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Peer review and quality improvement still hold promise as a career path, but the savvy professional should recognize the changing needs of employers and put themselves in a position to help, experts say.
There are a lot of changes going on right now, but you have to look closely to figure out how they might affect you. Janet Brown, RN, CPHQ, head of JB Quality Solutions consulting in Pasadena, CA, says she is seeing an interesting trend in the classes she teaches for those seeking CPHQ certification. Lately she has noticed that about a third of her classes are comprised of people who are either new to the field or have been in it for less than two years.
"I think that tells me that some people are getting out, but I have a sense that the passion lives, and health care organizations are certainly hiring, based on the fact that there are folks new to the job," Brown says. "I would worry if we saw the classes dwindling or never saw any young faces. It’s a good thing to see new people because it means somebody has job openings."
The role of the peer review and quality professional is changing, however. Brown says the person is becoming "less of a doer and more of a resource." There is so much information available now that health care organizations need a filter of sorts, someone on staff who can interpret quality standards and other information, Brown says.
"The resource center concept is what organizations are looking for these days," she says. "They’re looking for people who know how to help them make the best decisions. I’m not sure we have to have answers to all the questions, but we have to have enough understanding to know where the better options and practices are.
"I think the value of the professional is that they can offer process solutions, have answers to questions," she points out.
Brown says quality professionals should take steps to move in the direction of being a resource center, mainly by becoming familiar with the relevant literature, web sites, and other information.
She says you should work toward becoming "the resource center for quality" and know where to get practice guidelines, where to find valid performance measures, and which software vendors have the best products.
The other big change in the field is that the scope of a quality professional’s work is growing ever wider. Fewer professionals have departmental concerns these days, and Brown says many are moving up into much higher positions within the organization. That’s a trend she’s watched for the past five years.
"Quality has gone organizationwide, so we’re not seeing so much of the old situation where you had one person or a few in an organization whose job was to maintain and improve quality," she says.
"Quality also has moved into more of an overall integrated delivery system, with health care systems taking a broader approach instead of keeping it at a lower level with a quality improvement person focusing on just one facility," Brown explains. That can open up career opportunities. As quality becomes a regional concern for many health networks, many quality and peer review professionals are earning higher salaries. Brown says one colleague recently confided in her that she’s earning close to $100,000 a year, which represents a significant milestone in her career.
Another observer says she has seen a lot of job consolidation in recent years. Patrice Spath, RHIT, a consultant in Forest Grove, OR, says many quality managers are moving from positions where they managed a department to overseeing several hospitals or a hospital system. Quality managers also are getting more involved in patient safety and serving as patient safety officers.
"They’re getting more responsibilities on their desk, but not much change in income," she says. "A lot more on our plate without the time to do it or any additional money." Many quality managers also have the opportunity to get involved in compliance issues and could move into compliance officer positions. That’s more likely if you have a medical records background, Spath says.
Much of the trend toward more responsibility, with or without a better income, can be traced to increased public awareness about medical errors and quality, Brown says. The Institute of Medicine report on medical errors and the work done by The Leapfrog Group have focused more attention on quality and made the work of quality professionals more valuable, she says.
"Organizations are leaning strongly toward a quality emphasis and focus is clearly on very specific performance issues," she says. "They have to make quality a high priority, and that means employing people who know quality is a high priority."
Spath says health care providers increasingly are focused on data collection and analysis, so the quality manager who is skilled in that area will find better career opportunities.
"More and more people are getting into benchmarking projects using the data to judge quality for their own organization," she says. "That demands that you have better statistical analysis skills than you ever had before. As we move into patient safety and start applying some failure models and criticality analysis tools, we need a better understanding of those tools and even engineering principles."
Those skills will make you more desirable in the marketplace, but Spath says she still isn’t sure they will result in much more money in your pocket. The only health care professionals getting more money lately seem to be nurses and others who are in short supply, she says.
"Holding steady" is a term used by both Brown and Spath, and both say they see opportunities on the horizon. Brown says she hasn’t seen any downturns in the career field, and she expects the emphasis on quality to continue for a long time.
"It’s a good time to be in this career," she says. "Pay attention to the changes, and I think you’ll find good opportunities."