Leading Quality
Leading Quality is a podcast that explores real-world stories and strategies of healthcare quality improvement leaders, from frontline champions to C-suite executives. Each episode covers topics such as QI fundamentals, leadership, technology, and AI, offering practical insights for improving patient care. The show aims to provide inspirational conversations and innovative frameworks for those passionate about healthcare quality.
Episodes
ICYMI: Change Happens at the Speed of Trust: Lessons from a Decade of Physician-Led Improvement
This week, we're revisiting one of the earliest episodes of Leading Quality—and a conversation about what it really takes to build lasting improvement capability in healthcare. We'll be back with an all-new episode in our next release.How do you build a culture of quality improvement across an entire healthcare system? And what happens when you start with frontline clinicians rather than
How Do You Build a Safety Culture That Survives Leadership Turnover?
Why This Episode MattersHigh reliability is often treated as a collection of visible practices: safety huddles, rounding, event review, reporting systems. But Nicholas Testa argues that the practices matter only if they create an organization that can reliably surface risk, learn, and respond. The harder leadership problem is durability: can those behaviors continue when the CMO changes, the CEO
Lessons From Year One: Leading a Healthcare Learning System
Why This Episode MattersHealthcare organizations cannot learn simply because they have dashboards, safety reports, improvement methods, or formal escalation processes. Learning depends on whether people can surface what leaders do not know, challenge assumptions, admit uncertainty, and act on problems without making truth-telling personally dangerous. This second year-in-review episode examines th
Lessons From Year One: Building a Healthcare Learning System
Why This Episode MattersHealthcare organizations can run hundreds of improvement projects without becoming fundamentally better at improvement. After 26 conversations in the first year of Leading Quality, a larger question emerged: what makes an organization capable of learning repeatedly, across problems, teams, and time? This episode examines the difference between having people who know improve
Designing High-Velocity Organizations in Healthcare with Dr. Steve Spear
Why This Episode MattersHealthcare organizations often tolerate ambiguity, workarounds, and recurring operational problems until they produce serious harm. Dr. Steve Spear explains how leaders can apply the same disciplined thinking used in clinical diagnosis to the systems in which care is delivered—making problems visible early, investigating them rigorously, and building problem-solving capabil
Healthcare Needs a GPS for Life Outside the Hospital with Dr. Joshua Liu
Why This Episode MattersPatients spend most of their lives outside the hospital, yet healthcare teams often have limited visibility into what happens after discharge, between visits, or during long-term recovery. In this episode, Dr. Joshua Liu discusses how SeamlessMD was built to close that gap by helping patients navigate clinical journeys, giving care teams better insight into patient progress
Why Healthcare Improvement Gets Stuck in the Sidecar with Ken Segel
Why This Episode MattersHealthcare has made real gains in quality and safety, but Ken Segel argues that too much improvement work still lives as projects, dashboards, or specialist-led initiatives rather than as part of how organizations are run every day. This episode examines what it takes to move from episodic improvement to habitual excellence: a clinical operating system where safety, flow, p
Putting Safety Into the Genome of Healthcare with Dr. Peter Lachman
Why This Episode MattersPatient safety has often been built around what happens after harm occurs: incident reports, investigations, accountability, and corrective action. In this episode, Dr. Peter Lachman argues for a more proactive and moral view of safety: one where teams talk about risk every day, anticipate who may be harmed next, and make safety part of the “genome” of healthcare education,
Why Healthcare Leaders Only See the Tip of the Iceberg with Maria Mentzer
Why This Episode MattersHealthcare organizations often know they have problems with flow, safety, delays, frustration, and waste, but they may not actually see the work clearly enough to solve them. In this conversation, Maria Mentzer explains how See to Solve helps organizations surface hidden problems, involve the people closest to the work, and build practical problem-solving capability through
The Architecture of Belief: Amar Shah on Improvement at NHS Scale
Why This Episode MattersHealthcare organizations often treat improvement as a set of projects, tools, or training programs. Amar Shah’s work at East London NHS Foundation Trust (ELFT) and NHS England points to something larger: the long-term work of building belief, capability, infrastructure, and leadership routines so improvement becomes part of how a health system thinks and operates. This conv
From Needle-in-a-Haystack to 95%: AI, Goals of Care, and Systemwide Change
Why This Episode MattersGoals-of-care conversations can profoundly shape serious illness care, but in many health systems they remain difficult to find, inconsistently documented, and hard to measure. In this episode, Matthew Gonzales and Deborah Unger describe how Providence treated serious illness communication as a systemwide quality problem, combining leadership commitment, clinician training,
Building the Next Era of Healthcare Quality: Lessons from Belgium’s FlaQuM Model
Why This Episode MattersFor years, many Belgian hospitals invested heavily in accreditation. It brought structure, standards, and visible progress. But Kris Vanhaecht and other healthcare leaders began to notice a deeper problem: when accreditation became the goal, quality could become episodic. Energy rose before the survey, then faded after the label was achieved.The question became how to keep
Annie’s Story and the Hidden System Behind the Critical Error
Why This Episode MattersToo many healthcare organizations still respond to safety events as if the main question is who made the mistake. This conversation offers a better lens: what in the system made the event possible, and how can leaders learn early enough to prevent the next one?Using Annie’s story, Dr. Terry Fairbanks explains why strong event review matters, why timely response matters, and
Can AI Improve Clinician Well-Being?
