Towards a quality management competence framework: exploring needed competencies in quality management

What makes an effective Quality Improvement Manager? A qualitative study in the New Zealand Health System

PURPOSE

Quality improvement is an international priority, and health organisations invest heavily in this endeavour. Little, however, is known of the role and perspectives of Quality Improvement Managers who are responsible for quality improvement implementation. We explored the quality improvement managers' accounts of what competencies and qualities they require to achieve day-to-day and long-term quality improvement objectives.

DESIGN

Qualitative exploratory design using an interpretivist approach with semi-structured interviews analysed thematically.

SETTING AND PARTICIPANTS

Interviews were conducted with 56 quality improvement managers from 15 (out of 20) New Zealand District Health Boards. Participants were divided into two groups: traditional and clinical quality improvement managers. The former group consisted of those with formal quality improvement education-typically operations managers or process engineers. The latter group was represented by clinical staff-physicians and nurses-who received on-the-job training.

RESULTS

Three themes were identified: quality improvement expertise, leadership competencies and interpersonal competencies. Effective quality improvement managers require quality improvement experience and expertise in healthcare environments. They require leadership competencies including sense-giving, taking a long-term view and systems thinking. They also require interpersonal competencies including approachability, trustworthiness and supportiveness. Traditional and clinical quality improvement managers attributed different value to these characteristics with traditional quality improvement managers emphasising leadership competencies and interpersonal skills more than clinical quality improvement managers.

CONCLUSIONS

We differentiate between traditional and clinical quality improvement managers, and suggest how both groups can be better prepared to be effective in their roles. Both groups require a comprehensive socialisation and training process designed to meet specific learning needs.

Sustainable Quality Management Systems in the Current Paradigm: The Role of Leadership

This study supports the proposition that sustainability’s integration into Quality Management Systems (QMS) could be a viable pathway to the development of the Emergency paradigm, in which leadership plays a crucial role. A Systematic Literature Review (SLR) was performed in order to deepen leadership’s relationship with Quality Management (QM) from an evolutionary perspective. An exploratory survey was then conducted to assess quality managers’ perceptions of sustainability’s integration into QMS and their leadership styles, using the 5X Short Leader Form MLQ instrument. The results indicate that leadership is a critical element of QMS performance, enhancing transformational leadership, which appears to be the dominant self-perceived style of the quality managers who participated. Nevertheless, these practitioners recognise the difficulties in committing all employees to the sustainability journey. The theoretical and managerial implications give rise to this work. The SLR results could be a useful database to support future QM and Leadership research. The organisations could follow the suggested pathway to evolve their QMS to support solutions to some of the current challenges. At the same time, quality managers could reflect on their future professional challenges. This work has taken a step forward, indicating sustainable quality management systems as a viable pathway to explore QM knowledge regarding the Emergency paradigm, and thus enhancing leadership’s role.