Program Manager Stroke - Quality Management

CHRISTUS Santa Rosa Hospital - Westover Hills (CSRH-WH) is a 150-bed hospital serving the fastest growing area of San Antonio. Specialized care includes orthopedic and surgical services, ICU, women’s services, a newborn nursery, comprehensive cardiovascular care from diagnostics to open heart surgery, vascular lab, sleep center, emergency services, the CHRISTUS Weight Loss Institute, wound care, rehabilitation, and more. The campus also boasts an Outpatient Imaging Center and three medical plazas, one of which houses our CHRISTUS Santa Rosa Family Medicine Residency Program and CHRISTUS Santa Rosa Family Health Center.

In a High Reliability Organization, the Stroke Program Manager, reporting to the senior most Quality Management leader of the Ministry, is responsible for support of the Stroke Program of the hospitals assigned. This individual will demonstrate their expertise in quality management and performance improvement through the development, implementation, coordination and maintenance of Stroke Program standards, internal auditing and outcome reporting requirements as specified by certification, accrediting and benchmarking agencies.

Analyzes and trends data for opportunities for improvement/process improvement. Coordination of process improvement activities and required follow up to improve care of the stroke patient population. Develops implements and maintains policies and guidelines for best practice for treatment of stroke patients across the continuum of care to ensure quality patient care and outcomes. Assumes a leadership role and represents the Stroke Program on various hospital and community committees and serves as liaison to administration, medical staff and quality committees.

Provides education to all medical, nursing, ancillary staff and EMS regarding care of the Stroke patient and development of materials related to best practices of Stroke awareness and intervention. This role is expected to apply clinical knowledge and analytical skills to assist the Director of QM and leadership, of that hospital, to implement change with a strong focus on improving quality outcomes and results.

• Meets expectations of the applicable OneCHRISTUS
  
  Competencies:
  
  Leader of Self, Leader of Others, or Leader of Leaders.
• Communicate effectively to different audiences.
• Proficient in computer skills using EXCEL, PowerPoint, clinical systems, and registry databases.
• Knowledgeable on High-Reliability Principles and PDSA methodology.

Source: NAHQ Workforce Accelerator Competency Framework 2022:
Eight Domains

• Quality Leadership and Integration - Advance the organization’s commitment to health care quality through collaboration, learning opportunities and communication. Lead the integration of quality into the fabric of the organization through a coordinated infrastructure to achieve organizational objectives. Domain Level: Foundational.
• Performance and Process Improvement - Use performance and process improvement (PPI), project management and change management methods to support operational and clinical quality initiatives, improved performance and achieve organizational goals. Domain Level: Foundational.
• Population Health and Care Transitions - Evaluates and improve health care processes and care transitions to advance the efficient, effective, and safe care of defined populations. Domain Level: Foundational.
• Health Data and Analytics - Leverage the organizations analytic environment to help guide data-driven decision-making and inform quality improvement initiatives. Domain Level: Foundational.
• Regulatory and Accreditation - Direct organization-wide processes for evaluating, monitoring, and improving compliance with internal and external requirements. Lead the organization’s processes to prepare for, participate in, and follow up on regulatory, accreditation and certification surveys and activities. Domain Level: Foundational.
• Patients Safety - Cultivate a safe healthcare environment by promoting safe practices, nurturing a just culture, and improving processes that detect, mitigate, or prevent harm. Domain Level: Foundational.
• Quality Review and Accountability - Direct activities…