Schedule

Full-time: 40hrs/wk

Hours: Monday - Friday, day shift. Occasional on-call.

Hybrid work model

General Summary

Responsible for the patient safety improvement and management program for the entity to which assigned (e.g., hospital, medical group, etc.). Inspires all WSH clinicians and staff to achieve a level of reliability resulting in a safe, secure environment for all WSH patients, through timely response to and reporting of safety failures, investigating each event, ensuring utilization of Just Culture and peer review, to identify root causes, and eliminate current and future safety risk. Works in close collaboration with the System Patient Safety as well as physicians and staff in all assigned facilities to achieve these goals, as well as system and entity operating objectives. Maintains compliance with all entity and System patient safety policies and procedures as well as any regulatory and legal requirements.

Duties and Responsibilities

Essential Functions:

Fosters the use of the occurrence reporting system throughout the System to minimize blame and retribution and emphasize systems improvement. Coordinates and disseminates information to all entity employees on patient safety improvements. Facilitates the daily safety brief at the entity. Serves as an advisor on patient safety and peer review activities. Uses Lean methodologies to implement effective process improvement. Advocates for adoption of best safe practices identified in the literature. Oversees the methodology for investigation of serious reportable events, serious events and, as appropriate, identified incidents and infrastructure failures. Ensures that any actions as are immediately necessary to ensure patient safety as a result of any investigation are promptly undertaken. Facilitates and documents root cause analyses, as well as assists in accountability for and tracking of action step completion. Reports actions taken to ensure patient safety as a result of any investigation to entity's senior leadership team, WellSpan Clinical Performance Council, WellSpan Health Council, the WellSpan Patient Safety Committee, and/or the entity's Board of Directors, as appropriate. In conjunction with staff from the Quality Management and Risk Management departments, employs systematic techniques such as Failure Mode Effects and Criticality Analysis (FMECA) and root cause analysis for the investigation of failures of the entity. Provides entity trended reports from the System occurrence reporting systems and assists the Service Lines and Departments in providing trended occurrence reports to the entity Patient Safety Committee and other committees as needed. Assesses the entity's safety culture using industry standard assessment tools. Works with other members of leadership to develop and implement programs that seek to address issues of concerns from these surveys. Develops, implements and coordinates patient safety initiatives and goals such as Leapfrog Patient Safety metrics, IHI, The Joint Commission and National Patient Safety goals, DNV, and PA Department of Health. Reports WellSpan Health Patient Safety information to designated committees and boards as directed by senior leadership. Evaluates performance of patient safety program against measures developed from The Joint Commission or DNV and other standards related to patient safety, Sentinel Event Alerts and WellSpan Patient Safety Committee goals. Attends and chairs facility/entity Patient Safety Committee meetings and provides consultation to foster adoption of system-wide patient safety initiatives. Monitors the external environment for best practices and evaluates these for entity implementation. Serves as entity coordinator for management of all alerts and recalls on equipment and devices within the entity. Provides patient safety related training as needed, including such topics as Just Culture, root cause analysis, event reporting and management, etc.. If assigned to a hospital entity, oversees the hospital's responsibilities for patient safety reporting to the Pennsylvania Department of Health and the Pennsylvania Patient Safety Authority. Reviews assessments of compliance with the Joint Commission Sentinel Event Alert recommendations, if applicable.

Common Expectations:

Demonstrates a commitment to patient, visitor and staff by: complying with all applicable safety regulations; learning the impact of medical errors and methodology that will lead to reduction of errors; reporting actual and potential errors, as well as hazardous conditions; identifying opportunities to standardize processes and "error proof" systems that will lead to increased safety; and participating in safety education programs and root cause Maintains established policies and procedures, objectives, quality assessment, safety, environmental and infection control standards. Enhances professional growth and development through participation in educational programs, current literature, in-service meetings, and workshops. Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Required for All Jobs:

Performs other related duties as identified. WellSpan Health has adopted and implemented a compliance program to support WellSpan's values and standards for professionalism, integrity, and ethics. Expected to support and meet the values and standards of the organization and the performance expectations of the job, the department, and the compliance program. WellSpan Health has adopted and implemented a privacy program to safeguard the patient information and the business and operational information of the organization. Expected to support and meet the values and standards of the organization to safeguard patient and business/operational information.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Physical Demands:

Standing - Occasionally Walking - Occasionally Sitting - Frequently Reaching - Rarely Talking - Frequently Hearing - Frequently Repetitive Motions - Occasionally Eye/Hand/Foot Coordination - Occasionally

Travel Requirements:

Estimated Amount: - Travel required.

Qualifications

Minimum Education:

Bachelors Degree Required

Work Experience:

3 years Clinical experience preferably as licensed in a defined discipline. Required or Experience in Respiratory therapy, Physical/Occupational Therapy, Radiation therapy, Risk Management or Performance Improvement will also be considered. Required

Licenses:

Licensed Registered Nurse Upon Hire Preferred or Registered Nurse Multi State License Upon Hire Preferred or Licensed Registered Pharmacist Upon Hire Preferred

Knowledge, Skills, and Abilities:

Excellent interpersonal and written and oral communication skills. Excellent organizational skills. Knowledge of state and national patient safety regulations. You’re unique and you belong here.

At WellSpan Health, we are committed to treating all applicants fairly and equitably, regardless of their job classification. If you require assistance or accommodation due to a disability, please reach out to us via email at . We will evaluate requests for accommodation on a case-by-case basis. Please note that we will only respond to inquiries related to reasonable accommodation from this email address. Rest assured, all requests for assistance or accommodation are handled confidentially, allowing applicants to share their needs openly and honestly with us.