Leading Quality

Jason Meadows, MD
  • 5.0 (1)
  • MEDICINE

Welcome to Leading Quality, the show that dives into the real-world stories and strategies of healthcare quality improvement leaders at all levels, from Frontline Champions to C-Suite Executives.  Each episode uncovers how these dedicated professionals tackle complex topics in real healthcare environments.  Discussion range from QI fundamentals, to leadership, technology, AI, and beyond. If you’re passionate about elevating patient care and want practical insights that go beyond the buzzwords, this podcast is for you. Tune in for inspirational conversations, innovative frameworks, and the behind-the-scenes details you won’t hear anywhere else, and discover how you, too, can lead quality improvement from wherever you stand in healthcare. 

  1. JAN 29

    What Does a Chief Quality Officer Actually Do?

    Episode Summary What does the Chief Quality Officer role actually entail once you get past regulatory compliance and dashboards? In this episode, Dr. Abraham Jacob draws on years as a system-level CQO to explain how quality leadership really works in practice: where to start, what to prioritize, and how culture, safety, and accountability interact over time. The conversation is grounded in lived experience, including successes, failures, and lessons learned during periods of workforce instability and change. This episode is most useful for CQOs, CMOs, senior clinical leaders, and anyone building improvement capability at scale. Core Ideas from the Conversation Patient safety is a leverage point Reducing preventable harm creates alignment, urgency, and moral clarity in a way few other priorities do.Quality assurance is necessary but insufficient Meeting regulatory standards does not, by itself, produce better outcomes or learning systems.Variation reveals system design problems Unwarranted variation signals where workflows, standards, or training have failed the system.Psychological safety enables performance, not comfort Teams improve faster when speaking up is expected, acknowledged, and protected.Turnover threatens reliability more than leaders expect Standards erode quickly when onboarding, retraining, and reinforcement don’t keep pace.The CQO role is shifting toward stewardship and value Mature organizations expect CQOs to help lead system transformation, not just oversight.Questions This Episode Raises for Leaders Where does your quality function spend most of its energy: assurance, improvement, or capability building?What forms of harm are still tolerated because they’ve become routine?How do new staff actually learn “how we do things here,” beyond policies?Where might turnover be quietly undoing prior improvement gains?When was the last time you publicly reinforced speaking up, especially when it was inconvenient?Resources & References Mentioned “What Google Learned From Its Quest to Build the Perfect Team” Charles Duhigg, New York Times Magazine On psychological safety as the strongest predictor of team performance.Institute for Healthcare Improvement (IHI) Referenced as a formative influence on improvement science and leadership development.IHI Chief Quality Officer Professional Development Program A national program supporting CQOs in building system-level improvement capability.High Reliability Organizations (HRO) in Healthcare Principles focused on reducing harm and building reliable systems under pressure.Intermountain Healthcare – Advanced Training Program Cited as an early influence on variation reduction and outcomes-focused care.Key Driver Diagrams Discussed as a durable tool for linking strategy, drivers, and improvement work.Continue the Conversation You can connect with Dr. Abraham Jacob via email at akj@umn.edu or on LinkedIn. Reflection and dialogue are central to improvement, so take a moment to notice where these ideas show up in your own system. New episodes published every other Thursday at 7AM Eastern Time.

