Hospice Performance Improvement Coordinator (RN)

Daughters of Miriam Center for Nursing & Rehabilitation -

Job Description Summary

The Performance Improvement Coordinator is a professional, registered nurse responsible for all of the quality activities of the organization.   The Performance Improvement Coordinator has accountabilities for the monitoring, implementation and evaluation of process and programs to meet regulatory, accreditation and standards of practice.

Essential Job Functions / ResponsibilitieS

Responsible for the implementation and monitoring of the organization’s quality assessment performance improvement (QAPI) program.

Ensures that there are processes in place to monitor and measure all activities related to performance improvement.

Provides direction and coordination of QAPI activities utilizing continuous quality improvement principles and methodologies.

Coordinates activities related to clinical record review for data collection.

Compiles, trends and reports quality data in the following areas : patient care, safety, risk management, infection control, outcomes, and customer satisfaction.   Data is analyzed and compared internally and externally with other sources when available.

Works collaboratively with nursing supervisors to assure documentation is complete and consistent with care and reflects legal requirements.

Member of the Patient Grievance Committee collaborates with management staff in follow-up of concerns expressed by patients, families, and physicians.

Establishes a process model for improvement and provides education and training to organization personnel on the performance improvement plan, and team development.

Responsible for ensuring processes to monitor and evaluate safety, risk management and infection control programs.

Coordinates, educates and implements monitoring activities for safety, risk management, and infection control.

Coordinates mandatory inservice programs on OSHA regulations for safety and infection control.

Acts as resource to staff in identifying safety and risk management issues for patients and staff.

Reviews all incident reports for completeness, risk, standard of care determination and appropriate follow-up.   Maintains a log for trending and makes recommendations related to trends identified.

Maintains current knowledge related to home care safety and infection control standards.

Collaborates with nursing supervisors to provide a process to promote and ensure employee orientation, competency and inservice education programs.

Assists in the identification of skills for annual competence and provides inservice training support.

Maintains aggregate records of employee orientation and annual competency requirements as part of the PI plan.

Monitor organization compliance with regulatory and accreditation standards.

Maintains current knowledge related to Medicare Conditions of Participation to ensure that the organization is compliant with state, and federal guidelines.

Responsible for ensuring policies and procedures reflect all related local, state, and federal standards and makes recommendation for policy changes to the governing board.

Acts as a resource to clinical supervisors regarding standards, policies, regulations and provides inservice training to leadership and staff as needed in these areas.

Acts as a clinical resource to staff.

Maintains updated nursing knowledge and skills.

Assists with patient visits as needed.

Assists with administrative call on a rotational basis and clinical call as needed.

Provides assistance to community education team in meeting community education needs.

Makes public speaking engagements as scheduled by the community education team.

Maintain positive relationships with referral sources.

Maintain positive image in the community.

Acts as representative of the organization at community meetings, civic and professional organizations as needed.

Promote self-growth and collegial relationships with others in the home care industry.

Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal and professional networks and participates in professional organizations or societies.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job.   The incumbents may be requested to perform job-related tasks other than those stated in this description.

Position Qualifications

Registered nurse with current licensure to practice professional nursing in the State.

Bachelor’s degree in Nursing from an accredited program by the National League for Nursing.

Three to five year's clinical nursing experience.   (An emphasis in home care nursing is preferred).

Excellent understanding of performance improvement, quality assessment, and utilization management.

Is self-directed and able to work with minimal supervision.

Has excellent coordination and communication skills.