Chief Quality Officer, Ambulatory

Overview

Where you matter as much as the work you do

Join Emory Healthcare (EHC) if you’re looking for an opportunity with one of the nation's leading Atlanta hospitals in cardiology and heart surgery, cancer, neurology, and more! EHC is where those around you are dedicated to the power of teamwork, fostering an environment where you can learn, grow, and innovate with similarly passionate professionals. Work with us to improve the quality of life throughout Georgia through partnerships with the U.S. Centers for Disease Control and Prevention, Georgia Institute of Technology, and other organizations and make a bigger, greater impact than you ever thought possible.

Description

The Chief Quality Officer, Ambulatory Provides oversight, development and administration of local OU entity quality management, performance improvement, and regulatory compliance activities, to achieve Emory Healthcare (EHC) goal of clinical excellence. Supports the EHC Chief Quality Officer and Office of Quality leadership team with development and implementation of quality improvement activities. Serves as the OU entity QPS lead of oversight of infection control & prevention, patient safety, performance Improvement / process improvement and clinical innovation Oversees physician peer review and professional performance evaluations

Primary Duties and Responsibilities :

Collaborates with the EHC CQO and the Office of Quality leadership team to execute the EHC QPS plan and EHC strategic priorities by using methodologies of improvement to drive improvements of clinical and process outcomes related to patient safety, infection control & prevention, and other key quality performance metrics that are used to determine incentive and potential penalties as measured by CMS, private payers, and public benchmarking of EHC performance Maintains / obtains knowledge and then provides education regarding the relationship of quality with patient experience

Collaborates with other OU entity CQOs and service line QPS leads as needed to foster high reliability and standardization

Develops, plans, coordinates, and implements strategic and day-to-day quality (clinical improvement) programs at OU entity

Coordinates and oversee all survey activities, policy management, and regulatory reporting to ensure that full accreditation, certification, and licensure are maintained in all OU entity facilities

Collaborates with local hospital operating unit leaders, EU academic departments, and service line QPS leaders to ensure integration of clinical quality management, regulatory compliance, patient safety, and risk management efforts across EHC Partners with Director, Quality & Patient Safety staff in adherence with EHC policies and standards with the responsibility coaching, mentoring and performance management of staff

Supports the Patient Safety Quality Committee of the Board of Directors of EHC Participate in organizational committees at both the hospital and system committees as assigned or needed

Quality :

Anticipate national trends and initiatives in performance improvement, clinical quality, health care informatics, and the use of clinical technology for improvement efforts

Proactively reviews and analyzes key quality metrics and identifies opportunities for process improvement

Collaborates with the Quality & Patient Safety team and OU entity executive team for performance measurement, attainment of goals and performance of improvement activities to achieve maximal gain in healthcare outcomes

Provides direction, and collaborates with leadership, to inform clinical informatics usage and electronic health record optimization to ensure quality, safety, and performance excellence

Utilize data analytics to ensure consistent feedback is provided for all involved care providers regarding specific patient experience and quality performance results

Fosters the achievement of OU entity quality goals while addressing deficiencies that might lead to penalties

Ensures OU entity implements and are well positioned for local, state and national clinical regulatory programs, value-based purchasing methodologies, and comparison ratings, including, but not limited to US News and World Report, CMS Star ratings, and Leapfrog

Represents the department at report-outs with OU entity leadership, EHC QPS leadership, board of trustee meetings, and other relevant executive meetings

Regulatory Accreditation and Certification :

Provides leadership regarding regulatory standards practice policies, and compliance : regulatory body hospital-wide review / surveys (the Joint Commission, DCH, etc.) as well as surveys for disease-specific certifications

Serve as a physician QPS lead during regulatory surveys

Monitor and promote actions to achieve compliance with all relevant city, state and federal laws, government regulations, accrediting agency standards, and health system policies

Interprets, educates and assures hospital compliance with rules / regulations of The Joint Commission, CMS and any other regulatory agency with regards to quality of care and patient safety

Policy Management :

• Facilitate the dissemination, communication, and implementation EHC policies and procedures