    45 min

  2. JAN 15

    Building Improvement Into the DNA of Healthcare Systems

    Why This Episode Matters Quality improvement in healthcare is still too often treated as a series of isolated projects—well-intentioned, time-limited, and disconnected from daily operations. Despite decades of progress, this approach struggles to sustain change, reach every patient, or address equity at scale. This episode explores why that gap persists and what it takes to move from episodic improvement to system-level capability. It’s especially relevant for clinical leaders, quality executives, and educators trying to build improvement that actually lasts. The Arc of the Conversation This conversation traces Dr. Brian Wong’s journey from early exposure to system-level problem solving to his current role building quality improvement capacity across institutions. Rather than focusing on tools or frameworks, the discussion centers on how improvement becomes durable—through structure, relationships, education, and operational integration. What makes this episode different is its emphasis on how systems learn, not just how projects succeed. Key Ideas Explored Why project-based QI has a ceiling: Small, local projects can teach skills, but rarely sustain impact or scale across populations.Improvement without operations doesn’t last: QI efforts fail when they sit outside day-to-day workflows and resourcing.Structure shapes outcomes: Structural change creates the conditions for new behaviors and results to emerge.Equity requires system design: Improvement efforts can unintentionally exclude patients unless equity is embedded from the start.Education as a force multiplier: Building improvement capacity through training is foundational.Takeaways for Quality Leaders If improvement feels fragmented, ask whether your system is optimized for projects rather than learning.Notice where QI work depends on individual heroics instead of organizational support.Reflect on whether equity is treated as a separate initiative or built into how improvement is done.Consider how much protected time and infrastructure exist for people to improve the system they work in.Ask whether your organization is building capability or repeatedly relearning the same lessons.Pay attention to how improvement work is aligned (or misaligned) with operational priorities.Publications & Frameworks Explicitly Mentioned These are named in the transcript and are often things listeners may want to look up: SQUIRE Guidelines (Standards for QUality Improvement Reporting Excellence)Equity-focused QI scholarship“Equity in action: a scoping review and meta-framework for embedding equity in quality improvement" BMJ Quality and Safety 2024“Taking Action on Inequities: A Structural Paradigm for Quality and Safety” BMJ Quality and Safety 2024Continue the Conversation You can connect with Brian Wong on LinkedIn. Learn more about the Center for Quality Improvement and Patient Safety. This episode may be especially useful to leaders grappling with sustainability, scale, or equity in improvement work.  Consider sharing it with colleagues facing those same tensions. New episodes published every other Thursday at 7AM Eastern Time.

    1h 1m

  3. JAN 1

    Think Like a Scientist: Why Great Healthcare Leaders Don’t Pretend to Have the Answer

    Why This Episode Matters Healthcare organizations invest enormous effort in quality improvement projects, yet many struggle to achieve durable change. Too often, improvement is treated as something that happens at the frontline, while leadership behaviors, management systems, and organizational culture remain untouched. In this episode, Dr. Lee Erickson reflects on decades of hands-on improvement work to explain why real progress depends less on tools and more on how leaders think, learn, and show up. The conversation challenges familiar assumptions about accountability, expertise, and authority and offers a grounded alternative rooted in scientific thinking, transparency, and coaching. Key Ideas Explored Why improvement fails when leaders don’t change how they manageThinking like a scientist as a leadership skill, not just a clinical oneHow daily management systems surface problems early — without blameWhy spread depends on culture, trust, and peer-to-peer learningThe limits of outcome targets without process understandingBuilding networks of change agents instead of relying on heroic leadersTakeaways for Quality Leaders If you want front-line behavior to change, leadership behavior must change firstDon’t demand answers before experiments — design systems that allow learningUse data to create transparency and motivation, not fear or punishmentBuild truly interdisciplinary teams for complex problems like flow and dischargeTreat spread as a relational process, not a rollout planReplace command-and-control with coaching and problem-solving supportInvest in developing people who can think, test, and teach othersContinue the Conversation Connect with Dr. Lee Erickson on LinkedIn or through her organization Adaptient to continue the dialogue. This episode is especially useful for executives, physician leaders, and quality professionals trying to move beyond project-based improvement toward lasting cultural change. If this conversation resonated, consider sharing it with a colleague or leaving a thoughtful review. Resources & Frameworks Referenced Lean and Toyota Production System principlesA3 problem-solving methodologyPlan–Do–Study–Act (PDSA) cyclesLean Daily Management SystemsInterdisciplinary improvement teamsHelen Bevan’s work on change agents and spread (including the School for Change Agents)Incident Command System lessons from the COVID-19 responseNew episodes published every other Thursday at 7AM Eastern Time.

