To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
- 1. Plays an integral role in the Stroke Center program management and Joint Commission Stroke certification.
- 1.1. Is knowledgeable regarding Joint Commission standards for the certification program, communicates standards and apprises Stroke Committee and other stakeholders of new or revised standards or professional guidelines (AHA/ASA) that may impact the program.
- 1.2. Conducts periodic assessments of standards compliance and develops action plans in conjunction with Stroke program leadership.
- 1.3. Completes and submits the bi-annual certification application and the annual intracycle requirements, including the Stroke program?s Performance Improvement Plan and Performance Measures Data Report.
- 1.4. Coordinates the Joint Commission survey activities prior, during and post-certification, including any requirements for improvement.
- 1.5. Collaborates with Public Relations regarding marketing of the program and its services.
- 1.6. Identifies and maintains current reference and resource materials as well as documentation related to Joint Commission certification requirements.
- 2. Collaborates with the Stroke Medical Director and the Stroke Committee to establish the structure and processes for delivering and facilitating care that optimizes patient outcomes.
- 2.1. Utilizes Joint Commission certification standards and evidence-based practice guidelines to develop stroke order sets, policies, and standard operating procedures for hyperacute and acute stroke care for various stroke subtypes.
- 2.2. Collaborates with ED leadership to ensure timely and appropriate care for all patients suspected of stroke.
- 2.3. Conducts concurrent review and stroke tracers to evaluate the care provided and any opportunities for improvement. In conjunction with these activities, provides feedback to staff and managers.
- 2.4. Participates in educational opportunities to enhance stroke knowledge and professional development.
- 2.5. Facilitates the monthly Stroke Committee meeting; develops and maintains associated meeting documentation.
- 2.6. Facilitates the collaborative design, implementation and evaluation of the program to meet the needs of the population.
- 3. Responsible for the coordination, management and analysis of process and outcome measurement data and comparative data for stroke patients throughout the continuum of care. Utilizes this information to improve care.
- 3.1. Collects data via chart review, system reports, and stroke code activation to identify the monthly stroke population and create the stroke code log.
- 3.2. Validates data and reports from Premier, Get with the Guidelines (GWTG), and Joint Commission and reconciles reporting with system abstractors. Identifies missed opportunities on the individual and aggregate basis.
- 3.3. Responsible for data integrity of Joint Commission required metrics and Stroke Code metrics, and other measures pertinent to program expansion (i.e., Thrombectomy, Telestroke and Transfer metrics) and GWTG awards.
- 3.4. Provides performance feedback on an individual basis and in the aggregate to various stakeholders and reports up to Quality Council. Communicates performance data through multiple formats as needed (Medical Staff newsletter, Netpresenter, dashboards, etc.).
- 3.5. Communicates changes in measure requirements by regulatory and certification bodies (CMS, TJC, eCQM, etc.).
- 3.6. Prioritizes improvement initiatives in conjunction with program leadership and facilitates performance improvement projects as needed.
- 3.7. Utilizes performance improvement methodologies (Lean, PDCA, IHI model, etc.) and tools in designing, implementing, and evaluating performance. Employs health data analytic tools and methods to analyze and display data to foster data-driven decision-making.
- 4. Supports stroke and related education initiatives for patients, staff, and the community to optimize stroke symptom recognition, risk reduction and management, and the care of the stroke patient.
- 4.1. Collaborates with Education and Nurse/Department Managers and Directors to develop a comprehensive educational program that meets the learning needs of staff and the requirements of Stroke certification. Collaborates with Education and Managers to ensure staff are qualified and competent.
- 4.2. Collaborates with Community Health at Greenwich Hospital on providing a minimum of two educational programs per year (fairs, seminars, education/support groups, etc.) for the community. Solicits feedback from participants.
- 4.3. Coach and mentor staff on providing stroke education to patients and families through various methodologies (i.e., one-on-one, written materials, tracer activity, etc.).
- 4.4. Interacts with and contributes to the professional development of peers and colleagues. Shares knowledge and skills with peers and colleagues as evidenced by such activities as patient care conferences or presentations at formal or informal meetings.
- 4.5. Assists in the development of educational and promotional materials for patients, caregivers, staff and the community.
- 5. Collaborates with peers on system-wide and state-wide stroke initiatives.
- 5.1. Participates in Yale New Haven Health Stroke meetings and initiatives, as well as educational offerings. Works with peers on process improvements and program enhancements.
- 5.2. Represents Greenwich Hospital by participation in the Stroke Coordinators of Connecticut and the State of Connecticut Stroke Advisory Committee.
- 6. Performs other duties as assigned or directed to ensure smooth operation of the Stroke program.
- 7. Meets standards of professional behavior: puts patients and families first, provides excellent service, is respectful, compassionate, and accountable and demonstrates integrity.
Bachelor degree or higher in Nursing, Physical Therapy, or related field. MBA, MPH, MSN, or other. Masters degree in health related field preferred.
Monimum of 5 years progressive clinical experience in critical care, acute medical/surgical, or stroke care, with a minimum of 3 years experience in program management, education, operations, or process improvement.
Maintains licensure/certification in their professional discipline.
Strong, demonstrated interpersonal skills and proven ability to coordinate clinical and programmatic needs across a continuum of care. Outstanding communication, facilitation and problem-solving skills. Strong computer skills (e.g., Word, Excel, and PPT) and demonstrated ability to successfully lead process change. Healthcare clinical background essential with inpatient hospital experience required. Process improvement training and accreditation/certification experience preferred.
Possesses expert knowledge of Joint Commission certification standards and performance improvement tools to inform operations, maximize performance, and optimize outcomes across a multidisciplinary system.
Moderate stress from coordinating and supervising program. Standing/walking, frequent bending, reaching, stooping, squatting positions. May be exposed to infectious diseases.