As CEO of NAHQ, Stephanie Mercado spends a lot of time thinking about three things critical to the success of her organization: people, infrastructure and technology. And it’s the people, she notes, that leverage the other two resources.

This primary importance of people to realizing any organizational objective is true throughout healthcare, and that crystallizes the path forward to achieving higher quality care with better outcomes at lower cost.

The challenge of workforce readiness to deliver on value in healthcare is real. As real as it is, it continues to be unmet and an often-unrecognized element of advancing change that is so desperately needed in healthcare.

“It’s time to use competency-based training as a core lever to move the needle on important healthcare issues,” she says. “And it’s time to leverage quality and employee engagement as a business strategy.”

Securing Senior Leadership Buy-in

While senior executives are eager to improve quality and realize the promise of value in healthcare, they likely need more information to commit to investing in their quality workforce’s competency development as the way to achieve those goals. It will take showing them data and presenting a call-to-action.

Here’s how to be credible and compelling as a champion of healthcare quality competencies:

Articulate the problem.

Despite years of important improvement efforts ranging from adoption of EHRs to evidence-based protocols, progress on value in healthcare has been limited for much of U.S. healthcare. A recent Kaufman Hall study found just 13% of healthcare organizations are ready to execute value-based payment and delivery models. The reason: “Healthcare leaders lack a consistently coordinated, competent healthcare quality workforce to deploy the quality competencies and they lack the systems at the implementation level to achieve value,” Mercado says.

For the quality workforce, NAHQ’s new report, Key Workforce Competencies for Quality-Driven Healthcare, provides hard data and analysis of quality professionals’ self-assessed readiness to help their organizations succeed with value. It presents the NAHQ Healthcare Quality Competency Framework representing the validated industry-standard practices in quality work, but documents a high degree of variability in experience, training, and competencies among the healthcare quality workforce nationwide that must be overcome to achieve value. The report encourages healthcare executives to contemplate the readiness of their own workforce.

Educate the leadership.

Often times there is confusion about the difference between competency-based training and other training solutions. Mercado says, “Analogous to healthcare, competency-based training is akin to disease management, while other quality training solutions are symptom relief,” she explains. “We train with a total solution to address deep-seating competency gaps while other training programs identify and solve problems at the surface level, often one at a time.”

Mercado says this is also often just-in-time training to solve issues of the day, putting leaders in a situation of mopping up the floor when through competency-based training they could more easily turn off the faucet.

Identify solutions.

NAHQ’s workforce report offers a detailed and explicit roadmap for taking the quality workforce’s effectiveness to a new level of performance. Concrete steps include:

Adopting a universal standards-based competency framework, much as consistently applying evidence-based best practices are elevating clinical care. The NAHQ Healthcare Quality Competency Framework sets specific job requirements and capabilities across eight domain areas and 29 competency statements. The competencies, supported by 486 measurable behaviors, apply to all settings across the continuum and offer a career development path.

Encourage your team to take the NAHQ Self-Assessment so they can understand how they are achieving the industry standard in healthcare quality competencies to help your organization improve.

Invest in training and education that advances quality professionals’ capabilities, in both foundational responsibilities and new areas that are increasingly critical to improving value.

In addition, other resources and data underscore the importance of workforce training. The third annual LinkedIn workforce report says the shelf-life of skills is decreasing due to the pace of change and technology advances, Mercado says. LinkedIn recommends organizations train and re-train their teams to stay competitive. NAHQ offers both.

Show results.

It’s important that leadership know their investment will pay off. Some pioneering healthcare organizations have leveraged their investment in quality competencies to improve care while delivering impressive financial benefits as well. UHS and Lifespan, for example, have delivered multimillion-dollar savings and improved patient outcomes.

Several leaders explained their strategies and results at the recent NAHQ National Healthcare Quality Summit, including Intermountain, Lifespan and UHS.

Investing in quality workforce competencies delivers “a hard ROI to take to senior leadership,” Mercado says. The investment means “we are helping patients and saving money.”

Another benefit is stronger employee engagement and retention. “Just as healthcare is moving to a population health model to treat the whole person and not just acute episodes, quality workforce readiness can take a similar approach with a similar payoff,” Mercado says. “It’s time to move upstream in workforce training,” she says. By building quality competencies, organizations can “move from just-in-time remediation for solving acute business issues to focus on preventing workforce issues.”

To learn more about how your quality experts can support efforts to cut waste and drive better outcomes and costs, please contact NAHQ at

– Stephanie Mercado, CAE

Chief Executive Officer and Executive Director