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The Clinical Quality Leader RN, TC reflects the mission, vision, and values of Northwestern Memorial Hospital, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

The Clinical Quality Leader RN Leads interdisciplinary clinical groups to define measure and analyze quality, patient safety, and regulatory issues and practice concerns on behalf of quality committees.  Defines, collects, analyzes and presents data cogently to identify trends. Masters relevant evidence, professional and regulatory literature in both transplantation and improvement science. Leads improvement activities utilizing DMAIC, Lean, and other performance improvement tools as appropriate.  Applies knowledge of professional nursing standards, current research, best practices, regulatory standards, and interdisciplinary collaboration to advance problem analysis and resolution and creative process redesign. Participates in performance improvement initiatives, receives and monitors control plans and data trends under the purview of clinical interdisciplinary quality committees. Participates in developing policies, procedures and standards advancing clinical quality measurement and facilitates the review and revision of department policy, procedures, and protocols.

Responsibilities:

• Lead the vision, development, implementation and monitoring of a data-driven, evidence-based Quality Assurance, Process Improvement (QAPI) program in the Transplant Center.   Work cooperatively and collaboratively with physicians and staff at all levels to define and achieve common aims.  Model, teach and improve a culture of evidence based practice, safety, compliance and shared improvement in all venues.
• Ensure the integration of the Transplant Center QAPI program with overall NMH Quality structure.
• Coach and develop process improvement teams.  Act as change agent to systematically drive and implement change as prioritized by senior clinical leadership and quality / patient safety committees.  Bring leadership and communication skills to interdisciplinary quality/patient safety efforts.
• Ensure the development, implementation, monitoring of both process and outcomes, and documentation of Corrective Action Plans developed in response to regulatory non-compliance or patient care incidents.
• Identify, develop and implement key quality and patient safety metrics, indicators and benchmarks based on: 1) evidence basis in clinical literature, 2) the needs of the patient and NMH physician community; 3) Balancing effectiveness and efficiency, 4) national, state and local regulatory, accreditation requirements and 5) managed care agreements.
• Master relevant evidence and literature in transplantation science and regulation as well as improvement science, including clinical quality improvement, patient safety, human factors, failure modes, root cause analysis, and related performance and safety resources. 
• Apply knowledge of professional nursing standards, best practices, regulatory standards, and interdisciplinary collaboration to advance problem analysis and resolution and creative process redesign.
• Perform or facilitate medical record reviews, audits, and other data collection activities that assist in identifying potential quality issues and opportunities for improvement in patient care and services.
• Analyze quality and patient safety information to accurately and cogently reflect patterns and trends in the management of patient care and services.
• Integrate and innovate tools to promote standardized evidence-based clinical practice as appropriate (i.e., standardized order sets, clinical protocols and procedures). Facilitate the use of quality management principles and performance improvement tools within NMH.
• Ensures the regular review and revision of Center-specific policies, protocols and procedures to ensure regulatory compliance as well as reflecting best practices.
• Facilitate and implement communication of information to appropriate leadership and staff to improve the management of patient care and services.  Partner with operational and medical leadership to identify, develop and implement successful communication, education, and process solutions to engage staff and produce improved processes and outcomes.
• Ensure the timely, efficient and accurate production and dissemination of committee meeting minutes, reports, dashboards, and related correspondence. 
• Ensure perpetual compliance of the program, including reporting requirements, to relevant regulatory standards such as OPTN, CMS, and Joint Commission
• Partners with NUTORC in relevant transplant outcomes projects
• Responsible for self-development and professional engagement, including knowledge of literature and attendance at professional meetings, preparation of manuscripts, posters and presentations, involvement with local and regional/national task forces as relevant/available.
• Additional responsibilities as designated in support of organizational priorities.

Required:

• Licensed Registered Nurse in the State of Illinois through IDFPR
• Bachelor’s degree in Nursing (BSN)
• At least 5 years recent clinical experience in the acute care setting
• Master’s degree and/or other evidence of advanced commitment to profession.
• Recent experience in quality / patient safety activities. 
• Working knowledge of performance improvement framework (i.e., DMAIC), quality and patient safety metrics and process improvement, and application of analytic tools.
• Understanding of basic statistics, working knowledge of contemporary standards and data sets related to healthcare quality and patient safety initiatives
• Computer skills (Excel, Word, PowerPoint).
• Excellent leadership and communication (oral, written) skills.

Preferred:

• Certified Professional in Healthcare Quality (CPHQ)
• Master’s degree, or other evidence of advanced commitment to profession
• Experience in health care leadership role 
• Experience in transplantation
• DMAIC green belt prepared

• Evidence of publishable work (research, quality reports, clinical summaries)

Northwestern Medicine is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.

Background Check

Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check.  Results are evaluated on a case-by-case basis, and we follow all local, state, and federal laws, including the Illinois Health Care Worker Background Check Act.

Artificial Intelligence Disclosure

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person. 

Benefits

We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.

Sign-on Bonus Eligibility (if sign-on bonus offered for position): Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign on bonus. Exception: New graduate internal employees seeking their first licensed clinical position at NM may be eligible depending upon the job family.