10 Tips for Leading Quality Improvement as a New-in-Practice Pathologist

Quality improvement (QI) is a powerful way to enhance patient care, streamline workflows, and foster a culture of safety. In pathology, QI can include initiatives aimed at reducing diagnostic errors, improving turnaround times, enhancing test utilization, promoting operational efficiencies, reducing waste, reducing costs, and strengthening communications between healthcare departments. If you're early in your career, or new to your organization, it can feel daunting to drive change when you're not yet in a formal leadership role. 
Here are 10 practical tips to help you successfully lead a QI process change, even as a new-in-practice pathologist:

1. Start with a Problem That Matters

Choose a project that aligns with both institutional priorities and frontline operational challenges. Some questions you can ask yourself include: 

• Where are the bottlenecks, safety risks, or regulatory/quality gaps?
• What would make a meaningful difference for patients or staff?

Starting with a problem that resonates will help you gain buy-in and sustain momentum.

2. Build a Coalition Early

Identify stakeholders who are affected by the issue and invite them to be part of the process. Seek understanding of the current process and alignment of new proposed changes. Stakeholders may include: 

• Nurses
• Front desk staff
• Other physicians
• IT or data analysts

Showing respect for others' expertise and perspectives will earn you mutual respect and credibility. Although identifying and engaging all stakeholders is a significant time and labor investment, this exercise is worth the effort. Your QI project is destined to fail if implemented in a silo. Building relationships early fosters shared ownership and increases the likelihood of sustainable change.

3. Use a Framework

Follow established QI models such as:

• PDSA (Plan-Do-Study-Act)
• Lean
• Six Sigma

These frameworks help provide structure if you don’t know where to start. 
References: www.ihi.org, www.ahrq.gov, www.lean.org, www.jointcommission.org, www.asq.org, www.goleansixsigma.com

4. Also Communicate the Personal Benefits

Change is more likely to happen when people understand how it benefits them personally. Will your proposed process change lead to less work or interruptions on behalf of the stakeholder? Although you may have obvious reasons for process improvement (e.g. regulatory compliance, cost reduction), you might be surprised that even obvious reasons are not enough. Focusing on personal benefits can capture the attention of stakeholders and gain easier buy-in. 

5. Start Small and Iterate

Don’t try to fix everything at once. Pilot your change on a small scale and learn from the results. Iteration is key to sustainable improvement.

6. Leverage Data Wisely

Data doesn’t have to be perfect. Start with what’s available:

• EMR reports
• Manual chart reviews (ideally pulled in a sustainable manner)
• Staff or patient surveys

Track a few key metrics and don’t forget to visualize progress over time.

7. Frequent Communication 

Keep your team and stakeholders in the loop. Share wins, setbacks, and lessons learned. Use brief huddles or other forms of communication to maintain engagement. Visuals are an effective and efficient way to share data. 

8.  Share you Successes

Even small wins deserve recognition. Celebrate progress with your team and consider presenting your project at a departmental meeting. Recognize and reward individuals who have embraced the QI change and contribute to its success. 

9. Find a Senior Mentor 

A senior mentor can help you navigate institutional politics, access resources, and amplify your voice. Don’t be afraid to ask someone you respect to support your efforts. Senior allies include your department chair, laboratory director, CLIA director, medical director, etc.  

10. Be Patient and Persistent

Change takes time. Without a doubt, you will encounter resistance, delays, or data challenges. Do not give up. Stay curious, flexible, and focused on the “why” behind your project.

Leading QI as a new-in-practice pathologist is possible! You bring fresh eyes, frontline insight, and a deep sense of purpose to your professional life. With the right approach, you can drive meaningful change and grow as a leader in the process.
 

Jennifer Woo, MD, FCAP, is a pathologist at City of Hope National Medical Center in Southern California with primary focus on transfusion medicine. She is a member of the New-In-Practice Committee at the CAP.