ISQua founders' reunion, Udine, June 2015

The 30 years of ISQua's existence and efforts have witnessed dramatic increases of knowledge about, and attention to, quality of health care. The ISQua founders had a vision of what was needed to promote quality and how this could be achieved through international cooperation and collaboration. And, the founders have continued to work to make this vision a reality. However, while much has been achieved in 30 years, there is still much more to be done. There is still need for vision for the future and visionaries who will carry things forward. Eight founders and early members of ISQua summarized what they had learned about quality in health care since the first Udine meeting 30 years earlier. There was a remarkable consensus, based on 240 years of practical experience and empirical evidence, that the problems lie less in defining and measuring visions, expectations and standards than in effective change management. It is important to recognize that the weakness of improvement strategies usually lies not in the strategies themselves, but in how they are implemented in a local context. From personal experience of what does and does not work, and often supported by formal publications, the ISQua veterans proposed pointers for improvement at institutional and system level. Policymakers and managers should involve patients and users of health services wherever possible in defining, measuring and improving standards of performance. Experience has shown that patients and users can contribute …