The Unsung Architects of Safer Healthcare: The Role of Quality Professionals in Hospitals and Health Systems
- EvaluCare
- Feb 18, 2022
- 5 min read
Updated: Dec 5, 2025
Introduction
In a healthcare landscape marked by growing complexity and increasing patient needs, quality professionals serve as the often-overlooked linchpins ensuring that care is not only delivered but delivered with compassion.
The role of a healthcare quality professional encompasses far more than regulatory checkboxes or incident reviews; it is about driving systemic improvement, embedding safety into organizational culture, and designing care processes that fulfill the Institute of Medicine (IOM) STEEEP aims: Safe, Timely, Effective, Efficient, Equitable, and Patient and Family-Centered care.
This blog explores the expansive and critical role of healthcare quality professionals, their methodologies, the domains they influence, and how their expertise is uniquely positioned to support patients harmed by medical malpractice through organizations like EvaluCare.
The Scope of a Quality Professional: More Than Just "QA"
Healthcare quality professionals work at the intersection of clinical care, operations, and policy. Their scope of work includes three foundational pillars:
Quality Assurance (QA): Ensures care meets defined standards and regulations through audits, compliance checks, and protocol adherence.
Quality Control (QC): Monitors processes to detect deviations and trigger corrective actions to prevent errors.
Quality Improvement (QI): A continuous, systematic effort to improve care processes using methodologies such as Lean, Six Sigma, the IHI Model for Improvement, and the Theory of Constraints, and more.
Together, these functions enable quality professionals to proactively design, monitor, and refine the systems in which care occurs.
"Patients are not widgets, and hospitals are not factories, but the application of quality improvement principles borrowed from industry can save lives in healthcare." — AHRQ
Guiding Principles: The IOM STEEEP Aims
Quality professionals are tasked with operationalizing the IOM's six aims:
Safety: Preventing harm to patients.
Timeliness: Reducing waits and harmful delays.
Efficiency: Avoiding waste of resources.
Effectiveness: Providing services based on scientific knowledge.
Equitability: Ensuring care does not vary in quality due to personal characteristics.
Patient and Family-Centeredness: Respecting patient and family preferences, needs, and values.
Each initiative, workflow redesign, and metric analyzed is filtered through these aims to drive improvements that matter most.
Core Domains of Quality in Healthcare
The scope of work in healthcare quality spans across multiple specialized domains:
Continuous Quality Improvement (CQI), the umbrella other domains fall under.
Infection Prevention and Control
Regulatory, Accreditation, Compliance (e.g., The Joint Commission, CMS, DNV)
Patient Safety (Root Cause Analysis, Failure Mode Effects Analysis)
Patient and Family Advocacy
Patient and Family Experience
Data Analytics and Reporting (e.g., dashboards, scorecards, clinical registries)
Staff Education and Culture of Safety Training
Risk Management
Quality Professionals as Systems Thinkers
Quality professionals see healthcare delivery not as isolated events but as interconnected systems. They understand that:
An adverse event is often the result of system failure, not individual error.
Sustainable change requires altering underlying processes that are drivers, not just fixing symptoms.
Standardization and evidence-based best practices improve outcomes.
According to the Agency for Healthcare Research and Quality (AHRQ): "Improving quality is about designing better systems." Quality professionals are, by nature, system designers and watchdogs. They are the architects often called upon to design systems and the general contractor called on to build them.
"Every system is perfectly designed to get the results it gets." — Edwards Deming
Adjudicating Adverse Events and Aligning with Legal and Risk Teams
When harm occurs, quality professionals are often first on the scene. They lead investigations, coordinate root cause analyses, and recommend actions to prevent recurrence. They work closely with:
Risk Management: To document incidents, determine liability risk, identify system failures and negligence.
Legal Departments: To understand the legal implications and prepare for potential litigation.
However, a tension often exists. While risk and legal departments may focus on minimizing liability, quality professionals advocate for transparency, learning, and accountability even within the organization and systems they work in. This constant tension can often grow when risk and legal approaches outweigh doing what is right.
"To err is human, but to cover up is unforgivable, and to fail to learn is inexcusable." — Institute of Medicine, To Err Is Human
Mandatory Reporting and Accreditation Functions
Healthcare quality teams are responsible for:
Submitting mandatory safety event reports (e.g., sentinel events, serious reportable events)
Preparing for external surveys and inspections
Ensuring adherence to standards from accrediting bodies like The Joint Commission, NCQA, and CMS
Maintaining disease-specific certifications (e.g., stroke centers, oncology programs)
These activities not only fulfill regulatory requirements but can serve to identify opportunities for improvement.
Conclusion: Passionate About Safer Care and Patient Justice
Healthcare quality professionals dedicate their careers to making care safer. At EvaluCare, we bring that same passion to quality assurance strategies such as reviewing medical care with it innovative AI technology. Its unique blend of clinical expertise, systems-thinking understanding, and compassionate advocacy empowers patients to seek the truth and find justice.
If you or a loved one has been harmed and don’t know where to turn, EvaluCare is here to help.
Learn More at www.EvaluCare.net or email info@EvaluCare.net
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Eva, EvaluCare’s AI-powered SaaS, delivers quality review for inpatient care by checking adherence to thousands of evidence-based guidelines and protocols. It identifies care gaps, routes clear actions to the right clinicians, and accelerates improvement cycles, strengthening documentation and coding while reducing HACs, HAIs readmissions, length of stay and more. The result is an ROI, starting in the seven figures even for critical access hospitals. Learn more at evalucare.net or contact info@evalucare.net.
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About the Author
Jason Minor is a healthcare quality and transformation leader with nearly 30 years of continuous improvement experience. A Certified Lean Six Sigma Black Belt, Certified Professional in Healthcare Quality, Certified Professional in Patient Safety, and Certified Utilization Review Professional, he has led thousands of end‑to‑end improvement projects, mentored dozens of quality professionals, and pioneered healthcare SaaS innovations.
As Board Chair of the Vermont Program for Quality in Health Care, Jason has partnered with hospitals, non‑profits, and state agencies to elevate patient safety and care quality statewide. Previously, as Network Vice President of Quality at the UVM Health Network and through the Jeffords Institute for Quality, he guided the redesign of a system‑wide quality framework and led initiatives that achieved a number‑one patient safety ranking among the nation’s top academic medical centers.
In 2020, Jason founded EvaluCare to help organizations shift from episodic improvement to a robust quality assurance approach.
EvaluCare’s Eva platform leverages AI‑powered natural language processing, machine learning, and agentic orchestration to analyze and improve inpatient care and support comprehensive quality, mortality, peer, and utilization reviews.
Jason Minor, EvaluCare Executive Director
Network Director Continuous Systems Improvement Jeffords Institute for Quality UVM Health
Board Chair Vermont Program for Quality in Health Care Inc.,
Vice Chair Northwestern Counseling & Support Services, Inc
Lecturer UVM College of Nursing & Health Sciences in Healthcare Quality
Quality Peer Reviewer Vermont Care Partners: Centers of Excellence
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References
Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century.
AHRQ. Patient Safety Primer: Quality Improvement.
IHI. Model for Improvement.
National Database of Nursing Quality Indicators (NDNQI). Nursing-Sensitive Indicators.
