The World is One Village

Last weekend, I participated in the 3rd annual Middle East Forum for Quality Improvement in Health Care in Doha, the capital of Qatar on the Persian Gulf. The conference was sponsored jointly by the Institute for Healthcare Improvement (IHI) and Hamad Medical Corporation (HMC). The IHI was started more than 25 years ago by Drs. Donald Berwick and Paul Batalden. It is currently involved in projects in the Americas, Europe, Africa and Asia and is the world’s foremost organization for health
care improvement. Hamad Medical Corporation operates eight hospitals in Qatar and provides most of the care in that country. I gave a plenary address to the 2,500 delegates and also taught a workshop on patient flow with, my friend and colleague, Dr. John Boulton. John directs quality improvement at Hamad General Hospital in Doha. He visited GBMC as an IHI fellow in 2013.

I had never been to the Middle East before, so I was not sure what to expect and the trip was quite an adventure. I arrived in Doha after a 13-hour flight from Dulles. The Doha airport is very new and has all the amenities. The city has an incredible skyline with many 20 to 30-floor skyscrapers most of which have been built in the last decade. There is a sprawling landscape with homes for the 1.8 million inhabitants of the country, 300,000 of which are Qataris and the others are immigrant workers. Being in the desert, all of Qatar’s water comes from desalination. It is amazing how much green space there is in the city as it must all be irrigated by Doha’s complex system.

I stayed in a beautiful hotel in the center of the city that was attached to a very large indoor shopping mall that was complete with an ice skating rink! When I told a Qatari that I was surprised to find an indoor skating rink, he told me that since it was so hot there during the summer people stayed inside where it was air-conditioned or they went to the mall. While I was in Doha, it was above 100 degrees every day and it did not go below 80 at night. 

John gave me a tour of the sprawling campus that contains both Hamad General and the Women’s Hospital, where they deliver 12,000 babies per year. The two hospitals see a combined 1,500 emergency department patients per day! There are almost no primary care offices so everything goes
to the ED.

The amount of construction going on was incredible. There were cranes everywhere building schools, universities, hospitals, homes and office buildings. Since this was going on in the desert, sand was blowing everywhere. Qatar is scheduled to be the site of the 2020 Soccer World Cup Tournament, so the country is working hard to have its infrastructure in place by then. Outside of my hotel, an elevated metro line was being built. Transportation lines will be necessary for the World Cup and also to move Qatar’s growing population.

The Middle East Forum for Quality Improvement in Health Care meeting was at the Qatar National Convention Center (QNCC). The Center was completed a few years ago and it was huge. Disney on Ice was also performing at the QNCC while we were there. It was amazing to see families from all over the world with little children going to see the show.

The conference focused on patient safety, clinical quality, patient engagement and patient flow. Some of the highlights were the 200 posters presented mostly by teams from Hamad, a plenary by ex-astronaut, physician, diver and now hospital executive in Canada, Dave Williams, and one by Mark Gallagher, a Formula One racing executive. This presentation was a fascinating recounting of how Formula One had gone from having on average one driver death per year to no fatalities over the last eight years by studying the root causes of all mishaps and by applying human factors analysis to make the racing much safer.

I used the theme “The World is One Village” in my plenary address on flow. I wanted to leave the delegates from HMC with the message that the science of patient flow applies everywhere and we all struggle with the same issues (although the magnitude of the problem may be quite different.) There is a great need for dialogue and understanding in the world, and discussing how to solve the healthcare dilemmas of a country was a great opportunity for beginning this dialogue. I was also honored to be presenting as a plenary because my friend and mentor, Dr. Berwick, was presenting the day’s other plenary.

I learned so much during my trip and made many new friends. I was glad to have been a part of the conference, but I am also happy to be back home with a reinvigorated sense of pride for all that we do in our healthcare system at GBMC. I have greater appreciation for all that we have going for us.