Improving Quality Manager (QM) Resiliency with Open Communication and Trust between the QM and Program and Organizational Leaders

Background The QM role in the field of transplantation and cellular therapies is specialized. QMs may be at risk for stress and burnout, which results in low resiliency/less ability to recharge during change. Since 2017, the ASBMT Administrative Directors SIG Quality Working Group and the FACT Quality Management Committee have collaborated to identify opportunities to improve the resilience of the QM [1] . Methods A 59-question survey was created to collect anonymous data on the QM's personal resilience and the perceived benefits of improved resilience. Information was gathered regarding program size and complexity and key program personnel responsibilities and interpersonal interactions in order to assess work stressors associated with the QM role. The survey included a validated “Brief Resilience Scale” (BRS) [2] which quantitatively measures resilience (1 = low to 5 = high). A total of 98 QMs of the 130 U.S. hematopoietic cell transplant program respondents who completed the BRS and identified the QM role as their primary engagement were included in this analysis. Findings The mean and median BRS scores were 3.82 ± 0.67 and 4 respectively (range = 1.67 to 5). A link between improved resilience and increased productivity was reported in 75% of respondents. Two themes were evident from the data: trust and communication. Trust in their program director was reported by 77% of respondents, but only 42% reported this trust in senior executives and 56% in senior directors (Fig. 1). Those who reported trust in their senior directors and executives had statistically significant higher mean BRS scores, 4.00 and 4.11 respectively. While not reflected by lower BRS score, a proportionally high number of QMs reported that they did not engage in regular 1-to-1 meetings with their direct manager (27%), program director (45%) or organization's quality department (79%) (Fig. 2). Discussion Results for communication and sense of trust between QMs and organizational leaders varied. Lower than expected levels of 1-to-1 engagement between QMs and senior leadership did not always result in an observable decrease in the BRS score, and levels of trust between QMs and their program directors remained high. Interactions offer opportunities to strengthen communication and a sense of trust and to educate organizational leaders on the program's complexity and the crucial role of the QM. QMs must promote professionalism in quality and the importance of the QM to the program's success. At this time, further analysis into relationships between communication and trust may identify influencers which can be leveraged to improve QM resiliency.