How to Staff Your Quality Department

Here are some proven benchmarks

How many FTEs do you need in your hospital based quality department?

There aren’t many good benchmarking resources to answer this question. And I’ve looked far and wide.

There is just too much variation between hospitals and existing departments for most benchmarking organizations to land on a common formula. But over the years, I’ve tried many different designs and found a formula that works.

I’ve listed each position below and included  the number of FTEs for each based on the number of beds in your organization.

Below are my recommended staffing figures for your ideal quality department.

  • Quality Specialists—one FTE per one hundred beds
    • If you have 110 beds then you would need 2 FTEs and so on.
  • Process Improvement Specialists – one FTE per one hundred beds
  • Data Analysts*—one FTE for every two quality specialists
  • Safety Specialists—one FTE per two hundred beds
  • Infection Prevention Specialists—one FTE per one hundred beds
    • This benchmark is from their national association
  • Accreditation Specialist (The Joint Commission and CMS)—one per hospital
  • Medication Safety Specialist (PharmD)—one per hospital
  • Environmental Safety – one per hospital

Q Department Staffing

*These analysts are in addition to the staff required for core measure reporting—chart review—and registries requiring chart abstraction or review.

I hope these help, and keep in mind these are general recommendations. You’ll need to make adjustments based on your individual circumstances.

To date we’ve reviewed:

  • The general structure and types of staff for your quality department
  • An in-depth analysis of the skills and knowledge for a Quality Improvement Specialist
  • Benchmarks for staffing your department

In future posts we’ll cover each of the remaining positions and help you identify ideal candidates for your organization. Until next time…