One score years ago , I had a dream …….
I am a second generation physician with deep passion for medicine and the ideals of the caring professions. It came as no surprise when out of curiosity I enrolled for an expensive but short executive Post-Graduate Diploma in Quality Management. in early 1997. The faculty consisted of the Deming Medalist and current ASQ chair Prof. Kondo , John MacDonald and Brian Plowman from UK and James Maltbie from USA and David Hutton from Canada. The legendary Genuchi Taguchi and James Harrington were also faculty but I did not have the good fortune to attend their workshops. I immediately saw the fields potential for revolutionizing Indian healthcare. Twenty years later that dream remains alive.
I did not move from Quality Assurance to Quality Improvement, nor was I interested in moving from Medicine to Quality. I was interested in pulling Quality into Medicine. I knew I couldn’t do it alone so I immediately launched the ‘Alliance for Quality Improvement of Healthcare’ and chartered an five year ‘Vision-2002‘ initiative. When David Hutton mentioned that a Harvard based physician was doing some work , I proceeded to the Institute for Healthcare Improvement., Boston .
I attended two courses at Babson College led by Prof. David Gustafson, Dr Berwick, Mrs Bisognano, Dr Shan Cretin and others. Three courses at Chapel Hill on Applied Clinical Informatics led Dr David Kibbe and Dr Richard Scoville and one course on Clinical Quality led by Dr Brent James and Dr Eugene Nelson. All courses were attended using personal funds. I attended all the programs of IHI as I wanted to bring back the whole field to India. My return home -to India, to medicine has been odyssean.
In 2002, when the National Association for Healthcare Quality opened their certification to international applicants , I became the first ‘Certified Professional in Healthcare Quality‘ CPHQ in India.
The Quality Assurance movement had passed through the developing world like a lead ballon. The Quality Improvement era was a chance to frog leap. From the beginning I was interested in integrating the ‘idea of improvement into the epistemology of medicine rather than as an ‘managerial overlay’. My slogan was : to mainstream you have to go upstream. Create the academic space for quality. The language of ‘demand’ and ‘supply’ to be replaced by ‘capabilities’ and ‘opportunities’; by ‘freedom’ rather than ‘necessity’, ethos rather than strategy.
Leaders from both developed and developing countries met at the Rockefeller Foundation Bellagio Center, Italy in 2008  and agreed to rally for healthcare quality as World Health Assembly resolution before 2011.We did what little we could by initiating a online petition : Push for Change.
My chance discovery of quality improvement’s relevance to clinical practice wasn’t sudden. In 1994, I was first author of a award -winning paper on ‘Quality control in pulmonary function laboratory’. I later came to know that the inemitable Prof. C. N. Devanayagam MD, FRCP was actually a jury member. Ever since the theoretical interface between Medicine and Society became equally a priority for me. HealthcareProgress.org is a tribute to Prof. CND for the values he passed on to my generation of medical undergraduate.
In 1992, I attended the first workshop on clinical epidemiology organised at the Children’s Hospital, Egmore, India. This was before the term Evidence Based Medicine came into vogue. While in the US I attended the Clinical Decision Analysis Workshop conducted by the International Society for Clinical Decision Making. Dr Steve Pauker was leading a session in the next room but I could not enroll as I did not own a lap top.
In 2012, I attended the Evidence Based Healthcare sessions led by Dr Gordon Guyatt , Dr Peter Glaziou , Dr Kameshwar Prasad, Dr Victor Montori and others, at New Delhi. This was a memorable experience : When the conference committee led by Dr Kameshwar Prasad refused to accept corporate funding, all the international speakers travelled on their own money! The greatest demonstration of clinical freedom. For both the organisors and the speakers healthcare was a serious pursuit. Not a market place. We at iHQ, are proud to stand in their symbolic shadow.
OUR CURRENT INITIATIVES:
The Institute for Healthcare Quality was launched to bridge the ‘institutional deficit’ in Indian Healthcare. It is self funded by the Healthcare Quality Trust.[ Regt. No:E 7470]. Our single minded agenda is to build nation-wide ‘Capabilities for Improvement’. By capabilities we mean operationalizing the theory – practice link in Improvement Science.
Our recent strategic initiative is the Collabrum.
We cannot walk alone. We cannot turn back. If you find you could be a part of any of our initiatives , either as learner or teacher or if you feel that we could support your own ideas, talk to us : 91-9324933194. Lets begin the conversation!