Clinical Outcomes Specialist

At Houston Methodist, the Clinical Outcomes Specialist is responsible for supporting regulatory and/or accreditation quality reporting requirements, internal quality initiatives, clinical outcomes processes, and clinical benchmarking endeavors of the entity. This includes concurrent and/or retrospective data abstraction, data management, data analysis, report generation, results presentation and dissemination, and education of medical staff, entity staff and management.
PATIENT AGE GROUP(S) AND POPULATION(S) SERVED
Refer to departmental "Scope of Service" and "Provision of Care" plans, as applicable, for description of primary age groups and populations served by this job for the respective HM entity.

HOUSTON METHODIST EXPERIENCE EXPECTATIONS

• Provide personalized care and service by consistently demonstrating our I CARE values:
  • INTEGRITY: We are honest and ethical in all we say and do.
  • COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.
  • ACCOUNTABILITY: We hold ourselves accountable for all our actions.
  • RESPECT: We treat every individual as a person of worth, dignity, and value.
  • EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.

• Practices the Caring and Serving Model

• Delivers personalized service using HM Service Standards

• Provides for exceptional patient/customer experiences by following our Standards of Practice of always using Positive Language (AIDET, Managing Up, Key Words)

• Intentionally collaborates with other healthcare professionals involved in patients/customers or employees' experiential journeys to ensure strong communication, ease of access to information, and a seamless experience.

• Involves patients (customers) in shift/handoff reports by enabling their participation in their plan of care as applicable to the given job

• Displays cultural humility, diversity, equity and inclusion principles

• Actively supports the organization's vision, fulfills the mission and abides by the I CARE values

PEOPLE ESSENTIAL FUNCTIONS

• Communicates and disseminates timely data analysis and findings to management and appropriate entity and/or medical staff committees.

• Communicates timely and relevant feedback to team, management, entity, and/or medical staff as it pertains to assignment, errors in coding, performance/process improvement initiatives, ongoing projects and other related issues; follows-up on and closes the loop of each communication to ensure timely resolution or escalation if necessary.

• Adheres to agreed upon escalation process for communication within the department, entity and/or medical staff.

SERVICE ESSENTIAL FUNCTIONS

• Supports Department with data abstraction for regulatory and/or accreditation requirements and performance/process improvement projects.

• Interprets and analyzes data to determine trends, identify potential causative factors and opportunities for improvement. Incorporates analyses into routine monthly or ad hoc reports, using statistical tools/graphic models appropriate for data and intended audience. Presents the information to various committee or performance improvement teams.

• Serves as a resource, consultant, and expert for assigned registry or measure sets for the Department, entity leadership, and staff.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

• Accurately abstracts data through concurrent and/or retrospective medical record review; organizes and inputs data into appropriate database in accordance with specifications manual or coding instructions; adheres to volume requirement and submission deadlines; if required, meets registry volume requirement for follow-up phone calls to clinics, patients or families within the required time frame.

• Clarifies interpretation of specifications manual/coding instructions/abstraction guidelines with appropriate registry or measure set support team and disseminates information to team, entity and/or medical staff as needed.

• Reviews and validates accuracy and completeness of abstracted data on an established and agreed upon schedule and prior to submission; adheres to established department internal and external validation process to ensure quality, accuracy, and integrity of data.

• Supports RCAA/FMEA process as requested when patient outcomes suggest possible system failures.

FINANCE ESSENTIAL FUNCTIONS

• Manages department resources and assignment effectively and efficiently as evidenced by prudent use of office supplies, timely data abstraction, data entry, and data submission.

• Reports case reviews with incorrect diagnosis or procedure code and refers cases to Coding team for review and re-coding as appropriate.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

• Maintains knowledge of guidelines governing data abstraction, regulatory, and accreditation requirements; stays current with clinical knowledge for specialty area by participating in internal or external educational opportunities.

• Makes recommendations to team, department, or entity committees on how to improve processes and performance based on registry or clinical guidelines.

This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.
EDUCATION

• Bachelor of Science in Nursing required

WORK EXPERIENCE

• Three years of direct patient care in acute care hospital or ambulatory environment required

• Previous performance improvement experience preferred

LICENSES AND CERTIFICATIONS - REQUIRED

• RN - Registered Nurse - Texas State Licensure and/or Compact State Licensure within 60 days OR
• RN-Temp - Registered Nurse - Temporary State Licensure within 60 days

LICENSES AND CERTIFICATIONS - PREFERRED

• CPHQ - Certified Professional in Healthcare Quality (NAHQ)

KNOWLEDGE, SKILLS, AND ABILITIES

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations

• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security

• Ability to effectively communicate with patients, physicians, family members, and co-workers in a manner consistent with a customer service focus and application of positive language principles

• Ability to review medical information from multiple computer sources, abstract pertinent information, and assimilate findings based upon defined measurement guidelines

• Detail oriented

• Intermediate computer and analytical skills

• Skill in general use of Excel spreadsheet, relational database, presentation and word-processing software and the Internet; proficiency with MS Word, Excel, PowerPoint, and Outlook essential for success in this position

• Excellent time management and organizational skills

• Ability to work independently and with teams

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

• Uniform No
• Scrubs No
• Business professional Yes
• Other (department approved) No

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.

• On Call* No

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area No
• May require travel outside Houston Metropolitan area Yes

Since its founding in 1919, Houston Methodist Hospital has earned worldwide recognition. Houston Methodist Hospital is affiliated with the Weill Medical College of Cornell University and New York-Presbyterian Hospital, one of the nation's leading centers for medical education and research.  In 2020, U.S. News & World Report named Houston Methodist Hospital to its top ranked Honor Roll for the fourth time and second consecutive year. 2020 also marked the ninth year in a row Houston Methodist Hospital has been named the No. 1 hospital in Texas. Houston Methodist Hospital directs millions of research dollars into patient care and offers the latest innovations in medical, surgical and diagnostic techniques. With 952 operating beds, 85 operating rooms and over 8,000 employees, Houston Methodist offers complete care for patients from around the world.

 

The same high-quality care for which Houston Methodist is known is available at several Emergency Care Centers in Houston and the surrounding areas.  These Emergency Care Centers house exam rooms, full digital radiography suite, low radiation dose 16-slice CT scan, ultrasound and a full on-site stat chemistry lab.

---