Leading through disruption: 10 pillars defining the chief quality executive of the future

Why it matters: Too often, hospitals fix problems temporarily only to see them reappear years later. Episodic projects don’t deliver sustainable results, and in today’s fragmented healthcare system, that’s not enough. Systems thinking equips CQEs to identify interdependencies, while implementation science ensures solutions are durable and scalable across the continuum of care.

What the future will bring: Implementation science will become a defining CQE skill, bridging the gap between strategy and execution. CQEs will hardwire improvement into workflows so that safety and quality are not projects but cultural norms. By doing so, they will move their organizations from episodic heroics to sustained system transformation, ensuring gains last beyond leadership changes or shifting priorities. “If you can’t operationalize it, then it’s just another binder on a shelf,” said Dr. Micah Beachy, vice president, chief quality officer, at Nebraska Medicine.

4. Financial acumen

Why it matters: Quality is often dismissed as a “soft dollar” initiative — important for mission, but invisible on the profit and loss statement. CQEs must flip that narrative by demonstrating how fewer readmissions, shorter lengths of stay and better patient outcomes translate to hard financial value. Without this skill, quality leaders will remain marginalized in boardroom conversations dominated by cost and revenue. “Financial acumen is a pretty broad term,” said Dr. David Priest, chief quality, safety and epidemiology officer, Novant Health. “For me, it’s a value equation more than financial acumen. The value equation is the team member experience plus the patient experience plus safety and quality over total cost."

What the future will bring: The CQE of the future will reframe quality initiatives as investments that drive sustainability — demonstrating how avoided infections, readmissions or safety penalties protect margins and reputations. In boardrooms, they will become persuasive storytellers who translate improvement work into both human lives saved and dollars delivered. “Telling the story of how hundreds of patients got to go home to their families resonates more than, ‘We saved X dollars,’” Gulbransen said.

5. Digital and technological literacy

Why it matters: AI, predictive analytics and digital care are already reshaping the industry, but poorly governed tools can create inequities or safety risks. Quality leaders must be confident enough to interrogate dashboards, ask hard questions of vendors and translate technology’s impact into patient outcomes. Without digital fluency, CQEs risk being sidelined in some of the most consequential decisions health systems will make.

What the future will bring: CQEs will serve as ethical stewards of technology, ensuring AI, predictive analytics and digital platforms are deployed wisely and equitably. They won’t need to write code, but they will need to know how to ask the hard questions: Is this tool validated? Does it introduce bias? Does it actually improve patient outcomes? Their role will be to make sure that digital innovation drives quality, not just flash. “CQEs don’t need to be AI experts, but they need to leverage it strategically,” said Dr. Kimi Kobayashi, former chief quality officer and now chief medical officer at UMass Memorial Medical Center.

6. Commitment to equity, ethics and patient-centered care

Why it matters: Disparities in outcomes are no longer acceptable blind spots. Equity, like safety or timeliness, is a fundamental dimension of quality. CQEs must champion the integration of equity into every measure, ensuring that successes at the system level don’t mask inequities across patient populations. Without this commitment, health systems risk eroding trust in the very communities they serve.

What the future will bring: CQEs will integrate equity as a permanent dimension of quality — measured, monitored and acted upon alongside safety and efficiency. They will challenge systems to confront disparities head-on, embedding patient voice into strategy and ensuring decisions reflect diverse community needs. In doing so, they will position equity not as a “side initiative,” but as a marker of organizational excellence. “Measuring quality is one thing, but there must be an embedding of equity in everything we look at,” Eisenberg said. “If a metric looks great overall, but then you see a big gap when you overlay the equity piece — that’s where the real work begins. For tomorrow’s CQEs, that’s the call to lead differently — to redesign quality not just to measure success, but to make it equitable by design.”

7. Workforce leadership, adaptability and optimization

Why it matters: Healthcare teams are under enormous stress from burnout, turnover and workforce shortages. The CQE has a unique role in modeling empathy, coaching resilience and creating environments where staff can succeed. This isn’t just about retention — it’s about making quality improvement sustainable by ensuring that people feel supported and heard.

What the future will bring: CQEs will become talent architects, spotting and nurturing the next generation of leaders. They will model empathy and consistency in times of stress, creating environments where teams feel supported and motivated to excel. In a volatile workforce landscape, the CQE will help organizations adapt by aligning people, culture and process to shared goals of safety and quality. “I’m always scanning for the spark,” Gulbransen said.