    1h 1m

  4. 12/18/2025

    Why Building Leaders May Be the Most Important Quality Improvement Work

    Why This Episode Matters Healthcare quality work often stalls not because of a lack of methods or data, but because organizations fail to build the leadership and culture needed to sustain improvement. In this episode, Dr. Todd Allen reflects on his journey from frontline emergency medicine to senior quality leadership at Intermountain Healthcare and The Queen’s Health Systems, and how his view of quality evolved from tools and measurement to leadership, trust, and psychological safety. The conversation explores the design and impact of physician leadership development as a core strategy for cultural change—offering a perspective on quality improvement that goes far beyond projects, dashboards, or checklists. Key Ideas Explored Quality and leadership are inseparable: Sustainable improvement depends on leader behaviors, not just methods.Psychological safety enables learning: Without it, clinicians won’t question assumptions or surface problems.Technical skills aren’t enough: Character determines how tools like finance, strategy, and operations are used.Culture changes through behavior: Daily actions—not slogans—shape how organizations function.Leadership can be measured: Imperfect measurement still supports learning and accountability.Takeaways for Quality Leaders If improvement fades, examine leadership capability before redesigning projects.Pay attention to whether people feel safe speaking honestly in leadership spaces.Don’t assume leadership will develop on its own—teach it deliberately.Treat skepticism as a signal of missing trust, not resistance.Look for character-based leadership in everyday decisions.Invest in leadership development as a system capability, not a one-off program.Continue the Conversation Connect with Dr. Todd Allen on LinkedInThis episode may be especially useful for leaders building clinical programs, leadership pipelines, or communities of practice.If this conversation resonated, consider Rating and commenting on it to help others find it.Sharing it directly with someone interested in for leadership development or shaping culture in your organization.Resources & Frameworks Referenced W. Edwards Deming and Total Quality ManagementIntermountain Healthcare Advanced Training Program (ATP)Crucial Conversations (Patterson et al.)Kotter’s Change Management ModelHigh Reliability Organization (HRO) principlesNew episodes published every other Thursday at 7AM Eastern Time.

    50 min

  5. 12/04/2025

    The Hidden Danger Outside the Hospital: How Families and Clinicians Reinvented Home Care for Pediatric Oncology Patients

    What if some of the biggest gains in patient safety aren’t inside hospitals at all—but at the kitchen table? In this episode, Dr. Amy Billett and Dr. Chris Wong walk us through the groundbreaking, cross-disciplinary effort at Dana-Farber/Boston Children’s in collaboration with Ariadne Labs that cut ambulatory central-line–associated bloodstream infections (CLABSIs) for pediatric oncology patients by ~50%. It’s a story of co-design, equity, humility, and design thinking—with families as full collaborators, not passive recipients. Instead of pushing out top-down fixes, the team built the work with families, home-care nurses, and even a checklist engineer who transformed dense clinical instructions into clear, waterproof (yes, literally waterproof), one-page cognitive aids that could survive kitchens, bathrooms, and real homes. They aligned inpatient teaching with home supplies, created universal clean kits to eliminate equity gaps, rebuilt teach-backs to remove shame, and translated materials into Spanish and Arabic so safety didn’t depend on luck or language. You’ll also hear how Amy’s three-decade career in pediatric quality and safety shaped the work—and how her mentorship of Chris helped fuel the next generation of system thinkers committed to closing the “know-do gap” in medicine. At a time when more care is shifting homeward, this episode offers a playbook for making safety real beyond the hospital walls. What We Cover The overlooked problem: Ambulatory CLABSIs after discharge and their impact on hospitalizations, chemotherapy delays, and family burden.Why usual fixes failed: Families were doing complex care with inconsistent, hard-to-use instructions not designed for home environments.Co-design in action: Families, clinicians, home-care nurses, and a checklist engineer created standardized, waterproof, one-page cognitive aids and aligned teaching with real home supplies.Human-factors design: The checklist engineer brought clarity, usability, and visual design clinicians alone couldn’t achieve.A new model for teachbacks: Judgment-free, normalized teachbacks led by nurse champions—resulting in >90% caregiver independence.Equity at the center: Universal clean kits and multilingual materials ensured safe care didn’t depend on resources or language.Leadership & mentorship: How Amy’s decades in pediatric safety and Chris’s drive to close the know-do gap shaped the work.Ripple effects: National collaboratives adopting ambulatory CLABSI prevention and emerging focus on home medication safety.Key Takeaways Safety challenges often live beyond the hospital.Co-design works—families reveal solutions clinicians cannot see alone.Usability matters: Clear language and well-designed tools drive real behavior change.Equity requires universal design, not selective support. Connect with Today’s Guests Dr. Amy Billett Best contact method: https://www.linkedin.com/in/amy-billett-a351501a6/ Dr. Chris Wong Best contact method: https://www.linkedin.com/in/chris-i-wong-ciepiel-884880145/Profile Link: https://www.uhhospitals.org/doctors/WongCiepiel-Chris-1407171804

