Job Description
Job Description
Main Function
Contributes to the fulfillment of the organization’s mission and philosophy by assisting in the analysis, implementation, and evaluation of the quality program. Responsible for the progress and maintenance of organization-wide performance-improvement, risk management, and infection control programs.
Duties and Responsibilities
1. Philosophy
- Supports the facility’s ideology, mission, goals, and objectives
- Performs in accordance with the facility’s policies and procedures
- Follows the facility’s standards for ethical business conduct
- Conducts self as a positive role model and team member
- Recognizes patients’ rights and responsibilities and supports them in performance of job duties
2. General
Participate in facility committees, meetings, in-services, and activitiesPunctual and comply with attendance guidelinesGets along well with all employees and respects the rights of other employeesDemonstrate resourcefulness, independent thinking and seeks additional challenges and opportunities. Seeks to create new methods, techniques and processes.3. Communication
Communicates effectively and professionally with vendors, physicians, coworkers, patients and visitorsInteract with others in a positive, professional, respectful, and considerate mannerChecks and responds to emails in a timely and efficient manner4. Financial practices
Use facility resources appropriately and avoid wasteful practicesReports on wasteful practicesAnalyzes work area and makes recommendations for potential cost-effective improvements5. Compliance program
Assists in the implementation and maintenance of the organization’s adopted compliance programPerforms according to established compliance policies and procedures6. Safety / risk-management program
Adheres to safety policies and procedures in performing job duties and responsibilitiesReports observed or suspected safety violations, hazards, and policy / procedure noncompliance to the safety officer or other designated personComplete annual education requirements7. Professional competence
Participates in continuing education and other learning experiencesShares knowledge gained in continuing education with staffMaintains membership in relevant professional organizationsSeeking new learning experiences by accepting challenging opportunities and responsibilitiesWelcomes suggestions and recommendations8. Regulatory
Remains current on all applicable state and federal laws, rules, regulations, professional standards and accreditation standardsSubmits required reports on a timely basisDevelops, interprets and recommends implementation of policies, procedures, regulations, programs and recommended practices to ensure requirements are met9. CQI / Performance-improvement program
Assists in the development and implementation of the organization's adopted performance-improvement programMaintains and updates organization-wide performance-improvement programs, policies, and proceduresPerforms according to established performance-improvement policies and proceduresContributes to the performance-improvement process and identifies his or her role and contributions upon supervisor's requestOrganizes and participates in committees, educational programs, and performance-improvement activitiesContributes to the evaluation of the performance-improvement program and recommends appropriate revisions, if applicableDevelop effective data collection, organization, and evaluation systems for monitoring the quality of patient careSummarizes collected data and reports findings and recommendations in a timely manner to the performance-improvement committeeCoordinates performance-improvement activities and communicates outcomes to appropriate committees and individualsAssists in the evaluation of patients, and medical staff grievances to identify ways to improve patient care and performance standardsIdentifies resources required for the performance-improvement program and submits resource requests to the governing bodyAssists in identifying important indicators, establishing thresholds, and setting timeframe for evaluationMaintains performance-improvement status logServes as an educational resource for performance improvement and keeps facility current on state and federal rules and regulations and accrediting-body requirementsMaintains performance-improvement records in a confidential and organized manner10. Infection Control
Be familiar with facility policies and proceduresSurveillance, prevention, and control of infectionIdentify and reduce risk of acquiring and transmitting infections among patients, employees, physicians and other independent practitioners, contract workers, students and visitorsCoordinate infection control programs and educate staffOversees and coordinates with Inservice Coordinator annual evaluation of TB on all employeesMaintain record of exposures, infections tracking and trending, quarterly documentation and reporting to quality Committee and the Governing BoardEnsures that all personnel / employees comply with infection control policies in conjunction with the Director of NursingContinual monitoring of high risk and problem prone areas.Work with staff / employees to analyze the patterns and trends to identify and determine whether a problem or opportunity for improvement existsResponsibility for Assets
1. Responsible for performance-improvement program reference materials
2. Responsible for all performance-improvement program records / documentation
Required
1. RN degree
2. BLS / ACLS / PALS
3. Training / experience in performance-improvement / risk-management; certification preferred
4. Training / experience in project coordination and completion
5. Training / experience in healthcare
6. Strong ethical and moral character references
7. Language skills adequate for high-level written and interpersonal communication
Preferred
Bachelor’s DegreeANDREWS IS A TOBACCO FREE WORKPLACEThe Andrews Institute ASC (AIASC) is committed to promoting health, wellness, and disease prevention and to providing a safe, clean and healthy environment to Workforce Members, patients, and visitors. The use of tobacco and tobacco products is a known and established hazard to the health and well-being of tobacco users and can also directly impact nonusers. In addition, the use of tobacco and tobacco products has been shown to decrease employee productivity and efficiency and increase absenteeism. In recognition of these factors, the Andrews Institute ASC will no longer hire tobacco users.
