What the next generation of healthcare quality and safety leaders needs

Co-authored by Eric Richardson

This year's Healthcare Quality Week, Oct. 18-24, coincides with the 50th anniversary of the National Association for Healthcare Quality (NAHQ). Its theme, "People. Progress. Possibility.," raises a question that matters to every health system: What will the next generation of healthcare quality and safety leaders need to succeed?

To answer it, we spoke with Danielle Scheurer, M.D., MSCR, chief quality officer for MUSC Health. Her answer is clear. Quality improvement methods are necessary but no longer sufficient. Tomorrow's healthcare quality leaders must “speak finance,” understand the electronic health record (EHR), think strategically, shape policy, lead change and stay close to the front line, where patient safety is won or lost.

From the bedside to healthcare quality leadership

Dr. Scheurer entered the healthcare quality field the way many clinicians do: through frustration with a system that made good care harder than it should be.

"I was a full-time practicing clinician, a hospital medicine physician," Scheurer said. "The level of complexity of the system makes it very difficult for well-intended clinicians to execute on a good care plan and meet the needs of patients and families. Doing that full time felt like I was perpetuating a broken cycle of care that was not highly reliable. I couldn't stand being an innocent bystander in a broken system.”

Her first administrative role, director of inpatient medicine at Brigham and Women's Hospital in Boston, came with advice she still remembers. "My boss told me, 'If you make care better and you can demonstrate that, you will build a career around this.'"

She started with comprehensive unit-based safety programs, known as CUSP. About a year in, the hospital's chief operating officer called her into his office and shared that length of stay, falls, and pressure injuries were all improving on her units, enough that they stood out from the rest of the hospital. The COO's next question was simple: Could she do it everywhere?

That experience shaped a lesson that continues to guide her work today. While the patients she serves have changed, the mission has not.

"At the end of the day, it's all about the patient and their family and creating a system that works for them. We're far from arriving at that, but that's what gets me out of bed every day,” Scheurer said.

What skills do healthcare quality and safety leaders need?

Scheurer points to six competencies that increasingly set effective healthcare quality leaders apart.

1. Financial acumen: speaking the language of the business

"You have to understand how we get paid, how money flows and what motivates people, or you can't get anything done," Scheurer said. "It is absolutely essential to be able to speak finance."

That includes being able to build a strong business case for quality improvement, including a pro forma that holds up to scrutiny.

2. Informatics, data, and AI: understanding the EHR

Healthcare quality leaders also need to understand informatics, clinical workflows, decision support and artificial intelligence.

"We rely so heavily on the medical record to steer decision making in quality improvement," Scheurer said. "If you don't understand how people use the medical record and what your tool sets are, you're just not going to be successful."

Without that understanding, interventions can fall short, from alerts clinicians ignore to tools with little uptake.

3. Strategic thinking: anticipating change

Effective healthcare quality leaders need to understand not only what is happening within their own organizations but also where the broader industry is heading. That perspective allows them to anticipate change rather than simply react to it.

4. Advocacy: shaping how quality is measured

Quality leaders also need to understand how policy is made and how they can help shape it.

“Just because the rules are written this way today doesn’t mean it has to stay that way,” Scheurer said. “You have to understand what should change, for what reasons, and how to get that change. Too often, rules are written without our voice, and that’s an us problem. We can’t just be recipients.”

That means working through state and federal channels and advocacy organizations such as the American Hospital Association, the Association of American Medical Colleges, the South Carolina Hospital Association, and Vizient to shape measures that are efficient and meaningful.

5. Change management: the hardest skill to find

Of the six competencies, change management is the one Scheurer finds hardest to hire for.

"There's a playbook; you can read the steps,” she said. “But you have to do it to get good at it, and you have to learn from your mistakes."

6. Frontline improvement: going to the gemba
What separates someone who can read a dashboard from someone who can move a metric? Presence.

"The biggest mistake people make is trying to do quality or process improvement from a distance," Scheurer said. "You have to go to the gemba and understand what is actually happening in the field. Be non-threatening, ask open-ended questions, and don't come with your clipboard. Once you understand that, the change management almost takes care of itself."

Why the hard work matters

Scheurer's first interview question is always about motivation.

"Twenty years ago, people went into quality because they thought it was easy, that it was desk work," she said. "That's not it at all. This is a hard job, and if it's easy, you're doing it wrong. I got into this not because it was easy; I got into it because it was hard. You have to want to change the system, and that has to motivate you every day.”

How MUSC prepares healthcare quality and safety leaders

Those same competencies are reflected in MUSC's new Master of Science in Healthcare Quality and Safety (MSHQS), launching in January 2027. The curriculum integrates systems thinking, quality and safety methods, data and AI, finance, leadership, change management and applied decision-making.

Applied field experience is built into every course rather than reserved for the end of the program. Students complete interprofessional field exposure assignments that connect them with practicing quality, safety and clinical leaders, giving them opportunities to see how the principles they study are applied in real healthcare environments. Those experiences build toward an applied capstone project.

The curriculum is also being aligned with NAHQ's Healthcare Quality Competency Framework, and students can complete the program in 12 to 24 months at an accelerated or standard pace. Take the next step.

For anyone considering a move into healthcare quality, whether from the bedside, an analytics team, or a health administration role, Dr. Scheurer recommends formal training, professional certification, learning the core body of quality knowledge and shadowing people who do the work.

Many professionals may find they are already doing quality work, even if it is not yet in their title.

Read more: Why a Master's in Healthcare Quality and Safety Is Vital to the Healthcare Industry