Phoebe Putney Health System · 22 hours ago
Directory, Quality, Accreditation and Infection Prevention
Albany, GA
Full-time
Onsite
Lead/Staff, Director/Executive
3+ years expPhoebe Putney Health System is seeking a Director of Quality, Accreditation and Infection Prevention to facilitate the hospital's Quality Improvement Program and oversee the Infection Control Surveillance Program. This role involves coordinating compliance with accreditation agency standards and ensuring quality indicators are reported to CMS and the State.
Emergency MedicineHealth CareHospitalMedicalNon ProfitOncology
Responsibilities
Lead implementation of the annual Quality Assessment and Performance Improvement (QAPI) plan ensuring the allocation of resources to achieve success
Develop comprehensive, strategic and tactical plans to achieve hospital level progress in goal achievement; revises strategic plans accordingly
Utilize and foster use of evidence-based medicine to reduce unnecessary variation to standardize care and reduce costs
Inspire and guide team members through change while maximizing efficiency and effectiveness
Foster a culture of flexibility, innovation, and continuous learning
Develop, participate in, and/or lead quality improvement teams/committees; drives the implementation of evidenced based prevention strategies and monitors process and outcome measures toward success
Collaborate with others across Phoebe Health System to inspire a system approach where appropriate Stay current on industry trends and best practices to ensure the organization remains at the forefront of quality and safety initiatives
Partner with system and hospital leadership to ensure compliance with Federal and state standards and achieves a continual state of readiness
Stay abreast of all pertinent federal, state and hospital regulations, laws, and policies Manages regulatory compliance activities including preparation for survey, survey and follow-up documentation, corrective action planning/completion etc
Develops and maintains relationships with regulatory agencies and accrediting bodies
Partner with system and hospital leadership to lead a highly reliable organization and to achieve a goal of zero harm
Engage in and foster a culture of trust and transparency with the aim to reduce errors using just culture principles
Conduct and/or lead others in root cause analysis, common cause analysis, failure mode effects analysis (FMEA), proactive risk analysis
Ensure compliance with organization’s incident reporting system in a timely and accurate manner
Develop comprehensive, strategic and tactical plans to achieve hospital level progress in infection prevention goal achievement; revises strategic plans accordingly
Supervise and coordinate hospital infection control surveillance to identify actual nosocomial infections, clustering and outbreaks of infection and infection potentials
Plan and provide education and guidance in infection control and prevention measures
Ensure compliance with regulatory, accreditation and licensure requirements pertaining to infection control
Stay current on industry trends and best practices to ensure the organization remains at the forefront of infection prevention and control initiatives
Establish and monitor key performance indicators across the organization
Oversees the collection, analysis, assimilation, and reporting of quality data to drive improvement
Provide scheduled reports and data to leadership, committees, and external agencies
Partner in advancing analytical and technological solutions to improve data integrity and accuracy; standardizes quality reporting across the system where applicable
Qualification
Required
Bachelor's Degree in relevant field
3 or more years Quality Improvement, Project Management experience
Preferred
Master's Degree In Relevant Field
CPHQ - Certified Professional in Healthcare Quality
Company
Phoebe Putney Health System
Phoebe Putney Health System provides cardiovascular medicine, oncology, orthopedics, and women’s health care services.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Scott Steiner
President & Chief Executive Officer
Recent News
2024-11-21
| Americus Times-Recorder
2023-12-25
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