Infection Prevention :

Patient Safety :

Leads the patient safety efforts at OU entity in partnership with the Director, Quality & Patient Safety and OU entity leadership

Oversee all significant adverse events and mortality reviews in collaboration with the respective QPS team and relevant academic department and service line QPS leads

Investigate all major adverse events in collaboration with Patient Safety Manager

Apprise EHC CQO and VP QPS of all high-level, high harm serious adverse events

Oversee all other adverse events, including near-misses, deaths and complaints or grievance with a quality concern in a timely (per regulatory requirements) and thorough fashion

Refer non-clinical events to Patient Services Administration or other relevant departments Root Cause Analysis

Lead RCA preparation alongside Patient Safety Manager

Consult with service line or academic QPS on events relevant to their department

Lead the RCA meeting as well as pre-and-post serious event meetings

Oversee plans of correction to ensure the service line and academic department has meet accountability and responsibility of correction standards Work collaboratively across the organization to oversee the review and response to patient safety events, mortalities.

Serve as a primary resource during the patient safety debrief as well as lead the relevant Root Cause Analyses Foster an environment that supports a Just Culture, in which staff members feel safe to report errors and participate in the analysis and mitigation of errors

Quality Data Strategy and Program Reporting :

Professional Performance Evaluations and Peer Review Analysis :

Quality Education :

Serve as an expert in the education of staff and clinicians in the science of improvement, quality and patient safety

Partner with GME office and DIO to support trainee education and experience

Key Relationships :

Serve as physician quality and patient safety leader for their respective campus under the direction of the VP, Quality and Patient Safety Partner with the Local and Service Line QPS teams

Partner with the hospital, nursing, clinical leadership, digital technology, informatics teams Partners with key provider networks to ensure communication and continuity between care settings (including voluntary (non-employed) providers where applicable)

MINIMUM QUALIFICATION :

Medical degree from an accredited institution; board certification in medical specialty

Seven (7) years of progressive leadership in healthcare quality related position

Experience with the design and implementation of quality, performance improvement and patient safety efforts in a complex health system

Leadership experience in a complex, highly matrixed, academic health system for at least five (5) years at the corporate or health system level

Preferred Qualification :

Masters degree level degree

Certified Professional in Healthcare Quality (CPHQ), or Lean or Six Sigma Black Belt designation

Additional Details

Supporting a diverse, equitable and inclusive culture. Emory Healthcare (EHC) is dedicated to providing equal opportunities and access to all individuals regardless of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression and / or veteran's status. EHC does not discriminate on the basis of any factor stated above or prohibited under applicable law. EHC respects, values, and celebrates the unique perspectives and backgrounds of all individuals. EHC aspires to create an environment of collaboration and true belonging for all our patients and team members. Emory Healthcare (EHC) is committed to achieving a diverse workforce through equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.

ACCOMMODATIONS : EHC will provide reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to request a reasonable accommodation, please contact the Office of Diversity, Equity, and Inclusion.”

PHYSICAL REQUIREMENTS : (Medium-Heavy) 36-75 lbs., 0-33% of the work day (occasionally); 20-35 lbs., 34-66% of the workday; (frequently); 10-20 lbs., 67-100% of the workday (constantly); Lifting 75 lbs. max; Carrying of objects up to 35 lbs.; Occasional to frequent standing & walking; Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS : Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to : Blood-borne pathogen exposure; Bio-hazardous waste Chemicals / gases / fumes / vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot / Cold Temperatures; Indoor / Outdoor conditions; Latex; Lighting; Patient care / handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators; environmental conditions may vary depending on assigned work area and work tasks.

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Division Emory Healthcare Inc.

Campus Location Atlanta, GA, 30322

Campus Location US-GA-Atlanta

Department EHI Office of Quality

Job Type Regular Full-Time

Job Number 141886

Job Category Nursing

Schedule 8a-5p

Standard Hours 40 Hours

Hourly Minimum USD $0.00 / Hr.

Hourly Midpoint USD $0.00 / Hr.

Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.