HealthMarch 03, 2017

The role of chief quality officer

Why the CQO position is needed to improve care, ensure reimbursement, and attract patients.

Why focus on quality?

In today’s value-based healthcare landscape, it’s all about quality.  The federal government is providing considerable financial incentives for hospitals and systems who are demonstrating quality in terms of patient care and outcomes.

Conversely, facilities are also subject to steep penalties for various KPIs that correlate to poor care quality, such as high incidences of HACs, and readmission rates.

The CQO's role

The chief quality officer (CQO) in any organization is the manager responsible for monitoring the quality of the products or services provided. Many CQOs report directly to the chief executive officer (CEO) and are usually members of the management team. In healthcare, both small hospitals and major health systems charge CQOs with helping to collect and report the data that demonstrates high-quality outcomes, which are needed for reimbursement and to attract patients.

Like other high-level positions, organizations should seek out CQOs with a specific set of skills and experiences. Having a clinical background is helpful, especially when interacting with physicians, but that should be combined with someone who understands the business and administrative side of healthcare.

Qualified CQO candidates should have:

  • a minimum of five years experience leading a highly performing quality team within a hospital or health system
  • experience as a leader for performance excellence and applied knowledge of a performance improvement methodology, such as Lean or Six Sigma
  • in-depth knowledge of national trends and active nationally within the quality and performance improvement space
  • relevant experience using advanced clinical technologies to drive operationally efficiencies and outcome improvement
  • the ability to translate broad strategies into specific objectives and initiatives
  • responsibilities including systems and process redesign, implementation of evidence-based and industry best practices throughout the organization.

In an interview with HealthLeaders magazine, CQO David Ballard, MD, PhD, MSPH, FACP, of Texas-­based Baylor Scott & White Health, called the CQO title a “must­ have” for all health systems to show their commitment to quality care. Baylor Scott & White Health runs 41 hospitals, more than 950 patient sites, and more than 6,600 affiliated physicians. In this large organization, Ballard's direct reports—who include a chief patient safety officer, a chief patient experience officer, a chief health equity officer, and a chief clinical effectiveness officer—answer to the CEO and collaborate with other members of the C-suite, including the CFO, CNO, CMO, COO, and CIO.

Success as a CQO

A key pathway to reducing healthcare costs is to achieve continuous improvements in health outcomes while reducing ineffective care, healthcare waste, and harm to patients. The CQO must lead this charge. Ballard travels the country to teach other health systems how to structure their CQO positions, acknowledging that the approach differs based on an organization's size and priorities.

To be an effective CQO, you have to be a connector, and develop relationships in order to accomplish quality goals. For example, to reduce high-risk cardiac surgery mortality rates, Ballard worked closely with health system leaders, hospital leaders, cardiac surgeons, and operating room staff to institute a second-opinion rule. Together they sorted out benefits and likely risks for certain cardiac patients, ensuring clinicians could optimize a patient's functional status prior to surgery.

A good feel for the organization is a key to success, which makes promoting from within the ideal approach. Because this is such a relationship-based position, having internal experience gives you an advantage as CQO.

Expanding quality

While every staff member—from frontline workers to high-level executives—must play a part in providing quality care, health systems need a CQO in a leadership role to ensure that is happening.

For many years, CQOs had little guidance regarding their role in the health care system, but  the industry is coming to consensus. CQOs will be very key in the upcoming decade as healthcare moves from volume to value.

J. Michael Kramer, MD, MBA, senior vice president and CQO at Spectrum Health, a 12-hospital health system in Western Michigan with 184 ambulatory and service sites, said that in order to achieve high quality goals, clinical informatics and quality teams need to be tightly aligned.

Kramer focuses quality on four key areas:

1.Informatics and the ability to embed quality into the systems

2.Process improvement

3.Transparency in analytics

4.Transparency in professionalism.

The roles and responsibilities of CQOs can vary greatly from one organization to the next, but it is safe to say that CQO roles are expanding across the board. Naming a CQO elevates quality in the minds of hospital staff and patients alike.

Does your healthcare organization have a CQO? Tell us about your experiences working with him or her in the comments section.

For further reading on how Lippincott Solutions can help support increased quality, check out our FREE White Paper that documents independent research conducted by The Rockburn Institute, which used data from Centers for Medicare and Medicaid Services to determine that hospitals using our industry leading POC Lippincott Procedures and Lippincott Advisor software have higher clinical process of care & patient outcome scores within the Value-Based Purchasing (VBP) model than hospital that do not.

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