In many healthcare organizations, quality-related functions fall under the umbrella of the chief clinical officer or are spread out among other qualified clinicians or executives. Increasingly, however, the industry is witnessing the growth of the chief quality officer role.
As the healthcare industry transitions from a volume- to a value-based model, small hospitals and major health systems alike are saddling CQOs and quality executives with the task of collecting data that is highly accurate and can demonstrate the organization's standard of quality, according to Jim King, senior partner and CQO for executive search firm Witt/Kieffer.
"If a hospital or health system is going to get the highest level of reimbursement, it has to demonstrate the highest quality outcomes," says Mr. King. "Those who can't demonstrate this will really be at a disadvantage in the marketplace."
Consumerism in the industry is another factor driving the rise of the CQO since quality executives frequently oversee the reporting and transparency of hospital data.
"A hospital or other organization has to be able to put on its website incredibly transparent data for patients and others to see," says Mr. King.
CQO roles and responsibilities
Quality data collection and reporting are just a few of the responsibilities that CQOs may oversee.
The roles and responsibilities of quality officers vary considerably depending on a hospital's size, organizational structure, culture and other factors.
For instance, Ridgewood, N.J.-based Valley Health System — which is comprised of one hospital, one thousand credentialed physicians, a medical group and home care services — recently named Arlene Paquet, BSN, as assistant vice president for quality and patient safety, a new position created specifically to address needs within the system's hospital.
"We made quality and patient safety a priority, and restructured the entire department in order to make the needed changes that would promote a safer environment and provide a higher level of quality care to our patients," said Ms. Paquet.
One of Ms. Paquet's jobs as assistant vice president for quality and patient safety is making sure task forces assigned to working on quality improvements for specific indicators are held accountable and communicate among each other and with the rest of the organization.
One the other hand, John Bulger, DO, who has served as CQO and lead of the division of quality and safety for Danville, Pa,-based Geisinger Health System since 2011, works in a very different setting. Geisinger is an integrated physician-led system comprised of eight hospital campuses, a 1,100-member group practice, two research centers and a health plan.
Some of Dr. Bulger's responsibilities include weighing in on decisions regarding physician compensation and incentive packages, working with physician groups and service lines on quality initiatives and peer-reviewing fellow physicians.
Despite differences from one organization to another, hospitals that have or are in the process of creating a position dedicated to improving quality tend to include a few core responsibilities in the job description.
Mr. King outlines several tasks that may fall on the CQO to manage, including:
• Identifying and implementing unique and varied initiatives aimed at improving patient care quality
• Leading continuous improvement programs throughout the organization and helping develop a culture of continuous improvement and excellence
• Collaborating with other executives and engaging with leaders and clinicians throughout the organization in a hands-on fashion to build quality, efficiency, effectiveness and a sense of shared accountability
• Taking a clinical leadership role in evaluating care delivery and developing the infrastructure for improvement; and
• Strengthening the data and information capabilities of the organization and championing a data-driven environment
Mr. King adds that in some larger organizations, quality officers may also have to support independent and partner organizations in their quality efforts.
What makes an "ideal" CQO?
Similar to the role itself, there are some personal and professional attributes hospitals agree are crucial for a quality officer to possess, and some characteristics and skills that vary.
For instance, Dr. Bulger, Mr. King and Ms. Paquet all agree that having a clinical background can be very helpful, especially when interacting with physicians.
"I think having a clinical background influences the way you are viewed by physicians, so that's definitely a benefit," said Dr. Bulger.
Ms. Paquet echoed Dr. Bulger's thoughts. "My clinical background has helped me to understand barriers and workflow processes. Now I have a better idea of the issues physicians are faced with and I feel that makes me better equipped to help them facilitate change," she says.
Having clinical experience isn't the only thing hospitals look for in quality officers; Ms. Paquet argues passion about providing a safe environment and being able to work with technology and IT staff is a must. Meanwhile, Dr. Bulger highlights the importance of being a team-builder and coach who can solve emotionally charged problems, like adverse events.
According to Mr. King, hospitals actively seek out candidates with experience beyond the clinical realm as well.
"The CQO also has to have a pretty good handle on the business and administrative side of the industry, and so it tends to be someone with both clinical practice and prior executive experience — as in a CMO, CNO, vice president of medical affairs, clinical chair or other role," said Mr. King. "An MBA is a real asset. And if the organization doing the hiring is an ACO or integrated delivery system, it will want someone with experience in that arena."
Ultimately, successful quality officer candidates have the "full package," including an intellectual and experiential side complemented by an emotional side that cares about improving patient care.
Are CQOs really necessary?
Providing high-quality care is the responsibility of everyone in the hospital organizational structure, from frontline workers to high-level executives, so do hospitals really need to have a CQO or quality officer?
Maybe, maybe not. Dr. Bulger suggests the necessity of a CQO depends on the culture or organizational structure of a hospital, but it typically a good idea.
"Personally, I think there should be one person that is called upon — a separate individual in a complex organization — that is put in charge of quality," said Dr. Bulger. "For a hospital to say quality is No. 1 in their mission statement and not have an individual overseeing it, it doesn't align. Naming a CQO or quality officer elevates it in the minds of hospital staff and patients alike."