We can make health care better for every patient, every time care is needed. We know how—we have the knowledge and the tools to make it happen.  And we can do it largely with the resources available in any given country.

This novel yet simple idea was the outcome of an intensive, five-day meeting last month of 58 health leaders from 33 countries.  They gathered at the Salzburg Global Seminar, “Making Health Care Better in Low and Middle Income Economies: What are the next steps and how do we get there?” to chart a learning and action agenda to improve the performance of health systems in even the most resource-constrained settings. 

The Salzburg Call to Action

They issued their conclusions in a joint statement signed by all 58 participants: Better Care for All, Every Time: A Call to Action. 

What is different about this call?  I remember well the call for “Health for All by the Year 2000” which went sorely unheeded.  And of course, there are the current Millennium Development Goals, which call for substantial reductions in maternal and child mortality by 2015—a target that many nations are not on track to meet.   

For one thing, the Salzburg Call to Action focuses on the how—what strategies and policies can get us there. The big idea put forth in Salzburg is that powerful methods are available and can be applied in even weak and severely under-funded settings to make care better now. They are known by many names, but can be termed simply: quality improvement methods.

Quality improvement methods enable ordinary health workers to re-organize care delivery processes. They provide a means to implement better practices and streamline and change how care is delivered to yield better results with available resources. By making changes in the current ways of delivering health care, rather than simply adding more resources into dysfunctional systems, quality improvement methods are about changing what we do with what we have—putting the knowledge and the responsibility for improvement in the hands of every health worker, every patient, every district health team, every program manager, and every policymaker.

Quality improvement is not a magic bullet, but rather, in the words of Don Berwick in JAMA, “disciplined, scientifically grounded approaches to continual improvement” of the health care delivery work we do. 

The evidence is vast and persuasive that quality improvement methods are effective, that health systems can improve, and even do so fairly quickly.  We can overcome the knowing and doing gap. The Salzburg Statement calls on patients, communities, health care workers, non-governmental organizations, development partners, governments, and leaders to apply these methods to make lasting changes in how health care meets the needs of people around the world.

This week, the Salzburg Call to Action will be made to high-ranking health leaders gathered for the 65^th World Health Assembly (WHA).  Two of the leaders who were part of the Salzburg Global Seminar—Sir Liam Donaldson, WHO Patient Safety Envoy, and Dr. Nils Daulaire, Director of the Office of Global Health Affairs, US Department of Health and Human Services—are presenting the Salzburg Statement at a special WHA session on patient safety on May 23. They hope to spur national health leaders gathered in Geneva to adopt these ideas to strengthen their own national efforts to protect patient safety and improve health care quality.

I invite all who want to make the health care we know is possible available to every person, every time it is needed, to read the Salzburg Statement.  If you support these ideas, I urge you to add your name to the statement too, as I and hundreds of others from over 50 countries have done.