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"You may lose the battle, but you will not lose the war"

Senior IHI Fellow, Enrique Ruelas presented his ‘10 Commandments to deal with politicians’ during Pierre Barker’s ‘Sustaining Execution’ session.

On the penultimate day of the Salzburg Global Seminar on ‘Making Health Care Better in Low and Middle Income Economies: What are the next steps and how do we get there?’, participants were given a new set of commandments to consider: ‘Ten Commandments for Dealing with Politicians’.

Enrique Ruelas, Senior Fellow at the Institute for Healthcare Improvement, Mexico, shared his commandments with the group as part of the Thursday morning session on ‘Sustaining Execution’ covering introducing QI systems to countries unfamiliar with the methodology and designing sustainability into healthcare initiatives from the start.

Mr. Ruelas’ commandments offered an insight into the psyche of politicians and included selling the concept of QI in healthcare to politicians, not arguing with them, and also aligning your position with existing initiatives. The full list can be seen overleaf.

Reflecting on the morning’s session, Bruce Agins, chair of the previous day’s session on leadership said: “There clearly is no one way to communicate the benefits or importance of QI... One has to know and read your audience to adapt your message appropriately, i.e. scanning and reading the environment effectively to tailor and craft your message.”

As with previous sessions, all key suggestions made by the group were collated by the session chair to be included in the final session to be held on Friday morning entitled ‘Next Steps’. Participants will not only reflect on the outcomes of the week-long Session but also produce a Salzburg Statement to be shared with key stakeholder groups.

Talking Point: What positive outcome will you take back to your colleagues from this session at Salzburg Global Seminar?

“That the patient matters and quality improvement is all about the patient.”
Natalia Largaespada Beer, Maternal and Child Health Technical Advisor, Ministry of Health, Belize

“Quality isn’t really my field...I was confused, and I guess I didn’t really grasp the importance of quality or the huge impact it has [until now].”
Michelle Vanzie, Director of Policy Analysis and Planning Unit, Ministry of Health, Belize

“From this meeting I will have a lot of friends! [I will have] a lot of challenges. We have discussed a lot of issues on quality so when I go back, I think my vision will be different.”
Babacar Ndoye, Co-ordinator, National Program Against Nosocomial Infections, Ministry of Health, Senegal

“This meeting has brought great light to ideas on what we can share with our country, not to show that QI is a program but a science. I think we can present, we can advocate to leadership that this is the QI methodology.”
Januario Reis, Clinical Site Monitoring Specialist, USAID, Mozambique

“The one this is the validation of the enthusiasm around using quality improvement to enhance the healthcare of poor around the world and create a quality movement to really make great progress very quickly in healthcare.”
Sheila Leatherman, Research Professor, Gillings School of Public Health, UNC, USA