Nebulous, But Necessary

Maureen O. Larkin, for HealthLeaders Media, June 25, 2008

Nebulous. That's how Eric Dobkin, MD, chief quality officer at Crozer-Keystone Health System describes the responsibilities of a hospital quality officer in this month's HealthLeaders magazine.

Infection control, clinical outcomes, and compliance with The Joint Commissions' standards are common tasks assigned to a quality officer, but often, the responsibilities don't end there. CQOs hear about it when the hospital noise level is too loud or the cleaning staff misses a spot on the hallway floor.

"You could make the argument that quality should only be measured by the outcomes required, or you can look at the food served in the cafeteria," says Dobkin, who also serves as the vice president of patient safety for the five hospital system in Delaware County, PA. "They all fall into the rubric of quality."

While the role may be nebulous, the growing importance of hospital quality isn't, evidenced by the number of hospitals—big and small—that are bringing quality responsibilities to the executive table by creating the chief quality officer role.

"Patients, regulatory agencies, the government—they're all demanding quality, says Beka Warren, RN, chief quality officer at The Memorial Hospital in Craig, CO. "In the past, what has been important to the board of trustees is the financial component. If we were doing well financially, we were considered to be doing well. [Today] in this hospital, we look very much at the quality things that are going on."

And just as a CEO has a chief executive who deals with the financial, he or she also should have an executive to oversee quality. But appointing just anyone to the position is ill-advised, Dobkin and Warren say. To be a good CQO, a person must work well with numbers, make sense of statistics, and be optimistic. They must always strive for excellence and be able to lead, even when they encounter resistance.

"It's your job to inspire a hospital to more than what's easy," Dobkin says. "Part of a CQOs job is to educate everyone—from the board to the C-suite to the staff level—about what quality and patient safety are all about."

But perhaps the most important thing that a CEO should remember when hiring a quality officer is that assigning an executive to oversee quality doesn't mean he or she can wash her hands of that responsibility. At The Memorial Hospital, CEO George Rohrich makes daily rounds and meets with his executive team to discuss what he observes on these rounds. He remains on the front lines of the 25-bed hospital's quality improvement efforts, and talks about it often with staff at all levels.

There’s no question that quality is important to him, Warren says, and his emphasis shows the importance of it.

Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at
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