Domhnall MacAuley attending the BMJ/IHI 12th International Forum on Quality and Safety in Health Care, Barcelona April 2007

Airports at 5am on a working day don’t have the same excitement as holiday travel. Suits, briefcases and determined frowns keeping the economy in the air. Nothing like the indignity of putting your toiletries in a clear plastic bag for the security check to make us all equal. Not much glamour.
To Barcelona for the sunshine, colour and a bit of brain stretching, with the focus on quality and safety in health care.

Tuesday, the real world…..
It began in a rather different environment. Barcelona and Belfast dont quite rhyme. Tuesday is my day in general practice and, in the interests of trying to maintain some continuity for patients, I try to protect the day. This means a late evening to ensure all the day’s work is complete before leaving in the early morning. The patients, of course, are not interested in my travel plans. Good medicine is taken for granted, and quality means being there. But general practice is never routine; my colleague spent the evening with the police and an ambulance trying to arrange the compulsory admission of a patient while I saw an urgent extra, checked the mail and results online and completed some insurance reports. A lovely spring evening alive with birdsong when I eventually locked the chain on the metal gates at 7pm.

Wednesday, travel and brain fog……
Wednesday was a bright early morning in a new quality day. The taxi was ready and waiting outside. The online check in worked smoothly, the security staff were helpful and I was greeted in the lounge by a pleasant well turned out receptionist at 5.30am. Thinking of these high quality service providers …. how would our practice rate? And the plane took off and landed safely-I took this for granted. Just like patients and health care.

Before we start, I must make a confession. When I hear the word quality, my eyes tend to glaze over. Some of the quality gurus sound as if they are speaking a different language. The words are familiar but, in this brave new world, they seem to have a different meaning . And, it can be risky to challenge some of their ideas. I missed the morning because of my travel but managed to make the first talk in the afternoon. The choice was easy. Any talk entitled “Saving money, saving lives