Quality and Patient Safety Manager

Job Summary

To reflect the mission, vision, and values of The View Hospital (TVH). To plan, lead, and set the quality and safety standards of healthcare considering the best practice prevailing in the industry in an effective and efficient manner to achieve the best patient experience.

Job Responsibilities 1

• Adheres to the TVH Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and accreditation standards (JCIA).
• Collaborates with the Office of Licensure, Accreditation, Regulation (OLAR) and Risk Management to comply with MoPH regulatory and licensing requirements and organizational bylaws, rules, regulations, policies, and procedures.
• Supervises and helps develop and maintain the quality program for the work unit, representing the department in accreditation inspections.
• Manages staff responsible for developing and implementing patient safety programs.

Job Responsibilities 2

• Supervises the investigation of errors and then plans for resolution of all safety-related incidents, including those involving employees, visitors, patients, and situations posing a threat to the Hospital's buildings and equipment.
• Will be instrumental in assisting executive management's desire to mitigate unintentional patient harm, and to reduce liability costs and exposure by reducing clinical risks.
• Maintains records of patient-related errors and evaluates this information in order to identify the cause of the error.
• Collects, reviews, and analyzes information from the facility's safety programs to identify corrective action and programs as necessary.
• Recommends changes, policies, or programs that could prevent future errors.
• Designs and presents training programs meant to increase awareness of patient safety initiatives.
• Manages subordinate staff in the day-to-day performance of their jobs.

Additional Responsibilities

• Ensures that project/department milestones/goals are met and adhering to approved budgets.
• Establishes, maintains, supports, and documents evidence of an ongoing Quality Improvement and Patient Safety program which includes effective mechanisms for monitoring and evaluating care rendered.
• Ensures compliance with applicable laws and regulations and approved policies.
• Participates in the planning and development of policies that guide the delivery of patient care services.
• Ensures Hospital-wide process to measure, assess data, plan change and sustain improvements in quality and patient safety.
• Supports Quality Improvement and Patient Safety Programs and implements a structure and process for overall monitoring and coordination.
• Supervises Significant Adverse Events (SAE) Investigation and performs and manages system-wide investigational reviews to determine if the event meets the criteria of an SAE.

Additional Responsibilities 2

• Facilitates the formation and ongoing progress of interdisciplinary Root Cause Analysis (RCAs) and Failure Mode Effects Analysis (FMEAs) events according to The Joint Commission International and other regulatory body requirements.
• Utilizes an evidence-based approach in case evaluation and proactive educational programs to accomplish patient safety objectives.
• Prepares and presents patient safety reviews utilizing meaningful written analysis, and data summary reports (charts, graphs, diagrams) to senior leadership and other multidisciplinary meetings.
• Provides education across the Hospital to a multitude of disciplines focusing on patient safety science principles and event or department’s specific needs.
• Performs other duties as assigned by the medical director.
• Participates in departmental activities that improve processes and efficiency and reduce waste.

Additional Responsibilities 3

Job Knowledge & Skills

• Certification in Healthcare Management (Preferred)
• Strong Knowledge of the healthcare industry.
• Comprehensive knowledge of the Accreditation Process in an acute Healthcare Facility with particular emphasis on JCI and preferably in more than one facility.
• Excellent multitasking skills.
• Critical thinking and problem-solving skills.
• Team player and good time-management skills.
• Great interpersonal and communication skills.
• Extensive knowledge of all aspects of hospital clinical operations, related to patient safety and quality activities.
• Familiarity with infection control, risk management, and regulatory affairs.
• Excellent administrative skills to deal effectively with all levels of hospital staff, the public, and agencies and entities involved in this area.
• Extensive knowledge of Quality and Patient Safety processes.

Job Experience

• Minimum 8 years of experience in Medical (required)
• 4 years of managerial experience.
• Minimum 3 years in GCC (preferred)

Education

• Bachelor's Degree in Doctor of Medicine
• Doctoral degree in Doctor of Medicine