Quality Assurance RN, Full Time, Days, Quality Resources

Located in Kailua, Adventist Health Castle has been one of the area's leading healthcare providers since 1963. We are comprised of a 160-bed hospital, eight medical offices, home care services, urgent cares and a vast scope of services located throughout O'ahu. In 2017, Adventist Health Castle was recognized with the Malcolm Baldrige National Quality Award, the nation's highest presidential honor for performance excellence. O'ahu is known for its ideal climate, diverse culture and picturesque landscape. The allure of Castle's laid-back lifestyle is complimented by its close-knit and proud community.

Job Summary:

Coordinates the ongoing development and implementation of organization wide quality improvement activities. Collaborates with hospital leadership, staff, physicians and information systems in facilitating specific job activities to achieve organizational goals. Assists in the coordination of studies performed within the Quality Assurance program and prepare reports as required.

Job Requirements:

Education and Work Experience:

• Bachelor's Degree in Nursing (BSN): Preferred

Licenses/Certifications:

• Registered Nurse (RN) licensure in the state of practice: Required

Department Specific License/Certifications:

• NIH Stroke Scale (NIHSS): Required
• Basic Life Support (BLS OR HS-BLS OR RQI BLS) certification: Required

Essential Functions:

• Prepares first level analytical and statistical reports for the department. Maintains information systems and report results regularly to the department director and appropriate leadership, physicians and staff. Assists with the maintenance of the company's quality assurance program and identifies opportunities to improve patient care within the center.
• Conducts concurrent and retrospective chart audits and data extraction and focused studies as assigned. Assists in the planning, organization and direction of Quality Assurance programs and related activities. Develops and maintains a calendar of chart review activities, including focus studies. Ensures chart reviews are timely, accurate, and meet all data requirements for JCAHO, CMS, Medical Staff and the Board Quality Council and Governing Board.
• Is responsible to perform initial screening and analysis of reported events, conduct data abstraction, and assist in facilitating meaningful Medical Staff case review documentation. Monitors physician specific tracking, trending and reporting and provides assistance in abstracting and aggregating physician specific OPPE data in accordance with the credentialing process.
• Monitors compliance with both internal standards and regulatory requirements and makes recommendations for the adjustment of company programs accordingly. Develops and implements appropriate plans of action to correct identified deficiencies as needed.
• Identifies peer review cases through internal and external sources as appropriate. Collaborates in planning, implementing, and evaluating department activities. Assist Department Heads and staff in the evaluation of programs and effect changes as necessary to improve programs and assure compliance with regulatory requirements.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations, including, but not limited to, measles, mumps, flu (based on the seasonal availability of the flu vaccine typically during October-March each year), COVID-19 vaccine (required in CA, HI and OR) etc., as a condition of employment, and annually thereafter. Medical and religious exemptions may apply.

Located in Kailua, Adventist Health Castle has been one of the area's leading healthcare providers since 1963. We are comprised of a 160-bed hospital, eight medical offices, home care services, urgent cares and a vast scope of services located throughout O'ahu. In 2017, Adventist Health Castle was recognized with the Malcolm Baldrige National Quality Award, the nation's highest presidential honor for performance excellence. O'ahu is known for its ideal climate, diverse culture and picturesque landscape. The allure of Castle's laid-back lifestyle is complimented by its close-knit and proud community.