Sustaining Change, Making an Impact. Long Live the Quality Revolution!

A speech by Dr Vicki Doyle at the 2019 Learning Event 

“We want to make things better for our communities. You are the first people to do QI at the community level.

People didn’t think that we could do it, but you are leading the way, you are leading the revolution. To lead a revolution, you need passion and courage to go beyond the status quo and to challenge the way that things are done. And you need energy.

This revolution is important because high quality care is not just for rich countries it is a basic obligation of all health systems. The right to health is meaningless without access to good quality care. It must start in the community because that is where everyone is living.

People like talking about quality but I like to see action. Even the President has a big four action plan and one of them is Universal Health Coverage (UHC). But UHC without quality is meaningless. There is a strong commitment at national and county level. We need to improve access but to do it with quality. We need to support our communities to take responsibility for their own health and ensure that the community providers are valued and meet the needs of the community.

We have revised the standards at the national level based on your experiences of implementing QI as it is you who know how to do it on the ground. We need to embrace our communities to listen to them and involve them. From there, we can find the gaps and share ideas on how to close these gaps.

There are good structures in place through the Work Improvement Teams (WITs), we have had training and your senior levels are supporting you. We are strengthening how the community is linking with the higher levels of the health system and we are using new tools for analysing and improving quality. But how do we know if we are having an impact? Do our communities trust us? Are we reaching the hard to reach? Are we using our resources wisely? Are we learning? Are we meeting minimum standards?

We need to celebrate the “aha!” moments when we are struggling to find the answer to things and then the lightbulb lights up. We need to persevere – not everything we do will be successful. Let’s love our data. Let’s stay passionate so the revolution keeps burning. Let’s be courageous to challenge and keep questioning. We can’t have a quiet revolution, we need to shout so don’t stay quiet.”