Area Quality and Safety Leader

This position is responsible for providing strategic oversight and guidance by leading the development and implementation of broad, complex quality programs and initiatives, serving as a leader and expert on clinical quality management programs and initiatives for two medical centers. Oversight of performance metrics and performance improvement activities across services lines and facilities. Oversight of evidence-based guidelines and criteria to optimize clinical outcomes; directing accreditation, licensing, and regulatory activities. Partnering with and directing medical staff in service areas to support peer review, practitioner performance review, developing, evaluating, and managing ongoing improvement systems to reduce care delivery risk and medical errors across the service area.

Essential Responsibilities:

• Serves as the subject matter expert for clinical quality improvement processes and regulations for executive internal and external stakeholders, executive sponsors, business owners, and external quality improvement organizations by: providing consultation on the interpretation, interaction, and implementation of current policies, regulations, and legislation, and advising on the long term strategies of KP to address the current climate and potential changes which may have long term effects on business operations; proactively engaging internal and external committees, projects, and relevant initiatives to actualize change and determine necessary infrastructure changes to move QA initiatives forward and ensure future KP compliance, as well as to communicate to senior leadership on the various changes and rationale for change; fostering and driving collaborative, results-oriented partnerships with practitioners, staff, management, and/or departments across clinical and administrative roles to ensure current and future compliance, and influencing the development and direction of KP policy and strategy to be compliant and adaptive; forecasting and determining the direction of future educational programs to raise awareness for current and changing regulation requirements, internal concerns, and system/database usage; and identifying and removing barriers to process improvement issues, weighing practical, technical, and KP capability considerations in addressing issues, and advising on policy changes.
• Ensures the outcomes of the quality of care complaints and review process by: representing KP in grievance meetings, cases, reviews, referrals, and other mechanisms; responding to and directing the preparations of all documentation, records, and information requested for specific and highly sensitive patient case reviews; reporting trends in the process flow of investigations and claims for red flags, appeal reasons, and overturns, reporting results, and advising on strategic direction to reduce reoccurrences; and defining the standards for the surveillance of quality improvement metrics, cases, quality care incidents, and near misses according to established protocols to ensure equal/consistent application of KP policies.
• Oversees infection prevention and control programs to improve employee and patient safety by: presenting information from epidemiological investigations, simulations, and research of significant clusters of infection or serious communicable disease concerns as a part of prevention, surveillance, and outbreak management to internal and external executive stakeholders in order to guide and develop long-term strategies; serving as the primary contact during significant outbreak containment protocols and efforts; and consulting with Administration on infection control implications of architectural design, renovation, and construction.
• Directs risk management efforts by: defining and presenting the standards for corrective action plans for improvement identified through utilization review, clinical records audit, claim denials, patient satisfaction surveys, and auditing surveys across the organization; utilizing information gathered from root cause analysis, failure mode and effect analysis, and other assessments in response to significant events, near misses, and good catches to establish new policies and procedures to mitigate future risk; defining the standards for health outcome analysis to continuously monitor oversight effectiveness; and defining the standards for health outcome analysis to continuously monitor oversight effectiveness.
• Oversees and is accountable for patient safety programs and initiatives by: serving as the primary contact during significant event management and response to safety hazards, accidents, incidents, threats, and significant events; and collaborating with executive management and external personnel to develop patient care and satisfaction programs which aim to improve patient flow, clinical support, patient services, and seamless transition of care.
• Oversees development of new clinical quality improvement programs by: maintaining relationships with key stakeholders, senior management, and external stakeholders to influence the long-term strategic plans for guidelines, metrics, and operational definitions of quality improvement, and ensuring the sustainability of the program; serving as a subject matter expert on a variety of health concepts, regulatory requirements, and change management principles to ensure KP strategies prioritize programs that optimize clinical quality, safety, or health outcomes; and providing insight into KPs capability of realizing strategic opportunities to develop as a learning organization by advocating for the program and consulting with executive management, technology stakeholders, and external vendors.
• Oversees the systems, procedures, and forms to improve data management programs and utilizes data to monitor and improve performance of all worker and patient safety programs by: ensuring the quality improvement monitoring agenda for the organization includes all aspects of data management and analysis of trends and patterns of practice are integrated into long-term strategic plans; acting as a subject matter expert in interpreting and applying data from databases, vital statistics, hospital patient discharge data, claims, and other relevant health sources to guide long-term KP strategy with data driven advice; and presenting and advising on the application of reports (e.g., infection control research, utilization reviews, population health needs analysis, patient satisfaction) in specified formats for executive internal and external stakeholders in order to guide long-term planning.

Oversees regulatory audits and survey efforts by: serving as the primary contact between applicable government, regulatory, other organization, and management for onsite visits and evaluations; establishing the long-term standards for requested audit documentation, information, reports, and tools throughout the auditing process; establishing the long-term standards for audit documentation, information, and reports; and forecasting and establishing continuous survey readiness activities to adapt to changes in regulatory and KP requirements