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The Clinical Quality Leader I reflects the mission, vision, and values of NM, adheres to the organizations Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. Participates with interdisciplinary clinical groups to define, measure and analyze quality and patient safety issues and practice concerns on behalf of quality committees. Defines, collects, analyzes and presents data cogently to identify trends. Masters relevant evidence and literature in relevant clinical area, discipline, and improvement science. Participates in and may lead improvement activities utilizing DMAIC, Lean, and other performance improvement tools as appropriate. Applies knowledge of professional standards, current research, best practices, and interdisciplinary collaboration to advance problem analysis and resolution and creative process redesign. Participates in developing policies, procedures and standards advancing clinical quality measurement. Description Core Quality Leader Functions
Work cooperatively and collaboratively with physicians and staff at all levels of seniority to define and achieve common aims.
Model, teach and improve a culture of safety and shared improvement.
Focus primarily in departmental and service line committees or focused improvement teams
Partner with operational and medical leadership to identify, develop and implement successful communication, education, and process solutions to engage staff and produce improved processes and outcomes.
Collaborate with medical staff leadership to select measures for Ongoing and Focused Professional Practice Evaluation (OPPE/FPPE).
Select, investigate and prepare clinical cases referred for peer review for medical staff (as assigned).
Coordinate peer review cases for individual department meetings and QI Subcommittee and assist department leadership with the completion ofpeer review minutes/forms (as assigned).
Support medical and hospital staff in data collection and analysis to accurately detect patterns or trends in quality and patient safety information. Perform medical record reviews and other data collection activities that assist in identifying potential quality issues and opportunities for improvement in patient care services.
Lead or participate in hospital wide committees/councils, performance improvement projects, and RCAs/FMEAs.
Produce/assist in the production of committee meeting minutes, reports, dashboards, and related correspondence.
Research and develop quality measurement, evaluation and improvement approaches with support from manager/mentor/peers.
Prepare assessments and recommendations for local committees and teams.
Develop skills to contribute to organizational learning and dissemination through publication, presentation, collaboration with clinical colleagues on these efforts.
Lead/Facilitate multidisciplinary QI projects resulting in measurable results Knowledge/Expertise
Maintain familiarity with the core literature and resources, and national, state and local regulatory and accreditation requirements, e.g. those related to clinical quality improvement, patient safety, human factors, failure modes, root cause analysis, and related performance and safety resources.
Apply professional clinical knowledge and other clinical standards, best practices, and interdisciplinary collaboration, relevant to assigned clinical area, to advance problem analysis and resolution and creative process redesign.
Integrate and innovate tools to promote standardized evidence-based clinical practice as appropriate (i.e., standardized order sets).
Facilitate the use of quality management principles and performance improvement tools. External
Assist clinical teams and leadership to respond to quality-related queries from external constituencies: patients, families, payers,media, researchers, etc.
Assure compliance with relevant quality / process improvement regulatory and accreditation requirements.
Master relevant clinical, quality measurement, patient safety and measurement as pertinent to assigned clinical ar ea. AA/EOE
Required: - Bachelors Degree in Nursing or an Allied Health Profession, or a Masters Degree in a healthcare related field
3+ years of recent experience in a professional healthcare environment
Medical record review/abstraction competence
Working knowledge of performance improvement methodologies (i.e. DMAIC), analytic tools and methods; familiarity with basic statistics as related to healthcare quality
Relevant computer skills (Excel, PowerPoint, Word, electronic medical records, clinical databases)
Effective leadership, facilitation, and communication (oral, written) skills.
Strong writing and presentation skills, good organizational skills, and excellent critical thinking skills.
Exceptionally strong interdisciplinary collaboration skills are needed. Preferred: - Quality management experience
Certified Professional in Healthcare Quality (CPHQ) or Certified Professional in Patient Safety (CPPS), masters degree and/or other evidence of advanced commitment to profession.
Knowledge of guidelines, healthcare standards, and regulations
Experience with clinical outcomes, safety, and patient satisfaction data
Evidence of publishable work (research, quality reports, clinical summaries)