Assistant Vice President (AVP) of Patient Safety

POSITION SUMMARY

The Assistant Vice President (AVP) of Patient Safety, provides system-wide leadership for Patient Safety and Infection Prevention. The AVP of Patient Safety is responsible for overseeing and implementing strategies to ensure the highest level of patient safety throughout the healthcare system and works collaboratively with executive teams, other administrative staff, and medical nursing, and ancillary staff to develop strategies to minimize patient harm and continue to improve the culture of safety. The AVP plays a critical role in promoting a culture of patient safety and continuous improvement, continuously strengthening the organization's commitment to the principles and practices of high reliability organizations (HRO), and monitoring internal and external trends to proactively respond to emerging risks and opportunities. Works closely with various stakeholders to minimize medical errors, improve quality of care, and enhance patient outcomes. The AVP maintains harm metrics and ensures they are communicated transparently through leadership teams within the organization. The AVP consults with various Patient Safety Organizations (PSOs) to develop programs and services that produce measurable improvements in processes and practices that affect patient safety.

The AVP Patient Safety develops and executes a Patient Safety Plan in alignment with the organization's overall mission and goals and updates the plan continuously and at least annually to incorporate best practices and the latest advancements in patient safety. The AVP ensures compliance with all applicable healthcare regulations, guidelines, and accreditation standards related to patient safety and keeps stakeholders informed about any changes in regulations or safety alerts and proactively implement necessary adjustments. The AVP coordinates annual Leapfrog survey data aggregations, reporting, and communication of scores to stakeholders.

This position also incorporates clinical outcomes data into the program, assists the Vice President for Quality in implementing Continuous Quality Improvement programs, including training and compliance. The AVP participates in committees and boards, and provides other related services in support of organization-wide objectives. The AVP assists in the development key performance indicators (KPIs) and metrics to track patient safety outcomes and regularly monitors and evaluate patient safety data to identify areas for improvement and celebrate successes (i.e. harm index).

This position supports organizational goals by providing quality customer service, participating in performance improvement activities and efforts and by demonstrating courtesy, professionalism and diplomacy with a strong commitment to teamwork.

The AVP Patient safety has system oversight of the Infection Prevention program and ensures that the program meets regulatory and accreditation requirements for surveillance, prevention and control of hospital-acquired infections, supervises the Infection Prevention staff. This position designs and implements the Infection Prevention Surveillance Program in conjunction with the Infection Prevention Committee and the Medical Staff. An ongoing review and analysis of hospital-acquired infection data, risk factors and special studies relevant to infection prevention are maintained with their direction.

The AVP assures the Patient Safety and Infection Prevention Program design meets The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS) and NJ-DOH requirements.

QUALIFICATIONS

EDUCATION: Master's Degree required in a Health Related Field (Nursing, Public Health,)

LICENSE/CERTIFICATION: Clinical licensure required (RN), Certified Professional in Patient Safety (CPPS), or Certified Professional Healthcare Quality (CPHQ) preferred.

EXPERIENCE: Minimum 10 years in healthcare with patient safety and clinical quality improvement preferably within a supervisory capacity. Strong knowledge of healthcare regulations, quality improvement methodologies, and patient safety best practices. Excellent communication, interpersonal, and leadership skills. Proven ability to collaborate and build effective relationships with diverse stakeholders. Analytical mindset with the ability to use data to drive decision-making and measure outcomes

PERFORMANCE EXPECTATIONS

Demonstrates the clinical competencies as established on the Assessment and Evaluation Tool.

WORK ENVIRONMENT

Potential for exposure to the hazards and risk of the hospital environment, including exposure to infectious disease, hazardous substances, and potential injury.

Requires the ability to walk, stand and reach a majority of the time. Intact vision and speech as well as sufficient hearing is also required. The essential functions for this position are listed on the Assessment and Evaluation Tool.

REPORTING RELATIONSHIP

This position reports to the Vice President of Quality and supervises incumbents as assigned.

The above statement reflect the general details considered necessary to describe the principle functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.

Status: Full-Time

Hours Per Week 40.00

Weekends Required? No

Holidays Required? No