    59 min

  6. 11/20/2025

    Values in a Crisis: Trust, Transparency, and the Culture That Endures

    What if the hardest part of quality isn’t finding the right answer, but making the right action unmistakable for the people who deliver care? That’s the thread we pull with Dr. Hilary Babcock—infectious disease physician, longtime infection prevention leader, and now chief quality officer helping steer a 12-hospital system of 33,000 people through transformation without losing its soul. We talk about learning to lead beyond subject-matter expertise and how COVID pressure-tested every leadership instinct. Hilary shares how she and her team turned dashboards into decisions, building a centralized quality hub with deep resources and a one-page “top five” for each priority so busy managers could act today. She explains why outcome views must be paired with real-time process visibility—knowing not just that CLABSIs ticked up, but exactly who is overdue for a dressing change right now—so data becomes a map rather than a mirror. We also go inside vaccine policy and trust. BJC implemented one of the nation’s earliest influenza mandates, treating it as a safety tool within a clear accommodation process. During the COVID rollout, transparency, values, and personal candor anchored tough choices about prioritization and access. The organization’s values—kindness, respect, excellence, safety, teamwork—moved from posters to practice, and a shift to centrally led, locally embedded quality teams helped spread best practices across hospitals while protecting local relationships. If you care about healthcare quality, leadership, and culture, you’ll leave with practical tactics and renewed optimism. Hit play, then share this with a colleague who wants to turn analytics into action. If the conversation resonated, subscribe, leave a review, and tell us the one change you’ll try this week.

    49 min

  7. 11/06/2025

    Human Factors as Healthcare’s Secret Advantage: How an Open Door and a Tiny Tube Revealed System Flaws

    A door swinging open in the OR. A tiny defect in IV tubing. Both seem trivial—until you realize they expose how fragile our systems really are. In this episode, Allie Muniak, Executive Director of Health System Improvement at Health Quality BC, shows how human factors turns everyday frustration into lifesaving insight. We follow her path from psychology to system redesign, uncovering how design, teamwork, and curiosity prevent harm long before checklists or policies do. Allie explains what human factors really means in healthcare—how people, technology, and environments interact under real-world pressure. She shares how normalizing observation as learning (not policing) helped surgical teams transform the safety checklist from a compliance tool into a culture of attention, anticipation, and role clarity. Then, a gripping case study: ICU nurses reporting spontaneous over-infusions after a new pump rollout. Rather than defaulting to “retrain the user,” a multidisciplinary team dug deeper—partnering with engineers and vendors to discover a hidden tubing defect that led to a global recall of hundreds of millions of sets. It’s a powerful example of how listening to the front line and rejecting blame can reshape safety worldwide. We close with lessons for every leader: slow down to see work as it’s really done, balance reactive review with proactive learning, and design systems that support clinicians instead of constraining them. If you care about real root cause analysis and systems that make the right action the easy one, this episode is for you. 🔗 Additional Resources Health Quality BC – Learn more about the organization’s work in system improvement and patient safety: ➡️ https://healthqualitybc.ca/ Allie Muniak – Executive Director, Health System Improvement, HQBC ➡️ LinkedIn: linkedin.com/in/allisonmuniak/?skipRedirect=true ➡️ Health Quality BC: https://healthqualitybc.ca/about-us/meet-our-team/allison-muniak/ 📚 Mentioned in This Episode The Checklist Manifesto by Atul Gawande — the seminal book behind the global surgical safety checklist movement. 👉 https://www.goodreads.com/book/show/6667514-the-checklist-manifestoSafety-I and Safety-II Framework (Erik Hollnagel) — foundational ideas for balancing reactive reviews with proactive learning. 👉 https://www.england.nhs.uk/signuptosafety/wp-content/uploads/sites/16/2015/10/safety-1-safety-2-whte-papr.pdf World Health Organization: Surgical Safety Checklist — global reference tool for surgical teamwork and communication. 👉 https://www.who.int/teams/integrated-health-services/patient-safety/research/safe-surgery

