2003 Salary Survey: Patient safety offers new opportunities in quality field
You may need skills enhancement to advance
Long hours and steady salaries are current trends for health care quality managers, according to the latest Hospital Peer Review Salary Survey. Although opportunities abound for today’s quality professionals, you may need additional skills to reap the benefits, say leaders in the field.
The 2003 Hospital Peer Review Salary Survey was mailed to readers in the June 2003 issue.
This year’s results suggest that quality managers are making about the same as last year, with 17% reporting an annual gross income of $50,000 to $59,000, and 19% reporting an annual gross income of $60,000 to $69,000. Slightly more than half reported that their salary increased by 1% to 3%, 24% reported an increase of 4% to 6%, and 11% received a 7% to 10% increase. (See Tables 1 and 2)
Quality managers still are putting in long hours, with the vast majority of respondents (81%) working more than 40 hours a week. Twenty-two percent report that they work 41-45 hours a week, and 37% report that they work 46-50 hour a week. Another 22% report working more than 50 hours a week. (See Table 3)
Patient safety is key role
More quality professionals are becoming organization vice presidents, and more organizations see the role as a key leader, regardless of title, says Janet A. Brown, RN, BSN, BA, CPHQ, FNAHQ, president of JB Quality Solutions Inc., based in Pasadena, CA.
Since patient safety remains the key focus, Brown recommends fine-tuning skills involving prevention activities. These include use of proactive methodologies such as Failure Mode and Effects Analysis, developing facilitywide incident identification tools, and having close links with risk management, physicians, and infection control.
Your key goal is to foster a culture that informs patients of what they should expect of their care, such as hand washing, and of adverse events should they occur, Brown says. "However, safety is only one dimension of quality for which the professional may assume leadership, training, and/or organizing responsibility," she says.
The quality professional is the organization’s advocate for continuing the quality focus, even though quality is everyone’s job, Brown says.
Quality remains in the forefront of the minds of consumer organizations such as the Leapfrog Group in Washington, DC and the Foundation for Accountability Portland, OR, she explains.
"It is the primary reason we tend to become responsible for assuring regulatory and accreditation compliance," says Brown.
As the field of knowledge and the need for that knowledge increases, quality professionals are moving from being "doers" to resources, says Brown. This means knowing where the information is, how to find and organize it, how to help interpret it for decision making, how to build and train teams, how to teach performance improvement processes, how to motivate, and how to market, she says.
Certification increasingly is an advantage, in both position and salary, adds Brown. "More employers prefer or require certification, and salaries are approximately $10,000 higher for quality professionals with the Certified Professional in Healthcare Quality [CPHQ]," she says.
The patient safety movement and the growing interest in Six Sigma offer quality managers new employment and advancement opportunities, says Fay A. Rozovsky, JD, president of the Richmond, VA-based Rozovsky Group.
Both career paths demand a strong understanding of statistical control methods, Rozovsky says. Although you may understand the fundamentals, the tools found in Six Sigma and in epidemiology may take some skill enhancement, she says. "Course work in this area will be useful, especially course work with a focus on health care."
Another must is a thorough understanding of regulatory and accreditation requirements and clinical risk management related to creating a culture of safe patient care, Rozovsky says. She recommends using the Chicago-based American Society for Healthcare Risk Management as a resource.
The Glenview, IL-based National Association for Healthcare Quality is another good resource on the accreditation requirements, says Rozovsky.
Some quality managers are getting involved in organizationwide performance improvement initiatives, such as Six Sigma and rapid cycle improvement, says Patrice L. Spath, BA, RHIT, a health care quality specialist with Forest Grove, OR-based Brown-Spath & Associates.
"This knowledge and experience raises the importance of the quality position within the organization, which is reflected in higher salaries and greater responsibilities," she says.
However, quality managers wishing to advance into these roles must gain additional skills, Spath says. She suggests taking "Black Belt" training in order to lead Six Sigma projects, or volunteering as reviewers for the Malcolm Baldrige National Quality Award or for state quality award programs. (See Table 4)
"Whatever you can do to gain additional skills will pay off in career advancements and increased value to your organization," she says.
Spath suggests utilizing these resources:
• The National Association for Healthcare Quality and other organizations sponsor educational programs for individuals who are new to health care quality management.
• Community colleges and universities may offer relevant coursework. "For example, students in health information management training programs are required to learn the fundamentals of health care quality management," Spath says.
• Many educational institutions offer an associate or degree program in health information management with on-line educational classes.
• The Chicago-based American Health Information Management Association offers a complete list of schools offering programs in health information management.
"In many cases, it is possible for the new quality manager to take one or two classes without enrolling in the complete program," she says.
• A list of state quality organizations is posted on the web site of Quality Digest (www.qualitydigest.com/html/qlinks.html).
"People should directly contact the award program in their state to learn more about the award and what volunteer opportunities may exist," Spath says.
Many of these award programs also offer low-cost training sessions, such as the Baldrige program (web: www.quality.nist.gov), Spath adds.
• To learn more about Six Sigma in health care, several organizations offer on-line learning opportunities, including the Milwaukee-based American Society for Quality (www.asq.org).
"A Google search will find lots of companies and organizations with Six Sigma training," says Spath. "It’s best if quality managers take courses that are specific to health care."
The survey found that almost half (48%) of respondents are between 46 and 55. "The quality profession is aging faster than there are younger professionals being added," says Brown. "Some have actually been in the field since its inception in the mid-1970s."
In addition, nurses and other health care professionals may change career directions and enter the quality field after years in another area, she says.
"Experienced quality professionals need to identify, train, and mentor younger, qualified people to be ready to essentially replace themselves in their workplace, whether that comes through retirement or a change of employment," she says.
Although a significant number of survey respondents (29%) have six years or less experience in quality management, a large percentage (61%) have worked in health care for 25 years or more, says Spath. (See Table 5)
This appears to indicate that many of the new quality managers are moving into that position either as a promotion within their own organization or from other health care settings, she adds.
"People with a health care background have a distinct advantage, but they may not have the data management skills needed to support today’s information-driven performance improvement efforts," says Spath.
This has training and orientation implications, Spath says, since people new to health care quality management must gain new skills either through on-the-job training or a formal education program.
Quality managers typically work long hours, which is an indication of the commitment necessary to support an organization’s quality program, Spath says.
"In my experience, the quality profession attracts those who attend to detail well, who strive to do all the right things right, who have a very hard time saying no,’ often at the cost of their own time, energy, and even health," Brown points out.
"In humor, I say we are the Type A’ personalities of health care, but I have seen and learned myself that we must also have a quality life and a healthy body - a balanced perspective," she says.
While a job in the quality management department might look inviting to a staff nurse or other staff member tired of the hectic environment of direct patient care, the pace of the job is not likely to slow down in the quality department, adds Spath.
Also, quality managers often are "exempt" employees who don’t qualify for overtime pay, which is a consideration for those people who have come to rely on this as a source of additional income.
"Quality management is a calling, and not necessarily a 9-to-5 job," says Spath. "Commitment is important."
Long hours and steady salaries are current trends for health care quality managers, according to the latest Hospital Peer Review Salary Survey. Although opportunities abound for todays quality professionals, you may need additional skills to reap the benefits, say leaders in the field.
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