Preparing Clinician-Leaders for the Next Era of Quality and Safety
As health care grows more complex, clinician-leaders must go beyond clinical expertise to cultivate purpose-driven, data-informed, and collaborative leadership that advances quality, safety, and trust across their organizations.
In today’s evolving health care environment, clinical expertise alone is no longer enough to help organizations succeed. With hospitals and health systems facing unprecedented challenges, including financial pressures, staffing shortages, growing complexity of care, and rising patient expectations, clinicians are increasingly being called upon to lead initiatives in quality, safety, and organizational improvement. Yet few clinician-leaders have received formal preparation for these responsibilities. Many move into leadership roles driven by their passion and experience, but soon realize they must also master new ways of thinking—about systems, communication, and teamwork—to achieve real change.
Patricia Folcarelli, RN, MA, PhD—the chief nursing officer and senior vice president for patient care services at Beth Israel Deaconess Medical Center and a faculty member in Harvard Medical School’s Safety, Quality, Informatics, and Leadership certificate program—has seen this evolution firsthand.
“Twenty-five years ago, quality and safety were just beginning to gain traction,” she recalls. “Today, they’re central to how we evaluate care—and clinicians are expected to lead the charge.”
Core Capabilities That Distinguish Effective Leaders
Through her work with emerging and experienced leaders, Folcarelli has observed that the most successful clinician-leaders share a set of capabilities that allows them to guide improvement amid uncertainty. They lead with purpose, create cultures of trust, partner closely with patients, learn from data and experience, and invest in the growth of their teams.
“These aren’t separate skill sets,” she says. “They reinforce one another, and together, they shape how leaders think and act when the stakes are high.” Folcarelli also stresses that since most leaders don’t come to their jobs excelling in these areas, it’s important for them to find opportunities that will enable them to develop this expertise.
She highlights five key capabilities that clinicians seeking to advance quality and safety within their organizations can cultivate through continuing education programs, networking opportunities, and other experiences to increase their effectiveness.
- Leading with Clarity and Empathy
At a time when health care workers are stretched thin, leaders who can communicate purpose and empathy will make the difference between burnout and engagement. Clinicians care deeply about their patients and their colleagues.
When they understand how their daily work connects to a bigger mission—such as by personally seeing that quality and safety are about helping people thrive—clinician-leaders find renewed energy, Folcarelli says. Purposeful leaders also set a tone of integrity and steadiness. They articulate the “why” behind change, create space for questions, and model respect in every interaction. This combination of clarity and compassion helps their teams stay focused, even when conditions are stressful or rapidly changing.
- Building a Culture of Safety and Trust
Every high-reliability organization starts with psychological safety. “People need to know they can speak up without fear of blame,” Folcarelli emphasizes. “If something doesn’t go as planned, that’s when learning happens.”
A true culture of safety is less about new rules and more about how people treat one another. It grows when leaders listen actively, respond constructively, and show that reporting an error is an act of professionalism, leading toward improvement rather than a failure. When caregivers feel safe to raise concerns, teams become stronger, and communication flows more freely. Over time, this trust fosters a mindset of shared accountability where everyone, from frontline nurses to senior executives, sees themselves as tasked with overseeing safety.
- Partnering with Patients and Families
One of the most powerful shifts in quality and safety work in recent years has been the recognition that patients and families are vital partners for improvement. “We’ve seen better results when patients are included in safety boards, room design, and quality committees,” Folcarelli says. “It’s not just symbolic—it changes the way teams think and act.”
Partnership can take many forms, from inviting patients to co-design discharge materials to incorporating family feedback into daily huddles to using digital tools to improve communication after a hospitalization. Such collaborations bring real-world insights to the table and remind teams why transparency and respect matter. When patients feel heard, they contribute ideas that lead to safer systems and more compassionate care. They are also apt to feel more satisfied with their overall care and experience.
- Learning from Data and Experience
While compassion and communication are essential, data remains a cornerstone of improvement. The key, Folcarelli notes, is knowing how to interpret information in ways that drive meaningful change. “Data can tell a story—but you need to know how to read it and, more importantly, how to act on it,” she says.
Clinician-leaders who are comfortable with data can use it to start conversations, not just fill dashboards. They ask questions such as: What’s behind these numbers? What do they tell us about our processes, our patients, and our people? By combining quantitative results with frontline experience, leaders can identify patterns, understand root causes, and design practical solutions. The goal isn’t perfection, Folcarelli stresses. Rather, it’s progress built on insight and reflection.
- Cultivating Continuous Learning and Team Development
Folcarelli points out that health care is evolving too quickly for anyone to lead alone. Sustainable improvement depends on teams that learn together. “Sometimes you need help from people who are a step ahead—or even two steps ahead,” she says. Trading advice and experiences with colleagues, both inside the organization and beyond, can be invaluable.
Effective clinician-leaders also nurture learning in others. They celebrate small wins, share lessons openly, and invest in their colleagues’ growth. Whether through mentoring, cross-disciplinary collaboration, or peer discussions, they cultivate resilience and adaptability across the organization. In doing so, they help create a workforce that is not only more skilled but also more hopeful, viewing improvement as a shared journey rather than a top-down mandate.
The Path Forward in Quality and Safety
As the landscape of health care continues to shift, clinician-leaders who take the time to build their skills in these areas will be well equipped to handle the challenges that arise and effectively steer their organizations through uncertainty. They will also be well positioned to help redefine what leadership in quality and safety looks like, with a focus on connection and collaboration.
“Quality and safety aren’t destinations,” Folcarelli stresses. “They are ongoing commitments—to our patients, to our teams, and to ourselves. This is essential to ensure that health systems implement the highest level of quality and safety for everyone involved.”