Company: Yampa Valley Medical Center (YVMC)
Location: Steamboat Springs CO
Title: Quality & Patient Safety Manager
- Responsible for the operational functions of the Quality and Patient Safety Department.
- Coordinates and supports the facility’s quality and safety programs.
- Collaborates with Medical Staff, Nursing Staff and Department Directors, and with Process Improvement, Infection Prevention, Risk Management, Clinical Documentation Improvement and Information Services to drive quality and safety initiatives and achieve optimal quality outcomes.
- Coordinates compliance with regulatory and accreditation standards and programs.
- Leads and manages the quality and safety programs at Yampa Valley Medical Center, aligning the programs with the strategic plan of the hospital, regulatory requirements and programs, government requirements and programs, and accreditation efforts. Educates and supports the Medical, Nursing and administrative staffs of the hospital in achieving aligned quality, safety and regulatory outcomes.
- Oversees and is responsible for the activities of the Performance Excellence Committee (PEC), supporting the Committee’s Chair and its member departments/functions in fulfilling their responsibilities to the Committee. Supports the PEC Chair in preparing for reports to the Medical Executive Committee and the Quality and Safety Committee of the Board.
- Coordinates and oversees the Patient Safety and Quality Team/Committee and its activities. Coordinates other assigned quality and patient safety committees. Represents Quality and Safety Management at organizational meetings, including departmental meetings, and meetings of the Medical Executive Committee and the Quality and Safety Committee of the Board.
- Serves as a content expert for designing and providing formal and informal education for the Medical and Nursing Staffs, clinical leaders and others, related to healthcare quality, government quality programs and patient safety.
- Oversees the Quality and Patient Safety Analyst/Peer Review Coordinator to assure key quality and safety performance indicator reports are abstracted, prepared, analyzed and submitted, including oversight of external regulatory data reporting and internal reporting to support YVMC’s quality and safety objectives. Also oversees the Analyst/Coordinator position to ensure that Peer Review quality and reporting functions are supported. Assures the development of quality and safety outcomes dashboards that are focused to the needs of YVMC, with revisions as necessary to support regulatory reporting.
- Advises and collaborates with Medical and Nursing Staffs to create department-specific integrated quality, safety and operational dashboards. Assists the Chief Medical Officer in selecting quality and safety outcomes to support clinician/provider quality and safety alignment.
- Collaborates with the Manager of Process Improvement (PI) to facilitate the application and implementation of PI activities to quality and safety projects, when indicated, to optimize outcomes.
- Collaborates with the Risk Manager on patient safety issues to optimize patient safety outcomes at YVMC.
- Serves on the Infection Prevention (IP) Committee and collaborates with the IP team to evaluate and risk-assess for infections at YVMC. Participates in IP education and activities.
- Applies analytics to identify and target various populations to drive quality improvement and measurable outcomes.
- Responsible for establishing and ensuring compliance with departmental budget.
- Perform other duties as assigned. Must be HIPAA compliant.
- Education: Nursing degree (BSN) preferred. Bachelor’s degree in business or organizational development or related field strongly desired.
- Work Experience: Minimum three years quality and safety management, risk management and regulatory standards experience. Peer review experience preferred. Supervisory experience required.
- Licenses/Certifications: RN Required . CPHQ preferred; required within 18 months of hire. Six-Sigma Greenbelt (or Lean equivalent) required within 12 months of hire; black belt within 24 months of hire preferred.
- Knowledge, Skills, Abilities: Advanced knowledge of reportable quality and safety outcomes, and principles of performance measurement and reporting, quality improvement, standards and practices related to quality of care, hospital safety programs, outcomes data management/measurement and hospital reimbursement required. Working knowledge of regulatory standards required. Strong computer skills (MS Office and web-based application) are necessary. Excellent communication and interpersonal skills, and ability to function as an educator, required. Ability to function effectively as a mediator and resolve conflict necessary.
- Working Environment: Works in a temperature controlled environment with natural and artificial lighting.
- Essential Physical Requirements: Able to perform repetitive standing, sitting, stooping, walking, and reaching. Performs minimal lifting of 15 lbs, carrying 15 lbs, and reaching over head 10 lbs.
For more information and to apply vist YVMC job “Quality & Patient Safety Manager” web page