Quality Review Specialist-RN Trauma

Job Summary

The Quality Review Specialist-RN provides consultative services regarding quality assessment and trends to medical staff and to hospital ancillary department personnel. In this role, the employee will perform comprehensive retrospective reviews in a timely manner utilizing criteria developed and approved by the medical staff, hospital, and regulatory agents.

Essential Functions

Utilizes in-depth knowledge of clinical workflows, policies and procedures, patient care / clinical business processes, regulatory requirements, and best practices to:

Risk Management

• Perform daily review of new occurrence reports.
• Identify occurrences that require additional follow-up and report these to the Director or designee in a timely manner.
• Ensure that occurrences are categorized correctly and all fields completed and correct.
• Verifies data accuracy with medical record if necessary.
• Ensure that occurrence reports are forwarded to all appropriate persons.
• Access other sources of data as needed for investigation and follow up.
• Serves as System Administrator for the occurrence reporting system.
• Primary liaison between Risk Management, Information Services, and system users.
• Manages access to the occurrence reporting system.
• Adds new locations and new users and provides new-user training.
• Assigns passwords and removes users as needed.
• Provides new user training and ongoing user support, paying keen attention to user needs and opportunities to offer solutions and modify processes to improve efficiencies.
• Coordinates with vendor and Information Services to troubleshoot system as needed.

Center for Best Practice & PN Quality

• Assists with development, implementation, and evaluation of the hospital's overall quality improvement program.
• Assist with coordination, preparation, and maintenance of performance improvement assessment and improvement activities.
• Responsible for data integrity and follows well defined processes for maintaining data integrity as well as manage assigned database.
• Assists in evaluation, analysis, maintenance and development of system functionality of the EHR to meet clinical objectives including participating in project plan development/tracking and workflow analysis.

Duties & Responsibilities

• Provides accurate and timely routine statistical analyses and reports to designated parties.
• Identifies need for new reports and develops and creates reports.
• Generates user-friendly reports from other databases.
• Evaluates and analyzes data for trends, identifies areas of concern, and uses data display techniques to provide reports for various meetings and hospital committees.
• Prepares materials for meetings and assists with maintenance of performance improvement project records.
• Represents department on committees / teams as assigned.
• Participates and supports department goals, objectives and timelines, working with a sense of urgency and accuracy to ensure effective implementation.
• Successfully engages in multiple initiatives simultaneously and demonstrates flexibility in role and a willingness to help others.
• Attains an annual minimum of 12 hours of continuing education in topics related to role.
• Resolves problems and recommends solutions through research, inquiry, and data analysis, maintaining support call logs and tracking of issues.
• Compiles and maintains accurate statistics pertaining to occurrence data.
• Participates in and contributes to investigations of serious unanticipated events and "close-calls".
• Participates in and contributes to development, implementation and evaluation of corrective action plans.
• Supports a culture of safety by encouraging staff to speak up and report safety and quality issues.
• Identifies opportunities for improvement and coordinates/participates in the development and implementation of action plans to make improvements.
• Works collaboratively and communicates effectively with administration, IS, and clinical care teams through participation in the planning, development, and evaluation and maintenance of the Clinical Information system.
• Audits database contents for accuracy and validity.
• Acts as a resource person in quality assessment activities with hospital departments and committees.
• Works directly with hospital personnel to provide assistance and guidance in establishing criteria, reviewing medical records, etc.
• Requires efficient use of numerous software products (Word, Excel, PowerPoint, Outlook, etc.).
• Performs all other duties as assigned.