Clinical Quality and Patient Safety Coordinator (RN)

Ephrata, PA | Nursing | Tracking Code: 56638

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Position Summary:

General Summary:
RN  Under the general supervision of the Regional Director-Quality Improvement, with matrix reporting relationship with the Hospital Patient Safety Officer, registered nurse uses data for healthcare quality and safety measures to review for trends and gaps related to documentation of clinical practice, established clinical staff quality improvement procedure and peer review indicators, and quality and patient safety performance. Performs Electronic Health Record review and research of patient safety related events and provides a brief clinical summary of the findings. Elevates and communicates gaps and opportunities with improvement recommendations through established channels to improve care quality and safety.

Provides support for Regulatory Compliance and Patient Safety and system Quality Departments in Ephrata.


Duties and Responsibilities:

Clinical Quality Accountabilities
1 Reviews quality and patient safety measure data for trends and data summary to focus any necessary record review. Provides critical information in quality improvement for the patients to the Hospitals Vice President of Medical Affairs (VPMA).
2 Utilizing the Quality Accountability Model and related QIRS scoring system, communicates with patient caregivers to alert them regarding progress to goals, targets and regulation requirements. Coaches staff regarding the expected documentation and care guidelines. 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.).
3 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 VPMA or Regional Director.

Patient Safety Accountabilities
4 Reviews patient medical records for compliance with established medical staff quality improvement/peer review indicators, enters cases with non-compliance into the web-based peer review tracking system and assigns cases for peer review in accordance with established procedures. Acts as primary administrator for the web-based peer review tracking system, uses peer review tracking system to prepare agenda materials for the medical staff quality improvement/peer review committees, and completes clinical follow-up correspondence and actions from the medical staff quality improvement/peer review committees in an accurate and timely manner.
5 Reviews patient medical records associated with patient safety events in the web-based event reporting system and ensures that appropriate action is taken to address the events, including documentation in the event reporting system and compliance with internal and external reporting and notification requirements.
6 Keeps Patient Safety Officer and Regional Director informed of any potential reportable patient safety event and potential areas of improvement from patient safety or medical staff quality improvement/peer review perspective.
7 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.
8 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.
9 Provides data abstraction from the Electronic Health Record, for needed Hospital measures, as needed and with high quality and good timing.

Required Skills

Current RN license in PA

2 years of experience in adult inpatient medical/surgical or critical care (important for the analysis of medical records, application of qualify criteria, etc)

Experience in electronic health/medical record review is preferred.

Ideal candidate will have experience in peer review process

Quality of Life

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization is comprised of a multispecialty medical group of more than 1,200 physicians and advanced practice clinicians, a regional behavioral health organization, a home care organization, six respected hospitals, more than 15,000 employees, and 140 patient care locations. WellSpan is a charitable, mission-driven organization, committed to exceptional care for all, lifelong wellness and healthy communities. We are committed to transforming the health of the communities we serve and to educating the next generation of clinicians, staff and leaders.

Quality of Life
Quality of Life

Lancaster City was the capital of Pennsylvania from 1799 to 1812. Today, Lancaster County includes a vibrant downtown business district, desirable suburban neighborhoods and sprawling agricultural farms. Life in Lancaster County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, an independent professional baseball team, fine dining and more. When visiting Lancaster, one can't help but recognizing the influence of the Pennsylvania Dutch — farm-to-table and beyond.

Conveniently located in southcentral Pennsylvania, Lancaster is within an easy commute to major cities and has ready access to public transportation. Residents can find local employment in healthcare, tourism, public administration, manufacturing, and both professional and semi-professional services. (Patient population: 535,000)

Equal Opportunity Employment

WellSpan Health is an equal opportunity employer. Employment selection and related decisions are made without regard to sex, race, age, disability, religion, national origin, color or any other protected class. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.

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