š Location: Hammond, LA, US
š¼ Type: Fulltime
š Work: On-site
š Description: Status: Full Time
Shift: Monday through Friday, 8am\\-4:30pm
Exempt: Yes
Summary:
The Clinical Review Specialist\\- RN is responsible for performing clinical chart reviews for purposes of peer review, performance improvement and identification of safety opportunities. Provides support for physician services, other clinical services, patient safety, external review, and performance management.Position is also responsible for supporting the system wide Performance Improvement initiatives by serving on projects that provide quality or safety assessment for clinical performance enhancement. Ensures compliance with all nationally recognized clinical standards of practice as adopted by the organization and in alignment with internal policies.
Other information:
Education:
Graduate of an RN program is required.
Licensure/Certification/Registration:
Current LA RN license is required.
Experience/Skills:
Three years clinical experience with experience in healthcare leadership role, compliance, performance improvement or safety nurse role preferred.
Working knowledge of Joint Commission, CMS Conditions of Participation, professional standards of practice, and State licensing laws preferred.
Ability to effectively communicate complex information in understandable format to medical staff members, hospital leadership, and others, including verbal and written communications
Must display knowledge, skills and experience in clinical chart review/data analysis techniques.
Must be able to develop and implement detailed programs and action plans, including impact analyses of performance improvement projects.
Computer experience required, including word processing, spreadsheet skills and the ability to master a variety of software applications
Knowledge of medical terminology and clinical application is mandatory.
Physical Demands:
Strength: Light
Push:Occasionally
Pull:Occasionally
Carry:Occasionally
Lift:Occasionally
Sit:Constantly
Stand: Occasionally
Walk: Frequently
Responsibilities:
* + Supports the physician peer review and profiling process by:i.Submitting physician performance issues identified during medical record review into the defined peer review system, including nurse audit of record pertinent to the identified issue.
ii.Assisting with quarterly and bi\\-annual physician performance profiles and annual Medical Staff reappointment processes, as requested.
iii.Corresponds with the medical staff and hospital directors on assigned projects, including letters for information, referred cases, and findings/results.
+ Communicates with Health Information Management, Information Systems, Case Management, Nursing and other hospital departments to assure maximum use of all available data sources for projects assigned.
+ Participates on CQI Teams formed as a result of projects assigned.
+ Participates in Joint Commission and/or other accreditation survey activities, as related to Peer Review, OPPE, FPPE, and Reappointment
+ Maintains confidentiality of information pertaining to patients, families, visitors, medical staff, and personnel in accordance with hospital policies and procedures and Medical Staff Bylaws
+ Collaborates with other members of the Patient Safety/Advocacy Department for the timely completion of all department projects.
+ Handles physician referral calls and provides contact information to callers.
+ Assists with data collection and display of report formats for programs utilized by Physician Services.
+ Works directly with and takes direction from Manager Patient Safety and Advocacy, CMO and Physician Services regarding OPPE, FPPE and physician review process
+ Accesses and uses Medkinetics database to support physician review processes.
+ Works with Chief Medical Officer to develop, implement, and monitor OPPE and FPPEindicators
+ Facilitates PPEC, including the intake, processing, and reporting/follow\\-through for all reported peer review\\-related events.
+ Works with other department personnel to ensure that most efficient and effective methods of profiling are implemented.n.Conducts new procedure review for newly granted privileges to members of the credentialed staff, both medical and advanced practice practitioners.
o.Assists with oversight of the medical services external comparative databases for medical services improvement measures.
+ Generates preliminary reports and data analyses for review and finalization by designated leadership for presentation at hospital and medical staff meetings
+ Works with patient safety staff and leadership to investigate and analyze actual and potential events that pose a risk to patient safety, related to medical and other clinical staff practices.
+ Serves as a resource to PI teams addressing performance improvement opportunities identified via medical initiatives as agreed upon by Leadership.
+ Corresponds with the medical staff and hospital leaders on assigned projects, including letters for information, referred cases, and findings/results.
+ Works with Leadership to develop educational programs for medical staff and/or patient care departments.
+ Reports to Leadership any actual or potential injury for patient as related to peer review findings.
+ Serves as a resource for medical/risk inquiries from physician, nurse administrators, and others regarding emergent patient care issues and loss control.
+ Maintains confidentiality of information pertaining to patients, families, visitors, medical staff, and personnel in accordance with hospital policies and procedures and Medical Staff Bylaws.
+ Follows North Oaks Health System compliance programs and federal and state regulatory guidelines.
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