Building the Ideal Quality & Safety Department, Part III

Is a Clinical or Nonclinical Background Better?

Clinical or Nonclinical Quality Specialists

Does the Quality Specialist (QS) need a clinical background? Not necessarily.

Many successful QSs have come from diverse backgrounds, including coding, psychology, industrial engineering, finance, and manufacturing.

I recommend that you assemble a department of quality specialists with a variety of backgrounds; it will increase your bench strength.

For instance, an advance-practice RN may be ideal for the acute myocardial infarction (AMI) team, whereas the finance person is ideal for facilitating difficult teams (after all, they are masters of the budget process) or working on ROI models.

I usually staff my department with 50 percent clinical and 50 percent nonclinical folks.

More Advantages of Nonclinical Staff

The nonclinical QS staff can often ask the questions that we clinical folks can’t because of the culture and mores in operation. They can feign ignorance when they purposefully ask a critical, by maybe “inappropriate” question.

They also see things we may not or things that we’ve adapted to such as normalized deviance. I once worked with a great QS who had come from Motorola and was trained in Six Sigma. He once asked during a diabetes disease management meeting why a 60 percent “defect rate” was acceptable to us. He was referring to the fact that we only had 40 percent of our patients with diabetes in good to optimal control.

You can imagine the docs’ reactions. They asked him what he was talking about. He explained that if one out of every two parts that the Motorola assembly line was producing was defective, the assembly line would have immediately shut down. Following a long moment of silence, the docs had discovered an entirely new view of their performance.

They quickly reset their goal to 75 percent of patients in good to optimal control, worked toward that goal, and made it that year and every year thereafter.

This is a great example of a nonclinical staff member reframing our clinical views and pushing us to new heights of performance.

What Kind of Degree is Best?

From a degree perspective, I look for individuals with master’s degrees. Some examples include a master’s degree in nursing, engineering, business, or finance. Those with bachelor’s degrees, I use to fill my entry-level positions.

Which is Better? Certification Versus Real-World Experience

I insist on a record of success in similar positions for my QS hires; it’s required to demonstrate expertise. Because I’m a pragmatist, I feel that certification is nice, but if a demonstrable record of success does not accompany it, it means little in my book.

I’ll always prefer to hire someone with a great portfolio of successful projects who doesn’t have certification. If they’ve had the training and demonstrate mastery of the six areas of expertise outlined above, that’s more than enough for me.