Quality Management: External Consultant Or In-House Manager

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Quality Management: External Consultant Or In-House Manager

Quality Management (QM) and Performance Improvement initiatives have always been a part of healthcare, but have become increasingly important as we shift to a value-based environment. A good QM team will ensure that your facility complies with best practices, reduces costs, gains a competitive advantage, and maintains high quality standards. As an administrator, you may be wondering if it is more efficient to rely on an in-house quality manager or an external QM consultant. Does the choice depend on the size, culture, or operations of my business? Is the answer the same for every organization?

While cost is an obvious factor, there are pros and cons to both maintaining internal staff and outsourcing. Further, it is possible to outsource some portions of QM without outsourcing the whole thing. In this article, we will examine those factors:



Having your own full-time staff may require you to pay out benefits which can add to the cost of having in-house QM staff relative to hiring someone external. On the other hand, the cost of a QM consultant may be less predictable and can range greatly depending on past experience and whether you pay per hour or based on the project.

Organizational Expertise

Large organizations tend to have in-house QM staff because employees will tend to gain a deeper understanding of the specific company. These people know who has the power to move initiatives in the organization, are knowledgeable about your core competencies, and may hold better authority because they are known throughout your facility.

On the other hand, QM consultants have worked with a range of businesses and bring expertise that may not exist within your organization. Seeing that the company has “brought in” a consultant may reinforce the importance of QM for your staff.


Having a quality manager on-site can be a great relief during surprise inspections or when any of your staff has questions on best practices. Depending on your contract with external QM staff, you may not be able to get a rapid response.


Organizational insurance typically covers liability expenses incurred by the actions of a full time employee, but not by those of contract employees or external consultants. Consultants have their own insurance, but it may not be adequate for your needs should something go wrong.



Outsourcing your QM consulting works best for small to mid-size companies. Cheaper costs, external experience, and perceived authority tend to outweigh the downsides in these settings. Larger companies may prefer in-house quality managers because they have a deeper knowledge of the company and are covered by the organizational insurance. In situations where these companies prefer an external consultant, they can alleviate these downsides by negotiating terms, for example by setting up a long term account or checking for broader liability coverage.

Here are some questions to ask yourself in deciding an in-house quality manager or an external consultant:

  1. What are the unique needs of the organization’s QM program? Are these needs long term or for a certain period of a time?
  2. How well is the QM defined in the organization? Does it require individuals with specific skills widely available in work force or special skills that are hard to find?
  3. What is the budget for quality management program? Is it enough to house a manger or hire a consultant?
  4. How important is it to have quality manager to grow within the organization?
  5. What is the time commitment and availability requirements and who would meet these better?

Quality management is a thought process that creates value and efficiency in an organization. We recommend that you evaluate your QM system year or with changing market and organizational needs to maximize its function.






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