History


The Georgia Health Quality Forum is a long-term project to reduce patient harm by building a professional capacity in quality improvement and patient safety. Our team brings together clinicians and researchers from across the world who want to make a difference in Georgian healthcare. We hope that you will find our work valuable and consider joining us in this effort.

MAQS

Earlier Initiatives


Three major projects serve as background to our initiative. The first is USAID’s Health Care Improvement (HCI) Project, which operated in Georgia from 2012 to 2014, and was extended under ASSIST funding through April 2015. The Georgian scope of work centered around a new quality improvement (QI) collaborative of 17 ambulatory sites and three hospitals in Imereti Region, focusing on cardiovascular disease, asthma, and respiratory tract infection. HCI also sought to adapt national protocols, develop continuous professional development modules, build evidence search and appraisal skills, and sustain effort via the new Georgia Health Quality Forum and a Facebook page. The second was USAID’s SUSTAIN project, which ran from 2009 to 2015, addressing several aspects of maternal and child health, particularly contraceptive use and perinatal care (JSI, 2015). The project included objectives in medical education reform and accreditation, and like HCI, leveraged a regional QI collaborative to research antibiotic prophylaxis compliance, to benchmark data, and to share reasons for non-compliance.

Both USAID projects completed successfully, producing clinical improvements – but unfortunately, both fell short of their desired goals to build “human resource and institutional capacity” and promote “greater efforts to institutionalize a culture of [QI] in both networks” (JSI, 2015). SUSTAIN evolved into specific focus on a national prenatal care system, including leveling old maternity houses and disseminating care guidelines, while the Georgia Health Quality Forum fell largely dormant once funding ended in March 2014.

The third was the Medical Alliance for Quality and Safety, founded by Dr. Nino Butskhrikidze and Dr. Eka Rukhadze, the Directors of Quality for EVEX Hospitals and Geo Hospitals, respectively. As practicing professionals, they were keenly interested in advancing the field of quality and patient safety, particularly through professional development. In addition to several international research presentations, they led a grassroots effort to integrate classes on these topics into the curriculum of several medical schools. The effort ran from 2012 until 2018, when a new chapter began through a chance meeting.

First meeting

A Meeting in the United States


In April 2018, a group of medical professionals from former Soviet states visited Suffolk University in Boston as part of the State Department’s Special American Business Internship Training (SABIT) Healthcare Program. After seeing Prof. Peter Martelli present research on high reliability organizing (HRO) in healthcare, one of the Georgian delegates, Dr. Eka Rukhadze, came up to introduce herself – and express interest in collaboration. She was taken aback when Martelli greeted her with “გამარჯობა”! He explained that he and his wife had traveled to Georgia six years earlier, loved the trip, and hoped to return one day. Rukhadze and Martelli agreed to explore opportunities, and upon her return to Tbilisi, she immediately contacted her longtime colleague, Dr. Nino Butskhrikidze, to join the nascent initiative.

Between 2018 and 2020, the small team corresponded frequently, including on syllabi, translating healthcare management texts, and to arrange an informal meeting in New York in March 2019. During this period, Dr. Lela Sturua, the IHI country representative, and Dr. Eka Cherkezishvili, the BMJ country representative, joined the team, bringing additional perspectives and helping to develop the work.

In 2020, Martelli applied for a Fulbright US Scholar grant and a university sabbatical, and both were granted for the 2021-2022 year.

Dangerous area

Working Together in Georgia


Between September and December 2021, the team began the first major research phase by benchmarking knowledge, attitudes, and behaviors on quality improvement and patient safety processes. Traveling across the country, they visited a dozen hospitals and conducted over 400 hours of interviews in seven cities to demonstrate the critical need to educate and advocate on these topics. The team also met with the Medical School Deans and Rectors of ten major universities to discuss curricular improvements necessary to develop a knowledgable and competent workforce. Georgian American University hosted Martelli during the Fulbright grant, and during this period, Dr. Giorgi Gabisonia, Vice-Dean for Quality Assurance and Programme Development, joined the initiative. The team presented their findings in various national and international outlets, and the work continued remotely in 2022, with the core team meeting regularly by Zoom to review work and discuss changes in Georgian healthcare.

In May 2023, Martelli returned with his graduate student, Shagorika Dé, to host an event for attendees from across the Georgian health sector. Speakers included Chris Anderson (US Embassy), Maureen Bisognano (IHI), Murat Kucukkaya (JCI), David Nash (Jefferson), and Steve Shortell (UC-Berkeley), covering the "why" and "how" of starting the journey to reduce patient harm nationally. They also met with medical students at Georgian American University, Tbilisi Medical Academy, and University of Georgia to establish student groups focused on QI and patient safety. During this period, Natalia Kalandarishvili, Chief Quality Officer at American Hospital Tbilisi, joined the core team.

In May 2024, Emerson College journalism professor, Gino Canella, joined Martelli on a visit to Tbilisi to continue the work and explore producing a documentary exploring patient harm in Georgian healthcare.

Georgian flag

The Initiative's Next Steps


The team is constantly working to improve Georgian healthcare, and we hope that you will consider joining our effort!

Please find contact information on the "Join Our Effort" page.