Senior Officer

Job Description

The Quality Senior Officer, in conjunction with the Manager and Head of Quality Directorate, is responsible for ensuring that on-going accreditation is attained and that all documentation relating to on-going accreditation is in place, up to date and available for auditing by the SHCC/PHCC and JCI Accreditation; the implementation and support of new quality initiatives are vital in this regard.

Tasks

• Assist in conducting and coordinating Joint Commission Accreditation and Reaccreditations.
• Assist the supervisor's in implementing Continuous Quality improvement Initiatives:
  
  

New Quality Management System

Patient Safety Walk rounds Program, involving analyzing and reporting on clinical practices, processes, error reporting and the environment from the perspective of patient safety

Clinical indicators (working towards Data Warehouse/Balanced Scorecard)

Sentinel Events and Root Cause analysis as per Sentinel Events Guidelines

Training for Quality improvement Initiatives and FOCUS POCA (System Improvement Methodology) Projects with a view to the next stages FMEA and 6 Sigma with reference to PCT's

• Perform retrospective or concurrent reviews on assigned areas utilizing IHHN approved Indicators Monitoring System (IMS) databases, indicators or criteria.
• Participate in Site Visits to the Facilities to work with staff on quality management programs and/or activities. Responsible for completion of a full and detailed Site Visit Report.
• Trainings:
  
  

Assist in training the staff from various facilities in areas of Quality Management, records requirement, techniques of continuous quality management and other related areas as assigned.

Conduct Quality Management Workshops as appropriate and as directed by the Head of Department

• Participate in area wide mini focus studies; to be undertaken in conjunction with the Department and other IHHN Directorates.
• Assist in Coordinating Quality Management Activities with IHHN Directorates as assigned by the Head of Department to maximize staff expertise in the area of Quality Management.
• Assist in preparation of monthly and quarterly reports regarding the Quality Management Program and compliance with same for all assigned facilities.
• Provide day to day operational support to as assigned in terms of; concurrent reviews, utilization reviews, retrospective monitoring, committee and Quality Management Team assignments, referral of identified issues or concerns to appropriate department(s) or areas etc
• Reviewing of Clinical incident Reporting System into the database, referring PCI's (action) reporting of trends, analyzing of reports, and identifying any Sentinel Event.
• Facilitate in maintaining the database and coordinating, analyzing and reporting on the Medication Safety program
  
  

12 Assist in conducting Patient Medical Record Audits

• Assist in developing, analyzing and reporting of Clinical Pathways
  
  

14 Attending Quality improvement Committee meetings in assigned clinical area(s)

• Assist in preparation of Hospital and Departmental policies and procedures.
• Assist in developing Quality improvement Plans
  
  

Note

17 Perform other job related duties as required

“Indus Hospital & Health Network is an employer that does not tolerate Sexual Exploitation and Abuse. All potential candidates will be subjected to rigorous background checks and controls.”