Setting Up Enterprise Quality Office Structure and Governance

Magnitude of Avoidable Patient Harm

The landmark Institute of Medicine report “To Err is Human” reported that an estimated 44,000-98,000 deaths occur each year in US hospitals due to avoidable medical errors. Subsequently, other researchers have estimated that this number may be as high as 200,000 deaths per year due to avoidable medical errors. There is also a huge financial cost to medical errors, totaling approximately 29 billion US$ per year. This presents an enormous challenge to the healthcare provider community, whose first aim is to “Do No Harm” according to the Hippocratic Oath. Data in most developing countries, and even in many emerging market countries about medical errors and avoidable harm are non-existent. Anecdotal reports point to a high degree of avoidable harm.

Quality of care should be considered a critical pillar of any healthcare organization’s mission. Robust measures should be developed, implemented and monitored to ensure continuous quality improvement and error-free care.

Providing high quality care should be the number 1 priority of all healthcare systems. Quality is the backbone of everything we do, or should strive to do, in healthcare. This requires engagement of all staff at all levels. High quality systems truly believe that “Quality is Everyone’s Job”, from the top-most executive to the junior-most employee of the organization. Such organizations also realize that quality is a journey, not a destination. This mindset requires everyone to be vigilant every day, every week, every month, and every year and continuously strive to improve.

Academic health systems and healthcare systems are increasingly complex organizations with multiple complementary and parallel missions. To be successful, they need to excel in all areas. There are three traditional pillars of these organization: Service, Education and Research. However, we firmly believe that a fourth pillar, Quality, should be central to the mission of all healthcare organizations.


In such complex landscape, a central office or department needs to bring all elements of Quality and Patient Safety under one roof. Having a “Quality Department” is now an essential element of high quality healthcare organizations.

We have experience in creating the framework, organizational structures, governance and monitoring of Corporate and Enterprise Quality Departments at local, regional and national levels across the globe. We can provide the expertise, training and related materials for successful creation of such department.

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