help.

We celebrated the end of the conference with them and the knowledge that after Malaysia, the 36th conference will be held in CAPE TOWN SOUTH AFRICA in 2019. Below, CEO Jacqui Stewart of COHSASA celebrates with the ISQua staff. All in all, a wonderful experience.