Quality Improvement Specialist

Mount Sinai Health System - New York, NY4.0

30+ days ago

Roles & Responsibilities:

The Quality Improvement (QI) Specialist works on-site at nursing facilities and serve as a designated liaison for the New York-Reducing Avoidable Hospitalizations (NY–RAH) project to promote better care for long-stay nursing facility residents. NY-RAH is part of a national demonstration and will be funded through a cooperative agreement with the national Medicare and Medicaid Coordination Office. The project and the position are expected to continue through 2020. This individual splits their time traveling between a minimum of two, maximum of three, nursing facilities located geographically within a reasonable distance.

The QI Specialist collects and analyzes data, identifies patterns and trends, and develops actionable next steps to reduce avoidable hospitalizations. The QI Specialist works with facility leadership to train facility front line staff; coordinate and facilitate meetings to review hospitalizations with transfer hospitals; and develops new processes and policies. S/he works with the nursing facility administrator, director of nursing, and medical director to identify the necessary resources to improve the quality of care of residents and support treatment in the appropriate setting. The QI Specialist is supported in these activities by the NY-RAH project management team, including data analytic specialists

  • Completes Quality Improvement tools and conducts Root Cause Analyses on transfers and review, report, and interprets conclusions to facility leadership
  • Conducts Performance Improvement Projects at the facility using project-provided claims data using the CMS Quality Assurance Performance Improvement (QAPI) principles
  • Works with facility leadership on preventative action plans based on QAPI audit findings, deviations, and events related to potentially avoidable transfers; plans follow-up audits/PDSA cycles to assess if the desired effect / change was achieved
  • Trains facility staff on best practices for identifying, documenting, and communicating changes of conditions using the INTERACT principles and tools
  • Reviews documentation and assess effectiveness of documentation review approaches; analyzes causes and develop solutions for documentation failures
  • Develops training materials and presentations for nursing facility staff based on areas of improvement defined in the Performance Improvement Projects and/or claims data
  • Presents project updates as requested
  • Works with NY-RAH project staff with other project responsibilities as necessary
  • Other duties as assigned

Requirements:

  • Education: Bachelor’s degree required
  • Nursing or other clinical background/experience preferred
  • Experience: Long-term care experience in either a clinical or administrative capacity
  • Knowledge of the INTERACT program preferred
  • Knowledge of QAPI or Lean/Six Sigma Principles required
  • Must have strong communicating, writing, and presenting skills, and must be comfortable presenting to nursing facility and hospital leadership staff

Job Type: Full-time