8. Crisis management and resilience building

Why it matters: Crises in healthcare are inevitable — whether it’s a pandemic, a cyberattack or a workforce collapse. CQEs are uniquely positioned to lead because their influence spans clinical teams, IT, operations and governance. This cross-functional reach allows them to coordinate responses across silos and build enterprise-wide playbooks. High-performing systems don’t just react — they learn. By embedding after-action reviews into quality cycles, CQEs can transform one-time disruptions into institutional knowledge. And as they take on more strategic roles, their ability to align resilience with enterprise risk management ensures quality and safety remain inseparable from business continuity.

What the future will bring: CQEs will embed resilience into daily operations so that readiness is not just a checklist but a living culture. They will build cross-functional playbooks that enable organizations to pivot quickly in the face of disruption, while preserving trust and patient safety. By hardwiring learning loops and integrating resilience into enterprise risk strategies, CQEs will ensure that systems emerge from crises stronger, not weaker. “The next big disruption isn’t ‘if ’— it’s ‘when,’” Scheurer said. “Whether it’s a cybersecurity event, climate issue or another pandemic, CQEs must lead through that volatility.”

9. Policy and regulatory knowledge

Why it matters: Compliance is table stakes, but it’s not strategy. Regulations define the guardrails for healthcare, yet too many organizations treat them as boxes to check. CQEs must be fluent in interpreting policy as an opportunity to educate boards, influence governance and leverage external requirements to drive internal improvement.

What the future will bring: CQEs will evolve from compliance enforcers to policy navigators and boardroom educators. They will continue to use regulations strategically, helping CEOs and boards understand not just what rules to follow but how those rules can drive improvement and alignment. Their fluency will make them invaluable in shaping governance conversations and preparing systems for what’s next. By leading cross-organizational efforts and embedding regulatory requirements into policy, the CQE can elevate the workforce’s focus from compliance-driven knowledge to patient-centered understanding. This positions the system to focus on the ultimate goal — not merely preparing for survey readiness, but advancing excellence in care delivery and consistently meeting patient needs. “As we all know, the buck stops with the board,” said Thomas Bates, chief quality officer, Keck Medicine of USC. “Board competency around quality can be quite different — and that means it’s our role to manage expectations, educate and make sure policy is driving improvement, not just compliance.”

10. Research and evidence-based practice leadership

Why it matters: Healthcare abounds with new technologies, therapies and models of care, but without evidence, innovation risks becoming noise. CQEs must ensure improvement initiatives are grounded in rigorous data and validated practices. Through thought leadership, dissemination of best practices and co-creation of innovative approaches with peers, they help define the evolving standards of excellence in quality leadership. This dual role — as both internal strategist and external contributor — positions the CQE as a pivotal force in elevating organizational outcomes while simultaneously strengthening the collective capacity of the field to address the most pressing challenges in healthcare.

What the future will bring: CQEs of the future won’t just lead inside their own organizations — they’ll help shape the field of quality itself. They’ll mentor rising leaders, building a pipeline of talent ready to take on growing complexity and deliver real results. And their influence will extend beyond hospital walls: By joining national collaboratives, publishing insights and positioning their systems as thought leaders, CQEs will help translate evidence into everyday practice while contributing new knowledge back to the profession. “You can’t solve today’s problems with yesterday’s solutions,” said Dr. Laura Haubner, senior vice president and chief quality officer at Tampa General Hospital. “Top performers don’t just have great ideas — they turn strategy into sustainability. That’s systems thinking plus change management plus implementation science.”

Too often, CQEs are invited into strategy only after decisions are made, reducing them to reactors. This undermines trust, performance and safety. Health systems that thrive will embed CQEs into enterprise strategy, from M&A to EHR design.

The future is now

This work began with a simple but powerful question: What will the future of quality leadership hold? The answer has become a call to action — not of fear, but of possibility.

The chief quality officer of tomorrow is not a compliance monitor tucked away in the background. They are vision-setters, system-shapers and culture-builders. They are the leaders who will define how health systems navigate disruption while never losing sight of the patient.

After all, the future isn’t waiting — it’s already here. And it belongs to those CQEs willing to step forward as strategists, storytellers and stewards.

"It’s time to move beyond the outdated perception of the CQE as merely a manager of metrics and compliance,” Eisenberg said. “While regulatory accountability remains essential, it’s only one dimension of the role. The CQE of the future is a transformative leader — driving system-wide improvement, shaping enterprise strategy and advancing organizational excellence at every level.”