Director Clinical Quality Improvement
3 months ago
San Ramon, California
The individual in this position is a key member of the hospital management team, and provides leadership and oversight to the strategic development and implementation of the quality and patient safety programs (performance improvement, patient safety, and accreditation) with responsibility for planning, organizing, directing the managerial and operational activities of the infrastructure required to support these services. The DCQI provides leadership in the promotion of a Culture of Safety, effective use of performance improvement methodologies, and data integrity, validity, and reliability. This position serves as the liaison with The Joint Commission, CMS, and other pertinent regulatory agencies and oversees the organization's continuous survey readiness processes. The DCQI works collaboratively with the Medical Staff to promote evidence-based quality and safety, patient-focused care aimed at optimal patient outcomes. The DCQI is responsible for ensuring the quality improvement goals are aligned and support organizational goals and priorities.
Minimum Education/Minimum Experience: Degree (Bachelors, Masters or Doctorate) in a health related field, with 5 years of relevant hospital management experience or other allied health professionals who have extensive hospital experience (>7 years, or other pertinent credentials) in the areas of responsibility will be considered.
Experience in quality/performance improvement, and as applicable in case management and other related areas of responsibility.
Demonstrated knowledge of Performance Improvement, Outcomes and Quality Management.
As applicable, DCQI candidate also has demonstrated knowledge in the areas of Peer Review, Risk Management, Patient Safety, Infection Control Prevention and Reporting.
Ability to interpret and process data in an analytical manner.
Excellent communication (written and verbal) and presentation skills. Computer operational skills, understanding of statistics, spreadsheets and database systems.
Current understanding of regulations as it relates to Joint Commission, State specific requirements, and Centers for Medicare & Medicaid Services (CMS).
Demonstrated understanding of Quality Improvement Organization (QIO) guidelines/required processes and understanding of current trends in quality and other areas of responsibility as applicable. Ability to lead and coordinate activities of a diverse group of people.
Ability to work with hospital team to motivate relevant constituencies to embrace change as required by the hospital's Commitment to Quality and other clinical initiatives.
Licenses/Certificates/Credentials: Registered Nurse Preferred, Certified Professional Risk Management Certification and/or Certified Professional Healthcare Quality Certification within three years of hire.
This individual's responsibilities include the following activities:
a) Responsible for leading the Quality / Performance Improvement activities across the hospital.
b) Integration of the Quality / Performance Improvement Program activities for the Medical and Hospital-wide Staff.
c) Data management and reporting for Quality / Performance Improvement initiatives.
d) Oversight of Quality / Performance Improvement department and staff.
e) Responsible for complying with all policies and procedures that pertain to HIPAA including the minimum requirements for the DCQI position.
f) other duties as assigned.
Required: Registered Professional Nurse (RN) with Bachelor, Master, or Doctorate degree inpatient care related field
Required: 5 years experience in QA/PI
Certifications: Required: Must be currently licensed, certified, or registered to practice profession as required by law, regulation in the state of practice or policy., CPHQ or eligible to take the exam within two years of employment.
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