Quality Assurance & Performance Improvement Nurse QAPI Nurse

Oasis Hospice And Palliative Care Inc.•Flossmoor, IL

1d•$85,000 - $89,000•Onsite

About The Position

The Quality Assurance & Performance Improvement Nurse (QAPI Nurse) plays a crucial role in ensuring the highest standards of patient care and regulatory compliance within the facility. This position involves extensive documentation review, collaboration with the clinical team, and proactive identification and resolution of issues related to patient care, safety, and regulatory adherence. The QAPI Nurse will lead initiatives to improve processes, analyze data, and provide education to staff to foster a culture of continuous quality improvement.

Requirements

Must be a licensed Registered Nurse (RN).
Experience in Quality Assurance and Performance Improvement (QAPI) is required.
Strong understanding of regulatory compliance, including CMS and The Joint Commission standards.
Proficiency in documentation review and validation.
Experience with incident investigation, root cause analysis, and developing prevention strategies.
Skilled in auditing care plans and ensuring compliance.
Ability to analyze data, identify trends, and implement system-wide improvements.
Experience in leading interdisciplinary teams.
Excellent communication and interpersonal skills for providing feedback and education to staff.
Proficiency in using quality indicator data for reporting and improvement initiatives.

Nice To Haves

Experience in Home Health Agency (HHA) care plans.
Familiarity with IDG documentation requirements.
Experience in deficiency management and correction.
Knowledge of infection control tracking and compliance.

Responsibilities

Collaborate with the Clinical Team to ensure documentation is complete, consistent with care, and reflects legal requirements in real-time.
Validate documentation accuracy and appropriateness in real-time.
Review admissions for physician orders, verbal certification, and complete documentation.
Review all discharges, including live discharges and patient deaths.
Ensure documentation supports and maintains regulatory compliance for all admissions and discharges.
Review all incidents, including falls and infections, and ensure interventions, reassessments, and care plan updates are completed.
Monitor infection tracking and compliance.
Conduct root cause analysis and implement prevention strategies for incidents, falls, and infections.
Lead interdisciplinary teams to identify and address systemic issues, such as reducing patient falls or medication errors.
Audit nursing care plans every 14 days and with condition changes, ensuring plans reflect physician orders and patient condition.
Audit HHA care plans every 14 days and with updates, ensuring they are updated accordingly.
Evaluate the quality and effectiveness of care plans.
Ensure IDG notes are timely and reflect patient status, decline, and plan effectiveness.
Identify, track, and ensure correction of deficiencies, providing timely feedback and education to staff.
Use audit findings to identify trends and support QAPI initiatives.
Ensure processes are in place to monitor and measure all activities related to performance improvement.
Implement the Agency’s continuous Quality Assessment and Performance Improvement (QAPI) plan and program.
Establish a process model for improvement and provide education and training to organization personnel on the performance improvement plan, as well as team development.
Manage quarterly clinical record review process and ensure timely and accurate results.
Tabulate and submit findings to the Clinical Director.
Analyze data and implement system-wide improvements.
Coordinate activities related to clinical record review for data collection.
Collect, track, and compile quality indicator data, including patient care, safety, risk management, infection control, outcomes, and customer satisfaction.
Compile, trend, and report quality data to the Clinical Director.
Ensure the facility meets standards set by the Centers for Medicare and Medicaid Services (CMS), The Joint Commission, and other accrediting bodies.
Implement and monitor the organization’s quality improvement program.