The Evolution of the Healthcare Chief Quality Officer
By Imran Ali, M.D., Dan Dimenstein and Vinny Gossain Prior to March 2020, healthcare delivery systems and hospitals saw incremental and stepwise improvement in quality...
By Imran Ali, M.D., Dan Dimenstein and Vinny Gossain
Prior to March 2020, healthcare delivery systems and hospitals saw incremental and stepwise improvement in quality of care and patient safety metrics. However, during the COVID-19 pandemic, hospitals throughout the country experienced a spike in, for example, blood stream infections, CAUTI, MRSA and patient falls. Now, as organizations transition out of pandemic operations, there is a renewed energy and focus on delivering high-quality care and creating industrywide benchmarks well above pre-pandemic levels.
Evidence of this revitalized commitment to quality: WittKieffer has seen a fivefold increase in healthcare organizations looking to hire chief quality officers since 2017. With reimbursement increasingly value-based and tied directly to quality measures, healthcare delivery systems are not only looking to improve quality and safety as a market differentiator but also as a method of ensuring financial sustainability.
Evolving Needs
As organizations’ have evolved in the past three years towards new models of care, the needs and considerations for quality and safety programs have also changed. On the quality side, regulatory changes have placed quality as a leading priority, requiring additional focus and leadership in this area. Complicating things, the increased rate of hospital and health system mergers and acquisitions has heightened the need for multi-site standardization and connecting platforms across the full continuum of care, sometimes across state lines and even across time zones. Patient Safety’s journey to zero harm remains steadfast by providing education and improvement through simulation, creating cultures to report near-miss events, improving processes and standardizing care delivery protocols. At the end of the day, organizations seek to create comfortable, empathetic and safe environments where patients leave their facilities measurably better than when they came in.
This evolution is causing healthcare providers to reimagine leadership responsible for quality and patient safety. The Chief Medical Officer was historically accountable for patient safety and quality. However, the pandemic forcibly expanded CMOs’ responsibilities, shifted their priorities and reduced their bandwidth. All of this has led to a glaring organizational need for senior leaders – Chief Quality Officers (CQOs) – whose sole focus is driving improvements in quality and safety and moving toward action orientation.
Introspection
Whether an organization is creating its first-ever CQO position or looking for its next one, an introspective needs assessment will go a long way toward determining the type of quality leader it requires. This needs assessment includes identifying the resources and personnel currently working in this sphere and how quality and safety are integrated with nursing, the physician staff, informatics and operations. Based on our frequent conversations with healthcare executives, current trends in CQO teams now include clinical documentation improvement and personnel with expertise in informatics and performance improvement. Additional consideration must be made if this leader will oversee both inpatient and ambulatory care while understanding how it may intersect with an organization’s population health management resources. The needs assessment will directly inform the job specifications for the organization’s CQO.
Identifying the Right Leader
Leadership personalities and stylistic needs vary from organization to organization. However, common themes arise for the traits and experiences needed for today’s CQO. In addition to having the relevant technical and scholarly experience (e.g., Lean/Six Sigma experience, systems and process design, CPHQ certification), a CQO must be comfortable leading people and working through influence, especially in today’s complex and matrixed healthcare environment. The CQO not only needs to be able to parse the data, but to tell a compelling story and be effective in change management. These individuals are executors and take accountability for their results while being able galvanize teams. While certain clinical specialties tend to occupy the CQO position, it is important to be specialty-agnostic in selecting for the position, instead selecting on an individual’s experience outside of one’s own specialty, ability to see the broader healthcare picture and to inspire a team.
In our recent recruitments of Chief Quality Officers, we have seen clients place a premium on the following competencies:
- Highly personable and approachable, able to connect with peers and staff to promote and maintain a culture of exceptional quality, performance improvement, patient safety and service excellence.
- Experienced in partnering with multiple constituents throughout an organization and driving consensus.
- A proven ability to leverage technology and embed quality improvement into operations.
- Results-oriented and persistent in achieving success and communicating an inspiring vision of the future.
In short, today’s CQO must be a leader first while also being intimately familiar with the technical and regulatory aspects of the job. Organizations must look to hire visionary executives who can champion a culture of safety and quality that dramatically enhances the organization’s ability to serve patients and the broader community.
Recruiting Challenges
In this highly competitive CQO job market, hospitals and health systems should recognize these inherent recruiting challenges:
- Organizations are seeking to maintain their quality leaders and working hard to retain them while these leaders are in demand. This makes it harder to hire experienced quality executives away from market competitors.
- The position’s reporting relationship needs to reflect the organization’s commitment to patient safety and quality, meaning that the CQO should have direct and frequent access to, and the trust of, the CEO and board. Candidates want to understand this commitment.
- Candidates want to understand technology and data resources the organization is allocating underneath the CQO’s purview to ensure they can succeed in their patient safety and quality goals.
The Future of Quality and Safety
As healthcare continues to evolve and quality and finances increasingly intertwine, having a robust system of quality and safety will be paramount in achieving the organizational mission and success in the marketplace. Hospitals and health systems will need to further integrate information systems that support and allow easier visualization quality and safety performance. Moreover, artificial intelligence (AI) promises to revolutionize the way care is provided and how quality and safety is achieved. The ability to gain care consistency across hospital-based efforts in imaging, pathology and medication optimization will make hospitals more reliable.
For the Chief Quality Officer of the future, perhaps the time is right to reimagine the title: Chief Outcomes Officer? Chief Clinical Performance Officer? Either way, the future is bright for leaders who will help design a new framework and create a new vision for healthcare quality and patient safety.
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