GMKA Forum “Quality and Safety in Healthcare”: Advancing Practical Solutions for Stronger, Safer Care in Ukraine
On September 26, 2025, the Global Medical Knowledge Alliance (GMKA), in partnership with the University of Toronto, Razom for Ukraine and UA-MED hosted the National Forum “Quality and Safety in Healthcare” in Lviv. The event brought together participants from Ukraine, the United States, Canada, and the United Kingdom to exchange best practices and explore how patient-centered, data-driven care can strengthen healthcare systems under the extreme pressures of war.
The Forum focused on integrating quality improvement and patient safety into all aspects of clinical practice, management, and education. Physicians, nurses, administrators, educators, and researchers came together with representatives of patient and international organizations to explore practical strategies for standardizing care, improving communication, reducing complications, and enhancing patient outcomes.
“Quality and safety are critical issues in every country, but especially in Ukraine, where resources are limited. In such conditions, it’s essential to ensure that every available resource delivers the greatest possible benefit. This challenge exists at many levels — for physicians, nurses, administrators, and the entire healthcare system. There are no simple solutions, but professional exchange and dialogue help better understand the problems, analyze results, and identify new opportunities for change,” said Serguei Melnitchouk, MD, MPH, FACS, Cardiac Surgeon at Massachusetts General Hospital, Associate Professor of Surgery at Harvard Medical School, and Co-Founder of GMKA.
Global and Ukrainian Expertise on One Stage
The Forum featured 38 speakers from leading medical and educational institutions in Ukraine and abroad, including:
- Harvard Medical School
- King’s College London
- University of Toronto
- Stanford Medicine
- University of Wisconsin–Madison
- Ministry of Health of Ukraine
Among them were:
- Serguei Melnitchouk, MD, MPH, FACS — Cardiac Surgeon at Massachusetts General Hospital, Associate Professor of Surgery at Harvard Medical School, and Co-Founder of GMKA
- Richard Sullivan, MD, PhD — Director of the Institute of Cancer Policy and Co-Chair of the Centre for Conflict & Health Security, King’s College London; Surgical Oncologist; Former Clinical Director of Cancer Research UK
- Michelle Hladunewich, MD, FRCP(C), MSc — Physician-in-Chief at Sunnybrook Health Sciences Centre; Medical Lead for Glomerulonephritis and Specialty Clinics, Ontario Renal Network; Professor at the University of Toronto
- Ajay Aggarwal, PhD, MSc — Professor of Cancer Services and Systems Research at the London School of Hygiene and Tropical Medicine (LSHTM) and Consultant Clinical Oncologist at Guy’s & St. Thomas’ NHS Trust, London (UK)
- Amanda Mayo, MD, MHSc, FRCPC — Chief of the St. John’s Rehab Program at Sunnybrook Health Sciences Centre; Associate Professor in the Department of Medicine at the University of Toronto; Associate Director, University of Toronto Centre for Quality Improvement and Patient Safety
- Yevhenii Honchar, MD — Deputy Minister of Health of Ukraine
- Andrii Skipalskyi, PhD, MS, MBA — Technical Officer and Unit Lead (NCD) at the World Health Organization Country Office in Ukraine
Experts shared universal Quality & Safety (Q&S) strategies applicable across all medical specialties, alongside modern approaches specific to oncology, surgery, anesthesiology, and military medicine. Discussions centered on practical methods to maintain safety, measure outcomes, and ensure resilience.
“For GMKA, it was essential to hold the first large-scale conference in Ukraine dedicated to quality and safety,” said Inesa Huivaniuk, MD, MPA, Executive Director of GMKA Ukraine and oncologic surgeon at the Kyiv Regional Oncology Center. “We made every effort to bring together international and Ukrainian stakeholders for meaningful discussion, to motivate them toward actionable plans, and to help drive change. Now that quality and safety have been designated as priorities by the Ministry of Health of Ukraine, our team is ready to support these initiatives and continue connecting professionals to advance these goals together.”
Internal Monitoring and Data-Driven Systems
A central theme across sessions was the need for systematic data collection and internal quality monitoring within hospitals. Experts agreed that improvement requires visibility into existing challenges.
“The biggest problem is not knowing your problem. We must diagnose the system to understand why failures happen — and that requires data. Remember: 80% of outcomes come from 20% of causes. Collect data, study the system, plan ahead. Without that, any change will fail,” — said Amanda Mayo, MD, MHSc, FRCPC.
Speakers highlighted that effective QI systems depend on an open reporting culture — one that allows staff to discuss errors without fear of punishment. Pavlo Kovtonyuk, Co-Founder of the Ukrainian Healthcare Center (UHC), emphasized leadership’s role in shaping this culture:
“Quality is a property of the system. Leaders must focus on building environments where people can reach their full potential through learning, not punishment.”
Michelle Hladunewich, MD, FRCP(C), MSc added that staff engagement is crucial: “People need to feel safe when reporting problems. A supportive system encourages openness, which ultimately improves performance.”
Oncology as a Journey: Quality at Every Stage
As part of the oncology session 8 expert speakers discussed how to strengthen quality and safety in oncology — from screening to treatment and follow-up. Topics included standardized diagnostics, evidence-based clinical protocols, multidisciplinary collaboration, and leadership in quality management.
