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Quality Improvement Specialist

Quality Improvement Article   (19,508 Views 2 Comments 716 Words)
by madwife2002 madwife2002 (Member)

madwife2002 has 26 years experience and works as a Director of Nursing Services.

3 Likes; 1 Follower; 74 Articles; 120,011 Visitors; 4,777 Posts


There is increasing emphasis on improving the quality of care provided by hospitals. Nurses are integral to patients' well being both in and out of acute care facilities; nurses are pivotal in hospital efforts to improve quality. Hospitals face increasing demands 
to participate in a wide range of quality improvement activities, they are reliant on nurses to help address these demands.

Quality Improvement Specialist

Majority of quality improvement jobs in health care can have many responsibilities that fall into specific categories, including but not limited to evaluation, analysis, training and education, regulatory and compliance responsibilities, and risk management. A quality improvement health care specialist would ideally be responsible for gathering and evaluating clinical data from the organization; analyzing data for patterns and trends in the delivery of healthcare; researching root causes for specific patient care trends; training and educating staff to promote good quality practices and ensure compliance with all applicable laws and regulations; working with leadership and staff to create policies and procedures to ensure good quality care and minimize harm to the patient; keeping up to date with all federal and state laws and regulations.

Quality improvement can be defined "as systematic, data-guided activities designed to bring about improvement in health care delivery in certain settings and particular situations".

A quality improvement strategy is defined as "any intervention aimed at reducing the quality gap for a group of patients represented by those encountered in routine practice".

Gaining a more in-depth understanding of the role that nurses play in quality improvement and the challenges nurses face can provide important insights about how hospitals can optimize resources to improve patient care quality.

Educational Requirements

  • Registered Nursing License in State of
  • 3-5 years clinical nursing experience
  • BSN preferred
  • Experience with NCQA, Medicaid and/or commercial regulatory requirements
  • CPHQ- Certified Professional in Healthcare Quality (preferred)

Duties and Responsibilities

Participate in design and implementation of Quality Improvement projects for HMO patients.

Assumes project lead role and develops project plan identifying all aspects of the project including timeline's for each task. Assures timely collection, processing and reporting of data per project.

Collaborates with IT and Analytic staff to facilitate design and development of appropriate database tools and reports.

Serves as a proactive liaison to Medical Leadership to facilitate physician engagement in projects, timely completion and submission of QM projects and HEDIS data collection and development of interventions for improvement.

Investigate patient complaints/grievances received from patients, family and HMO's.

Conduct QI audits/surveys as a way to recognize and/or identify potential quality issues or trends.

Attend various interdepartmental meetings as the QI RN representative, to support the departments' requirements.


Improving health care quality and patient safety are currently high on the nations health agenda, a focus that will only intensify going forward. Patients are demanding better health care, and who can be placed better than the nurse to be the leader of quality.

In other countries, it is the expectation that all registered nurses are actively involved with improving quality initiatives through research, changes are made through the hard work of floor nurses who strive daily to improve quality outcomes.

We need to be given the recognition of being change agents, quality improvers and educators. Self identification of issues and problems should be the norm rather than the exception. We should be identifying areas of improvement, making plans of correction and auditing the plans are effective after they are implemented.

The stakes for US hospitals to demonstrate high quality is increasing; at the same time resources are becoming more and more limited. Therefore, hospitals will have to become more skillful and sophisticated in discerning and pursuing activities that substantively contribute to the achievement of their quality.

This evolution also will require increased sophistication by the hospitals to optimize available resources to carry out their work.

Nurses are at the forefront of improving quality care, although it is considered everyone's responsibility to improve quality of care. Nurses often find themselves in the unique position of being the change agent for any patient quality event, we have a high stake in the game and we need to cash in on all opportunities that could improve the quality of life for our patients.


National Association for Healthcare Quality (NAHQ)

National Committee for Quality Assurance (NCQA)


RN with 26 years of experience many of those years spent in dialysis. I have worked in acute care, home, ICHD as a CN, FA, and currently a director.

3 Likes; 1 Follower; 74 Articles; 120,011 Visitors; 4,777 Posts

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Thank you for the information. I am looking into crossing over into Quality after being in patient care for 20 years. Any advice of making this a smooth transition would be greatly appreciated.

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