Job Description

Full-Time - 1.0 FTE/80 Hours Biweekly

Day Shift

Primarily M-F with occasional off-shift and weekend coverage, if needed

General Summary

Uses data for healthcare quality and safety measures to review for trends and gaps related to documentation of clinical practice. Facilitates quality performance initiatives to achieve evidence-based practice outcomes. Prepares unit-level quality performance reports. Elevates and communicates gaps and opportunities with improvement recommendations through established channels to improve care quality and safety. Partners with nursing leadership and entity Quality, Safety and Accreditation to ensure departmental readiness. Participates in development and implementation of quality assessment indicators. Provides project management for selected planning and operational implementation of quality initiatives, developing project work plans, impact and communicating progress and any identified risks. Assists in coordination, development, and training with the goal of efficient intra-council interfacing to maximize outcomes.

Duties and Responsibilities

• Provides project oversight, including planning, scheduling, vendor management, risk assessment, change management, time management, interpersonal leadership skills, and project control.
• Collaborates with key stakeholders to develop action plans driven by Nurse Sensitive Indicators metrics and annual strategic quality objectives.
• Applies lean and process improvement principles and quality improvement tools and techniques to identified processes/systems/ tasks.
• Creates timelines and deliverables for workflow development, implementation and monitoring for selected quality measures.
• Compiles data for and prepares regularly scheduled or special reports, analyses and statements.
• Educates to measure definitions when sharing data. Facilitates conversations and assists staff to identify and translate quality outcomes into a change in practice (e.g., policy, procedure, process, protocol, etc.).
• Researches and analyzes requests, using knowledge of the system network and internal and external resources, for possible process improvement/quality improvement opportunities, as assigned by the Director, Vice President-Medical Affairs, or Regional Director.
• Provides consultation regarding data analysis and interpretation to clinicians, leadership and others. Works collaboratively to provide consistent, meaningful information to all levels of the organization, including the information provided to the Hospital Board of Directors.
• Uses problem analysis skills and critical thinking to collect and analyze data, propose solutions, develop and write reports, letters and materials needed to achieve desirable results as requested. Able to manage advanced database and spreadsheet applications (e.g., formulas, linking calculations, graphing and reporting) as well as web-based systems needed to obtain or manage clinical information.

Common Expectations:

• Enhances professional growth and development through participation in educational programs, current literature, in-service meetings, and workshops.
• Routinely performs professional clinical improvement assessments in all job aspects. Participates in Performance Improvement projects to enhance quality and streamline workflow.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Qualifications

Minimum Education:

• Associates Degree Graduate of an accredited nursing program. Required or
• Bachelors Degree Accredited Nursing Program Required
• Masters Degree Accredited Nursing Program Preferred

Work Experience:

• 2 years Relevant experience Required and
• Experience in healthcare quality assurance or performance improvement Required

Licenses:

• Licensed Registered Nurse Upon Hire Required or
• Registered Nurse Multi State License Upon Hire Required

Knowledge, Skills, and Abilities:

• Proven outstanding interpersonal skills
• Demonstrated ability to function as a team player
• Excellent computer skills, including word processing, internet, data entry, and spreadsheet use, and able to conceptualize and convey the importance/impact of data integrity in terms of patient management, study results, cost efficiency, quality of service, and the goals of clinical improvement and related project management
• Knowledge of Lean Principles and Quality Improvement methodologies
• Excellent prioritization and organizational skills

WellSpan Health’s vision is to reimagine healthcare through the delivery of comprehensive, equitable health and wellness solutions throughout our continuum of care. As an integrated delivery system focused on leading in value-based care, we encompass more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region’s largest and one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000 aligned physicians and advanced practice providers is dedicated to providing the highest quality and safety, inspiring our patients and communities to be their healthiest.