Discussions focused on how these principles can be realistically applied within the Ukrainian oncology system, balancing ongoing challenges with emerging strengths.
“It’s important to focus on clear, simple goals — ones that are specific, measurable, and realistic. That’s exactly the purpose of the GMKA Forum — to show that quality is built from simple things that can deliver big results,” — said Inesa Huivaniuk, MD, MPA.
She also emphasized the foundational role of education, highlighting GMKA’s mission as a non-profit organization dedicated to expanding access to evidence-based medical knowledge in Ukraine:
“It’s not always possible to provide everyone with material resources, but education can be made widely available. The quality of medical care — and ultimately the patient experience, as the system’s primary beneficiary — depends on it.”
Perioperative Care A Systematic Approach to Safe Surgery and Anesthesia
The perioperative session included 11 speakers and explored how QI principles can improve surgical, anesthetic, and intensive care outcomes. Key topics included:
- Preoperative assessment and optimization
- Prehabilitation and early postoperative rehabilitation
- Integration of QI programs into clinical workflows
- Leadership and team management in perioperative safety
- Infection control and rational antimicrobial use
- Using technology to reduce complications and standardize care
Speakers showcased QI programs from Ukrainian hospitals that successfully reduced complication rates and improved institutional reliability.
Natalia Aliieva, Clinical Pharmacist and Deputy Head of the Infection Control Department at the First Lviv Territorial Medical Union, highlighted the value of continuous monitoring:
“To evaluate a program’s effectiveness, it’s essential to systematically collect data and monitor outcomes after interventions. But experience only has real power when it’s shared. Publishing results and presenting them to Ukrainian and international colleagues builds trust and professional support.”
Medicine Under Fire: Quality That Saves Lives
Another focus area was quality and safety in military medicine — ensuring consistent standards during evacuation, stabilization, and treatment of the wounded. Experts from Ukraine, US and Canada discussed:
- Education and simulation-based team training
- Implementation of trauma protocols, including massive hemorrhage management
- Development of trauma registries and databases for performance evaluation and knowledge sharing
Viktoriia Kovach, MD, Head of the Medical Service of the Third Army Corps, stressed that continuous learning is key even in battlefield environments:
“Quality is built on education, teamwork, and learning from mistakes. Commanders and medical leaders must see errors as opportunities for improvement, not grounds for punishment. Punishment doesn’t bring back lives, but better-trained teams can prevent future losses.”
Trauma Surgeon & Surgical Critical Care Intensivist, Board Member and Humanitarian Trauma Surgeon at MedGlobal, Trauma Medical Director and Chief of Surgical ICU, Assistant Professor of Surgery at HCA Florida Memorial Hospital Michael Samotowka, MD, FACS, FCCP, FCCM, provided practical advice on scaling QI programs in Ukraine:
“Learn from proven examples in the US, Europe, and Canada, analyze Ukrainian experience, and adapt international practices to your context. Build a reliable data foundation and trauma registry, identify what’s realistically achievable, and start small. Choose two to five hospitals with supportive leadership and engaged physicians — that’s where programs can take root. Once the ‘wheel’ of change starts turning, you can scale it regionally and eventually nationwide.”
Poster Session and International Expert Presentations
A poster session allowed participants to present ongoing QI projects and receive feedback from peers and international experts. The Best Poster Award went to Stanislav Kravchuk, MD, for his study “Point-of-Care Ultrasound in the War in Ukraine.”
The Forum also featured online presentations from specialists in the United States and Australia, covering radiation oncology safety culture, infection management in combat injuries, and QI implementation in small hospitals. All presentations are publicly available on the GMKA YouTube channel, extending access to healthcare professionals nationwide.
Consolidating Knowledge for Systemic Change
The “Quality and Safety in Healthcare” Forum established a professional community committed to measurable improvement and international collaboration. Through lectures, discussions, and networking, participants exchanged practical strategies for building a culture of quality, strengthening data infrastructure, and improving clinical reliability even under resource constraints.
Speakers consistently emphasized that acknowledging system flaws and learning from adverse events is the foundation for progress. Building an open, data-driven, and supportive environment enables healthcare workers to deliver safer, higher-quality care — and sustain those improvements long-term.
Inesa Huivaniuk, MD concluded: “Our task now is to continue this dialogue and support hospitals that are ready to implement quality and safety projects. Sustainable transformation depends on collaboration, data, and a shared commitment to learn and improve.”
Partners and Support
The Forum was made possible through the collaboration of GMKA’s partners and supporters dedicated to advancing healthcare quality and patient safety in Ukraine:
Partners: UA - MED, MedGlobal, Razom, Doctors United for Ukraine, NOVA Ukraine, United Help Ukraine, Ukrainian-Swiss Project, Servier, Tokarev Foundation, UMANA, Novartis, HealthSolutions, Global Health Institute (University of Wisconsin–Madison), Dobrobut, Exelixis, OncoHub, August Mission.
Media Partners: Livyi Bereh, Media Hub, Divoche, Gender in Detail
Information Partners: Medical Marketing Community, Lviv Cluster