The symposium was also the occasion for previewing the results of the Fund's 2003 International Health Policy Survey. This year's survey elicited the views of chief executive officers of larger hospitals in Australia, Canada, New Zealand, the United Kingdom, and the United States on efforts by their institutions to improve quality and patient safety and to cope with such diverse challenges as financial deficits, market competition, nursing and physician shortages, waiting lists, emergency room crises, rapid changes in medical and information technology, modernization of facilities, and preparedness for a terrorist event. The survey was designed to provide a cross-national perspective on the trade-offs hospitals face and opportunities for innovation.

In a roundtable discussion, Secretary of State for Health John Reid, MP (United Kingdom), Health Minister Annette King (New Zealand), Assistant Minister Ian Shugart (Canada), Deputy Secretary Philip Davies (Australia), and Carolyn Clancy, M.D., Agency for Healthcare Research and Quality director (United States) had a candid exchange of views on national issues, including health care quality, health system sustainability and priorities, nursing shortages, and the impact of the media on health policy and consumer expectations. Scholars then introduced case studies illustrating country approaches to managing waiting lists, addressing nursing shortages, and improving emergency room care, as well as innovative chronic care models for coordinating the patient's journey across settings and disease stages. Several papers and survey results presented at the symposium will be submitted for consideration for a May/June 2004 special international issue of Health Affairs. The symposium is directed by Robin Osborn, assistant vice president and director of the Fund's International Program in Health Policy and Practice, and cosponsored by Health Affairs, in collaboration with founding editor John Iglehart.