Job Summary
- Responsible for leading comprehensive, sophisticated and effective organization-wide quality improvement processes and programs to achieve best practice. Provides training, defines methodologies, directs the collection and analysis of data, and facilitates development of and promotes support for best practices and evidence-based medicine. A keen daily focus is applied to elevating the level of care and services we provide through organizational compliance with King’s Daughters’ quality standards, as well as Federal and State regulatory standards. Ensures that all accreditation requirements are met or exceeded and that the organization is compliant with pertinent infection control standards and quality medical practice requirements. Further, oversees the implementing, monitoring, and results of patient safety standards and all quality and performance improvement activities. A key responsibility is serving as a strategic business partner with the President/CEO, CMOs and other senior executives of King’s Daughters to ensure that areas of responsibility serve the business needs of the organization and exceed patient and family. Accountable for structure, process, and outcomes of key performance improvement activities throughout the organization. Supports the mission, vision and philosophy of King’s Daughters Medical Center.
Duties & Essential Functions
- Serves as a contributing and named member of a highly motivated, talented, and strong, team-oriented executive team. This group is results-oriented and meets weekly to discuss and review business and people strategies, customer satisfaction and quality of care outcomes, policies and operating performance for King’s Daughters and its affiliated organizations. This position is part of the Senior Leadership Team and will provide input to major corporate decisions, strategizing, problem solving and planning as well as monitoring healthcare trends and benchmarking mechanisms.
- Ensures the clinical and customer service quality initiatives of the organization are a top priority of all departments and the team members within the Quality Division.
- Develops and coordinates all King’s Daughters clinical quality and process improvement activities.
- Responsible for all quality control functions including devising or approving organizational efforts to ensure compliance with applicable legal and regulatory requirements.
- Responsible for development of annual division operating and capital budgets. Perpetually reviews activities, costs, operations and forecast data to determine assigned departments’ progress toward established goals and objectives.
- Responsible for the design and effective implementation of total quality management and continuous improvement programs. Develops and oversees master plan timetable for implementing and achieving total quality initiatives.
- Plans and organizes all activities under his/her control in an effective manner. This includes preparing strategic and tactical plans as well as designing appropriate organizational structures for areas of responsibility. This responsibility also includes organizing and delegating work, establishing appropriate time frames for completion of work, and for providing necessary leadership to ensure effective work results. This position is also responsible for participating in the development of corporate strategic and business plans and services.
- Selects, develops, motivates, supports, coaches and counsels’ assigned staff consistent with good human resources management practices and creates a work environment which allows participation in order to promote retention, productivity, team member safety and a quality, customer-oriented approach. Provides individual and team performance feedback and development support. Communicates effectively and conducts management staff meetings where major issues of accountability are openly discussed.
- Serves as Co-Chairman of the Medical Center Infection Control Committee. Ensures compliance with CDC guidelines and appropriate infection control guidelines. Administers control process to monitor the organization’s infection control programs ensuring infection control goals are realized.
- Serves as Chairman of the Process Improvement Steering Committee. Serves as a member of the Corporate Strategic Planning Committee.
- Serves as the organization’s champion for the Quality key priority. Monitors communication, enhancements, and overall leadership of King’s Daughters’ quality and accreditation initiatives and patient safety.
- Develops and maintains open, honest and mutually-beneficial relationships with the President/CEO, CMO, executives, Board members, leadership and other staff members, vendors and representatives of external agencies. Relationships will be maintained in a manner consistent with King’s Daughters’ image, mission, values and philosophies.
- Works closely with the Board of Directors’ Quality Committee Chair and facilitates committee meetings and activities.
- Coordinates and supports quality improvement project teams throughout the Medical Center.
- Actively supports the community by participating in King’s Daughters-sponsored programs and in serving on a community Board(s) and participating in other civic activities. Also encourages assigned staff to take part in volunteer and community support activities.
- Ensures King’s Daughters is compliant with all applicable Joint Commission and other accreditation, licensure, and regulatory affairs.
- Works collaboratively with others in the organization to resolve problems, and facilitate timely solutions to concerns and barriers.
- Documents and works to resolve all complex problems relating to quality, infection control, patient safety, and accreditation standards reporting progress on problem resolution to King’s Daughters Administration and the Board of Directors.
- Works closely with all levels of King’s Daughters leadership to monitor quality indicators and performance to ensure that the quality goals are met.
- Designs, establishes and maintains an effective organization for managing projects relating to process improvement, resource management, reengineering, clinical guideline developments, performance monitoring, benchmark studies, measurement and tracking.
- Examines, analyzes, and interprets industry and local area clinical data and keeps King’s Daughters Leaders advised in order to mitigate threats and capitalize on opportunities for quality improvement.
- Establishes and maintains strong communications, relationships, and dialogue with King’s Daughters Leaders and medical leadership individually and collectively to promote cooperation and build enthusiasm for quality improvement and improved outcomes.
- Provides leadership in the development of new systems and services to enhance clinical quality, patient care, customer relations, and safety.
- Keeps abreast of trends and developments in the healthcare field. Monitors quality issues and innovations that might impact the organization and its medical staff.
- Increases the awareness King’s Daughters quality initiatives via public presentations and the publication of articles in various periodicals/journals.
- Makes presentations to professional, civic, and business groups to educate the community on quality of care, health and delivery issues.
- Serves as a consultant both internally and externally on quality care, process improvement, and patient safety initiatives.
- Attends executive management meetings and is prepared to discuss legislation or policy matters that may affect the organization in the future.
- Serves as a member of the King’s Daughters’ Leadership Team.
- Assists the CMOs with Medical Staff Peer Review.
- Responsible for representing the organization to State and Federal agencies and advocating the organization’s position on legislation and regulatory affairs to elected representatives and their staff, as well as to officials and staff in regulatory and other agencies. May represent organizational interests in dealing with trade, industry, or professional organizations.
Education/License/Certification/Other Requirements
- Minimum requirement:
  - Bachelor’s degree in a clinical healthcare discipline.
  - Five or more years of quality management experience in an institution with a regional and/or national reputation for service excellence and quality outcomes.
- Preferred qualifications:
  - Master’s degree in a clinical healthcare discipline.
Working Environment
- The work environment is in an office/Medical Center setting
- This position requires occasional travel to off-site locations
- The noise level in the work environment is usually low
Physical Demands
- Regularly required to maintain a stationary position behind a computer, while in meetings or while presenting to groups.
- Frequently required to move about inside the office and Medical Center while rounding on departments.
- Regularly required to communicate telephonically and face to face with colleagues and customers.
- Regularly required to operate a computer and telephone.
- Occasionally required to lift and/or move up to 10 pounds.
- Frequent stress related to level of responsibility, regulatory issues and deadlines
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, and depth perception.

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King's Daughters Medical Center

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