Job Summary:
Oversees daily operations of quality, safety, and performance improvement programs. Supervises Patient Safety and Performance Improvement staff and supports initiatives to reduce preventable harm and improve patient outcomes. Works with network leadership to implement quality and safety priorities, collaborating with leaders, physicians, and staff to achieve organizational goals.
Job Requirements:
Education and Work Experience:
- Bachelor's degree in Health Care Administration, Nursing, Public Health, or related field or equivalent combination of education/related experience: Required
- Three years' of healthcare or related experience: Required
- Two years' in quality, patient safety, or performance improvement: Required
- Two years' leadership experience in acute care or other healthcare setting: Required
- Clinical background: Preferred
Licenses/Certifications:
- Certified Professional in Healthcare Quality (CPHQ) or Certified Professional in Patient Safety (CPPS) certification: Required within two years of hire
- Lean or Six Sigma certification: Preferred
- Certified Professional in Healthcare Quality (CPHQ) or CPPS or Lean or Six Sigma Green Belt (LGB): Required
Essential Functions:
- Oversees daily operations of quality, patient safety, and performance improvement programs. Supervises Quality/PI and patient safety staff, providing feedback and coaching. Ensures alignment of local activities with system priorities.
- Supports patient safety initiatives, including root cause analyses and corrective action follow-up. Oversees event reporting and learning systems, ensuring timely review and communication of findings. Promotes a culture of safety within assigned entity or service line. Assists regulatory team in maintaining continuous readiness for Joint Commission, CMS, CDPH, and other accreditation/regulatory surveys.
- Supports improvement projects to reduce harm, improve clinical outcomes, and enhance operational efficiency. Applies Lean and performance improvement methodologies; assist leaders and teams with PI tools. Monitors project outcomes and support sustainability of improvements.
- Provides guidance to staff on patient safety and quality improvement methods. Supports interdisciplinary collaboration to improve workflows and outcomes.
- Ensures timely collection, validation, and reporting of quality, safety, and regulatory metrics. Prepares and presents data to entity leaders and committees, highlighting improvement opportunities. Coordinates with system Quality and Patient Safety on benchmarking and reporting requirements.
- Performs other job-related duties as assigned.
