Job Summary

The Quality Support Analyst supports quality, safety and improvement within the Clinical Quality Department; with various Executives, Physicians, Nursing Leaders, other internal FHN leaders; and with several specific external partners. This team member supports various leaders with data and reports, coordinates meetings & associated details, and manages several data bases integral to daily activities related to quality improvement and patient safety.

Direct responsibilities involve supporting the Board Quality Chari and the Quality Assurance and Safety Improvement Committee, the Chief Quality Officer and Medical Staff Quality Committee (MSQC), the Chief Medical Informatics Officer and Acute Care Committee (ACC), Med Safety Committee, Utilization Review Committee and Clinical Quality staff members as needed for standing meetings and quality functions such as RCAs, Safe Tables, FMEAs, Comprehensive Care Reviews, Performance Improvement Teams. Lead analyst for NDNQI including entering date, managing reports, recommending & facilitating process improvement activities.

This team member supports functions with external partners such as the Midwest Alliance for Patient Safety/Patient Safety Organization serving as liaison, managing internal Patient Safety Work Product (PSWP), external reporting to the MAPS/PSO. This team member is the liaison with the Vizient/CDB for various teams/committees and supports various activities with the Vizient Consultant(s). A variety of external community partners, such as Nursing Home Collaborative, Patient Family Advisory Council, and Connect the Dots Subgroups are also supported by this team member.

This team member serves as the subject matter expert to the build for OurFHN QM/RM module utilized for Incident reporting and Compliant Management.

Job Responsibilities

• Executive Support for Board Quality Chair, Board Quality Committee, CQO, MSQC & Peer Review Function, ACC, and others as assigned.
• Liaison with Vizient Clinical Data Base (reports, teams, meetings, trainings, updates)
• Lead analyst for NDNQI including input of data, report analytics, report distribution & process improvement activity facilitation.
• Administrative support for Midwest Alliance Patient Safety (MAPS) Patient Safety Organization as lead contributor (oversee entering events, running reports, providing training and education, etc.)
• Administrative support for various standing and project-oriented teams/committees created from the core functions of the Clinical Quality Team. (e.g. Patient Safety Task Force, Regulatory (CMS, Joint Commission) Oversight Committee, Infection Control Associates, Readmission Coalition Team & Subgroups, Utilization Review Committee, Nursing Home Continuum of Care Committee, Connect the DOTS Subgroup)
• Assist in coordination & support (agendas, reports, minutes, maintain calendars & PDrive files) for various improvement teams.
• Assist in the development, organization and ongoing management of the required internal and external reporting for CMS Clinical Quality Indicators and State Required Reporting (e.g. Hospital Inpatient, Hospital Outpatient), Infection Control balance scorecards, VBC Report Card and NET/Board reports, LEM, etc.
• Subject Matter Expert for OurFHN QM/RM Module related to build improvements/edits and creation and distribution of patient concern/grievance, and incident reports.
• Assist in the Infection Preventionist with date entry & data base management of organization-wide surveillance monitoring as need.
• Facilitate coordination of members, meetings, projects and reports for the Patient Family advisory Council
• Oversees review process of order sets, insuring timely review by teams.
• Support case managers and social worker with UR calls, patient requests, and various reports.
• Continually improved departmental systems through organization, communication, reports, etc. that increase the effectiveness and efficiency of the work done in the department
• Proactively engages with work team to offer support, explore possibilities, complete PDSAs, etc.
• Edit OurFHN QM/RM module as needed from improvement efforts and priority packs.
• Assist with data entry & system support NHSN, web-based reporting.
• Assist with Patient Focused Consultants with specific projects or tasks as needed.
• Liaison to other staff, departments and/or teams in regard to core measures, clinical outcomes, safety indicator patient outcomes, regulatory expectations, and incident reports.
• Optimize computer skills and data management by engaging with multiple teams as opportunities arise.
• Remain flexible in prioritizing daily work assignments according to reporting/request timelines
• Focus on Delivering Exvellence through appropriate Quality Improvement Team(s).

Requirements

Education: Associates degree required. Bachelors preferred.

Required Experience: 2-5 years of healthcare experience required.

Special Skills and Abilities:

• Computer Skills (MS Word, Excel, PowerPoint)
• OurFHN QM/RM Build expert
• Certified Vixient Clinical Database Analyst
• MAPS/PSO Collaborator

Physical Requirements:

Populations Served

While performing this job, the employee may care for patients in the following age groups.

• No direct responsibility to treat or care for patients
• Serves patients in areas other than direct patient care

While performing this job, the employee does not care for patients in the following age groups.

• Neonate (< 30 days)
• Infant (< 1 year old)
• Early Childhood (1 year and < 5 years old)
• Late Childhood (5 years and < 13 years old)
• Adolescent (13 and < 17 years old)
• Young Adult (17 to < 30 years old)
• Middle Adult (30 years to < 60 years old)
• Older Adult (> 60 years old)