    37 min

  8. 10/23/2025

    Small Changes That Move Mountains: Metrics That Matter and the Outpatient Revolution

    A small change at the bedside can ripple across an entire system. That’s the spark behind this conversation with Dr. Khalil Sivjee, Medical Director at Cleveland Clinic Canada and pulmonary–critical care physician, as we explore how data, design, and relentless measurement turn delays into decisions and anxiety into action. We begin in the ICU, where a simple ventilator-liberation protocol challenged “that’s how we do it” and proved that even a junior clinician can drive measurable improvement. From there, Khalil zooms out to outpatient redesign—mapping the lung-cancer journey from first nodule to treatment and collapsing months-long waits by pre-ordering imaging, biopsies, and consults. Supported by EMR flags that signal when access drifts off target, this work redefines what it means to be data-driven. We unpack “metrics that matter”—from reducing “scanxiety” through faster imaging turnaround to tracking safety events and service-line dashboards that keep teams focused on what patients actually feel. Then the conversation expands into the workplace, where Cleveland Clinic’s corporate advisory model helps companies build healthier environments through smarter design—air quality, ergonomics, mental-health screening, and on-site “pre-primary” checks that spot hypertension and diabetes early. Finally, we look to the frontier of access: portable diagnostic kits and AI-enabled triage that bring care to students, remote workers, and underserved communities. The distance between a question and a clinical answer keeps shrinking. The takeaway: the future of outpatient care is near-home, proactive, and measurable. Put the patient at the center, bring services to them, and measure everything that matters. If this resonates, follow, share, and leave a review—and tell us the one metric you think every clinic should track. 🔗 Resources & Links Guest Links Dr. Khalil Sivjee – Cleveland Clinic Canada Profile: https://my.clevelandclinic.org/canada/staff/sivjee-khalilDr. Khalil Sivjee – LinkedIn: https://www.linkedin.com/in/khalil-sivjee-a3021a9a/ Specific References Mentioned in the Episode Cleveland Clinic Canada — Official site for outpatient and corporate health programs: https://my.clevelandclinic.org/canadaTytocare — Remote diagnostic platform discussed in the episode: https://www.tytocare.com

    44 min
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About

Welcome to Leading Quality, the show that dives into the real-world stories and strategies of healthcare quality improvement leaders at all levels, from Frontline Champions to C-Suite Executives.  Each episode uncovers how these dedicated professionals tackle complex topics in real healthcare environments.  Discussion range from QI fundamentals, to leadership, technology, AI, and beyond. If you’re passionate about elevating patient care and want practical insights that go beyond the buzzwords, this podcast is for you. Tune in for inspirational conversations, innovative frameworks, and the behind-the-scenes details you won’t hear anywhere else, and discover how you, too, can lead quality improvement from wherever you stand in healthcare. 

Information

  • Creator
    Jason Meadows, MD
  • Years Active
    2025 - 2026
  • Episodes
    13
  • Rating
    Clean
  • Copyright
    © 2026 Thrive Healthcare Improvement
  • Show Website
    Leading Quality