Quality Improvement (QI) is central to delivering safe, effective, and responsive healthcare services. Yet achieving real, lasting improvement depends not only on the tools (Lean, Six Sigma, Model for Improvement, co-design, data dashboards, etc.), but on the people who steer QI work every day: QI professionals.
A recent qualitative study of 56 QI Managers (QIMs) across 15 public health boards in New Zealand — published as “What makes an effective Quality Improvement Manager?” — identifies three clusters of competencies essential for QI managers who want to drive both day-to-day improvements and long-term cultural change.
Drawing on that study, and the wider literature on QI leadership, this post outlines what makes an effective QI professional today, and why these skills matter for organisations using platforms like Life QI.
Methodological fluency: Effective QI professionals need solid grounding in QI frameworks and tools — e.g. process mapping, measurement for improvement, root-cause analysis, PDSA cycles, co-design methodologies. The NZ study found many QIMs emphasised that without being “experts” in what they are recommending, it’s hard to gain credibility.
Healthcare-specific experience: QI in a hospital or clinic is very different from process improvement in manufacturing or non-health services. Managers with prior experience in healthcare understand the complexities — clinical workflows, patient safety, regulatory constraints, professional hierarchies — making them more effective.
Continuing learning and adaptation: Many QIMs in the NZ study reported that what they learned in formal training often wasn’t enough to handle real-world challenges — dealing with unexpected resistance, resource constraints, or unintended consequences. Continuous on-the-job learning was essential.
For organisations using tools like Life QI, this underscores why methodical QI training and contextual understanding matter — not just ticking off training boxes.
QI initiatives rarely succeed simply by applying tools. They require leadership, in the truest sense: shaping vision, guiding sense-making, aligning stakeholders, and stewarding long-term change. The NZ study breaks this down into several key dimensions:
Sense-giving: QIMs need the ability to help colleagues re-interpret what “quality” and “improvement” mean. In many health settings, QI can feel foreign — borrowed from manufacturing or business. QI professionals help translate QI into meaningful improvements for clinicians and patients.
Long-term thinking & capacity building: Rather than delivering one-off projects, effective QIMs aim to build internal capability. They see their role as enabling teams to own and lead improvement work themselves — shifting from dependency on external “experts” to embedding a continuous improvement mindset.
Systems thinking: Healthcare is complex. Improving one part (e.g. a ward process) without seeing the broader system can lead to sub-optimisation — improvements in one area that cause problems elsewhere. Effective QI professionals keep a “whole organisation” perspective.
Motivation and influence: Because QI work often competes with clinical priorities, QIMs need to motivate and influence staff — not through coercion or money (in many cases), but through recognition, shared purpose, and demonstrating the value of improvement for patients and staff.
Leadership for QI therefore involves guiding people’s mindsets, aligning diverse stakeholders, and sustaining momentum over time — not just managing processes. This echoes broader evidence showing that successful QI depends on embedding a culture of improvement and learning across the organisation.
Beyond technical and leadership skill, the “soft side” of human relationships often determines whether QI initiatives take root. The NZ study identifies three interpersonal traits that matter:
Approachability: QIMs must be accessible so frontline staff feel comfortable sharing ideas, concerns or problems. High power-distance, or a perception that QIMs are “management outsiders”, undermines trust and stifles open communication.
Supportiveness: Many staff have little or no formal QI training; good QIMs coach them, guide them, and help them build confidence. Improvement work often requires persistence and experimentation, and staff need to feel supported when early attempts don’t deliver.
Trustworthiness: Trust is foundational. Staff need to believe QIMs understand their pressures, respect their clinical judgment, and have credible intentions. Without trust, QI efforts may be resisted or ignored.
Especially when QI professionals come from non-clinical backgrounds (operations, engineering, administration), interpersonal skills become critical to overcome the “outsider” perception. The NZ study found that traditional QIMs placed more emphasis on these traits — often to compensate for lack of clinical background.
QI failures often stem not from poor tools, but from weak leadership, lack of engagement, cultural resistance, or fragmented efforts.
When QI professionals:
In contrast, when QI professionals combine technical competence with leadership vision and interpersonal trust, QI becomes more than a series of improvement projects. It becomes a continuous culture, aligned to values, embedded in everyday work, and owned by staff.
For healthcare organisations, and for teams using tools like Life QI, these findings have several implications:
Invest in QI training — but don’t stop at tools: Training programmes should go beyond methodology to build systems thinking, change leadership, and interpersonal skills.
Appoint QI professionals with mixed backgrounds — or build balanced teams: A blend of QI experts + clinical insiders often works best. Experts offer methodological rigour; clinical insiders offer legitimacy and contextual insight.
Foster QI as culture, not just projects: Encourage QI professionals to take long-term, capacity-building view: coaching, mentoring, embedding QI into routine work.
Use QI platforms as enablers — not replacements — of human leadership: Tools like Life QI can support data collection, tracking, collaboration, but they don’t replace the need for sense-givers, coaches, and trusted leaders.
Quality Improvement professionals play a critical, often under-appreciated, role within healthcare organisations. The study from New Zealand shows that success depends not just on QI tools — but on a blend of technical expertise, leadership vision and interpersonal trust.
In other words: effective QI leadership is as much about people as process.
For organisations committed to continuous improvement — and for users of platforms like Life QI — this means that investing in people, relationships, and culture is as important as investing in software.
Akmal, A., Podgorodnichenko, N., Stokes, T. et al. What makes an effective Quality Improvement Manager? A qualitative study in the New Zealand Health System. BMC Health Serv Res 22, 50 (2022). https://doi.org/10.1186/s12913-021-07433-w
Robin DC. Kumar, Leadership in healthcare, Clinics in Integrated Care, Volume 10, 2022, 100080, ISSN 2666-8696, https://doi.org/10.1016/j.intcar.2021.100080.
Øvretveit, J., Leading Improvement Effectively, The Health Foundation, March 2009, https://www.health.org.uk/reports-and-analysis/reports/leading-improvement-effectively