Quality Nurse Specialist-Quality Outcomes -60708
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POST DATE 8/10/2016
END DATE 10/13/2016
West Virginia University Hospital
JOB DESCRIPTIONJOB DESCRIPTION
Job Title: Quality Nurse Specialist (60708)
Department: Center for Quality Outcomes
Reports to: Director, Quality Outcomes
FLSA Status: Exempt
Date: January, 2014
* Education: Registered Nurse Required, Bachelor of Science, Nursing (BSN) and/or advanced degree (MSN, MPH, MPA) preferred
* Experience 3 years in clinical healthcare setting with responsibilities reflecting direct management of patient care, including planning, coordination, and delivery of services required.
* Licensure: Current RN licensure in West Virginia
Primary responsibility is to assist the Center for Quality Outcomes in the improvement of clinical effectiveness and continual readiness for Joint Commission surveys. Oversees performance improvement activities, regulatory compliance, and other initiatives that lead to effective clinical resource utilization and improvements in quality. Promotes interdisciplinary collaboration and teamwork to promote excellence in patient centered care. Promotes patient education of common disease states and management.
ESSENTIAL DUTIES AND RESPONSIBILITIES: include the following. Other duties may be assigned.
Depending on particular area of responsibility, incumbent may perform any of the following:
1.0 Assists in the development and implementation of quality activities and monitors quality
indicators for assessment of quality across the continuum of care (ambulatory and inpatient).
1.1 Develops and implements mechanisms for ongoing data collection, analysis, and
reporting of quality indicators
1.2 Initiates mechanisms to ensure timely and accurate reporting of data
1.3 Monitors appropriateness criteria and reports the data for specific procedures and
1.4 Develops performance improvement initiatives throughout the institution and
supports the impetus for sustained performance improvement
1.5 Works collaboratively with the Decision Support personnel and staff for variance
2.0 Works in collaboration with the interdisciplinary health care team to support resource
utilization and quality improvement. Utilizes information systems to collect and analyze data.
2.1 Identifies strategies for and facilitates teams to achieve appropriate resource
2.2 Provides reports and analysis to support team s goals
2.3 Collects, analyzes, and presents data via internal software systems, external
comparative databases and through manual review.
3.0 Prepares the institution (ambulatory and inpatient) to successfully meet Joint Commission standards and Centers for Medicare and Medicaid Service (CMS) conditions of participation.
3.1 Collects data through survey audits of departments, chart review, and staff
3.2 Analyzes data for trends and for medical staff and institutional compliance with
Joint Commission standards and CMS conditions of participation.
3.3 Develops and submits reports for appropriate individuals and committees within
3.4 Interacts with faculty and staff to present quality initiative updates, reports, and
3.5 Assists in the development of appropriate policies, processes, and activities to
support continuous readiness for Joint Commission and Centers for Medicare and Medicaid Services.
4.0 Assists in the implementation of evidence-based indicators associated with Joint
Commission Core Measures and Centers for Medicare Services Scope of Work initiatives and monitors these indicators for compliance.
4.1 Develops and implements mechanisms for ongoing monitoring and analysis of
4.2 Ensures timely and accurate monitoring of patients care of compliance with Joint
Commission Core Measures and Centers for Medicare and Medicaid Services Scope of Work initiatives.
4.3 Monitors appropriateness criteria and alerts services of patient-centered
4.4 Obtains orders for appropriate interventions.
4.5 Documents evidence of compliance or exclusion criteria for the evidence-based
indicators in the medical record.
4.6 Develops performance improvement initiatives throughout the institution related
to evidence-based indicators and supports the impetus for sustained performance improvement
4.7 Works collaboratively with the Decision Support personnel and staff for variance
5.0 In conjunction with the Accreditation Coordinator, prepares the institution to successfully
meet Joint Commission Core measures and Centers for Medicare and Medicaid Services (CMS) Scope of Work Indicators.
5.1 Collects data through survey of departments, chart review, and staff interviews.
5.2 Analyzes data for trends and for medical staff and institutional compliance with
Joint Commission Core Measures and Centers for Medicare and Medicaid Services Scope of Work initiatives.
5.3 Develops and submits reports for appropriate individuals and committees within
5.4 Interacts with faculty and staff to attain high levels of compliance with Joint
Commission Core measures and CMS Scope of Work initiatives.
5.5 Assists in the development of appropriate policies, processes, and activities to
support compliance with Joint Commission Core Measures and Centers for Medicare and Medicaid Services Scope of Work initiatives.
6.0 In conjunction with Insurance Services at West Virginia United Health System, participates in payor-based quality improvement initiatives (QualityBLUE, Ambulatory QualityBLUE).
6.1 Collects data through survey, chart review, and staff/patient interviews
6.2 Analyzes data for trends
6.3 Develops and submits reports as required by payors
6.4 Interacts with hospital staff, faculty, and residents to attain high levels of compliance with measures.
6.5 Presents findings, initiatives, and recommendations to payors.
7.0 In conjunction with CMS, QualityBLUE, Get-with-the-Guidelines and other best practices and
initiatives, provide and participate in patient education and disease management.
7.1 Collects data through survey, chart review, and staff/patient interviews
7.2 Analyzes data for trends
7.3 Develops and submits reports for appropriate individuals and committees the organization
7.4 Interact and educate patients on disease states, medical management and possible adverse events
(Congestive Heart Failure, Anticoagulation, etc.)
7.5 Collaborates with physicians, nursing staff, and other health care providers to ensure comprehensive,
coordinated patient and family education. Promotes excellence in practice related to disease state
management education by role-modeling advances skills and providing instruction and expertise in dealing
with complex problems.
PERFORMANCE STANDARD: Adheres to the established Performance Expectations for WVUH Employees in the areas of People, Service, Performance Improvement, Shared