Why This Episode MattersHealthcare organizations are investing heavily in new technologies, yet many implementations unintentionally add complexity to clinicians’ daily work. This episode explores a different question: what if we deliberately evaluate tools for their ability to reduce friction and support clinician well-being?Dr. Chris Dale and Dr. Ryan Dix discuss the development and evaluation o
Why So Much Healthcare Quality Work Fails to Change the System (And What You Can Do About It)
Why This Episode MattersMany healthcare organizations say quality matters. Far fewer are built so improvement is part of daily operations. Too often, quality is treated as a department, a committee agenda, or a set of projects at the edge of the real work.In this conversation, Dr. David M. Williams offers a different frame. He argues that quality should function as an organizational strategy: clar
Leading with Love: Culture Change After a Healthcare Merger
Why This Episode MattersQuality functions in healthcare often struggle with perception. Too frequently, they are viewed as auditors or enforcers rather than strategic partners in improvement. In complex environments like post-merger health systems, this perception can become an even greater barrier to progress.In this episode, Lisa Harton, DNP, MBA/MPH, RN shares a grounded, experience-based appro
Closing the Gap Between Potential and Performance in Healthcare
Why This Episode MattersHealthcare organizations are rich with intelligence, talent, and commitment. Yet leaders across systems feel exhausted, constrained, and stuck solving the same problems year after year.In this conversation, Dr. Laura Desveaux challenges the idea that improvement is primarily about adding more initiatives. Instead, she reframes leadership as the disciplined practice of learn
Building the Support System Family Doctors Have Been Missing
Why This Episode MattersIn health systems around the world, the promise of better data is often discussed—but rarely realized in a way that actually supports clinicians at the point of care. In this episode, Gayle Grout shares her journey from technology and consulting into leading the Health Data Coalition of British Columbia (HDC), a physician-led not-for-profit organization that aggregates elec
What Does a Chief Quality Officer Actually Do?
Episode SummaryWhat 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 exp
Building Improvement Into the DNA of Healthcare Systems
Why This Episode MattersQuality 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 impro
Think Like a Scientist: Why Great Healthcare Leaders Don’t Pretend to Have the Answer
Why This Episode MattersHealthcare 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 wo
Why Building Leaders May Be the Most Important Quality Improvement Work
Why This Episode MattersHealthcare 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
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 b
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 abo
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, te
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 challeng
How a High Reliability Transformation Cut Preventable Harm by 90%
Safety isn’t a side project. It’s the operating system. We sit down with Paul Lambrecht, a rare blend of front line paramedic sensibility and executive discipline, to unpack how high reliability organizing moves from idea to front line work. From standing up daily safety huddles to building a just culture where ARCC and SBAR actually get used, Paul explains how to turn near misses into gold, flat
Change Happens at the Speed of Trust: Lessons from a Decade of Physician-Led Improvement
As Stephen Covey once wrote, "Change happens at the speed of trust." This simple yet profound insight applied by this week's guest, Dr. Curt Smecher captures the essence of how British Columbia's Physician Quality Improvement program transformed healthcare from the ground up. Affectionately known as "Papa QI," Smecher shares the remarkable journey of creating a physic
From 1 to 4 CMS Stars: A Quality Transformation Journey
What transforms a one-star hospital into a four-star institution in just four years? The answer lies not in fancy technology or complex solutions, but in approaching problems with genuine humility and data-driven focus.Dr. Kimiyoshi Kobayashi brings a refreshing perspective to healthcare quality leadership in this illuminating conversation. As Chief Medical Officer at UMass Memorial Medical Center
Finding Joy in Healthcare: One Physician's Journey from Burnout to Advocacy
Dr. Lawrence Yang's powerful story begins with a stark confession: "My body had to say no for me because I didn't know how to do it myself." This candid admission sets the tone for a conversation that weaves together personal vulnerability, system transformation, and the science of hope.As a family physician who once installed a bedroom and shower in his clinic to work longer h
Introduction - Leading Quality
Healthcare is more complex than ever — with patients seeing multiple specialists, interacting with advanced technology, and relying on coordinated teams to deliver safe, effective care. In this introductory episode, host Dr. Jason Meadows shares why he created Leading Quality and what listeners can expect. This podcast will spotlight the people — from senior leaders to frontline innovators — who
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