AdventHealth Registered Nurse Accreditation/Performance Improvement Specialist Full Time in Sebring, Florida
" Registered Nurse Accreditation/Performance Improvement Specialist Full Time" AdventHealth Sebring
Location Address: 4200 Sun 'n Lake Boulevard Sebring, FL 33872
Top Reasons to Work at AdventHealth Sebring
Faith Based & Mission driven Facility
Largest Employer in the County
Surrounded by beautiful Lakes, Golf Courses and Florida’s oldest State Park
Close knit community with a home town family feel
2 hours to just about any beach on either Coast
Full Time- Days
You Will Be Responsible For:
Provides direction to department and facility leadership in planning of a systematic, organization- wide approach to continuous regulatory readiness
Chairs the Continuous Survey Readiness Committee
Communicates relevant changes to standards
Prepares reports and/or presentations
Coordinates educational materials/ presentations for committee members
Coordinates the planning and execution of the TJC intra-cycle monitoring (ICM)
Conducts tracer activity within the hospital and the clinic setting
Performs chart abstractions, audits, and documentation reviews to identify compliance with regulatory bodies.
Interviews staff through the tracer methodology process
Prepares summaries of gathered information
Participates in EOC rounds
Plans, develops, and conducts educational programs on accreditation for employees
Facilitates mock surveys and assists in the development of plans for improvement
Prepares survey specific documentation as requested by regulatory agencies
Participates in on-site surveys, including coordination of agendas, coordination of scribes, communication with surveyors and on-site staff, and communication of preliminary findings
Facilitates the development of corrective action plans as part of post-survey activities
Collaborate with all members of the healthcare team
Maintains knowledge in regulatory compliance
Conducts Failure Mode Effect Analysis (FMEA) as indicated/ required by regulatory entities and in accordance with the Patient Safety Plan
Attends and provides support for multiple hospital committees, such as UR/Performance Improvement/Patient Safety, Glycemic Management, Water Management, Environment of Care, Emergency Management, etc.
Self-directed in maintaining and improving own competence in cognitive aspects of nursing practice
What You Will Need:
Associates Degree in Nursing
Minimum 3 years as acute care nurse
Registered Nurse with current licensure to practice in the State of Florida required
Strong organization skills, including completing work by established deadlines.
Ability to evaluate and correlate clinical information with appropriate criteria and is able to utilize available computer hardware and software.
Skills to develop and engage in educational activities to facilitate learners’ achievement of specific objectives.
The Accreditation/ Performance Improvement Specialist serves as a member of the Quality Department. This position leads regulatory survey readiness program planning for AdventHealth Lake Placid, Sebring, and AdventHealth Wauchula. This position coordinates survey activities, i.e. The Joint Commission (TJC), Agency for Health Care Administration (AHCA), and CMS Validation Surveys. This position is also responsible for managing selected Performance Improvement Initiatives within the facility. This individual proceeds on their own initiative in compliance with policies and procedures prescribed by the Quality Department leadership.
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.