Nurse-Quality Safety Improvement (QSI) Assistant Chief

Full Job Description

Functions as a clinical expert and executes position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex patient care.

Assesses, plans, implements, and evaluates delivery of care based on age specific components. Demonstrates performance and leadership that is broad enough to improve the care for a group of patients.

Basic Requirements: English Language Proficiency. In accordance with 38 U.S.C.

7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.

Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE); OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program.

Upon achievement of a State license, the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program.

(Reference VA Handbook 5005, Appendix G6); OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active, and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program.

Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD).

Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia.

Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements, but do not possess the required licensure, may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification.

Grade Determinations: The following Scope, Education and Dimension criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade.

The Dimension requirements (Practice, Veteran/Patient Driven Care, Leadership, Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: https://apply.usastaffing.gov/ViewQuestionnaire/12891164.

Grade/Level Scope Education Nurse I, Level I Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies.

An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required.

Nurse I, Level II Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex.

An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required.

Nurse I, Level III Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations.

An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience.

Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others.

A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience.

Nurse III Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting.

MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III.

*Note: Foreign education programs/degrees are not creditable as related degrees.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

Preferred experience: At least 3 years supervisory experience At least 4 years administrative experience Experience reading, interpreting, and analyzing The Joint Commission (TJC) or Office of Inspector General (OIG) Standards or other technical or administrative directives, polices and regulations Experience utilizing Performance Improvement methodologies Experience leading, planning and executing TJC, OIG, CARF, and/or other regulatory site visits Ability to use sound judgement in leading QM activities and actions for problem solving and decisions Ability to analyze complex and critical data and easily identify trends, issues of concerns, action needed to accomplish facility requirements Ability to be flexible, adaptable, and prioritize multiple tasks with competing deadlines Ability to effectively and positively work with others to achieve common goal Ability to maintain confidentiality with sensitive assignments and/or facility reports Organized and detailed oriented as required for data tracking and monitoring assignments Prefer Masters Prepared Nurse Physical Requirements: Physical aspects associated with work required of this assignment are typical for the occupation, see Duties section for essential job duties of the position.

May require standing, lifting, carrying, sitting, stooping, bending, puling, and pushing.

May be required to wear personal protective equipment and undergo annual TB screening or testing as conditions of employment.

Work Environment: Work is performed in an office/clinic setting with minimal risks that requires normal safety precautions; the area is adequately lighted, heated, and ventilated.

However, the work environment requires someone with the ability to handle several tasks at once in sometimes stressful situations. Major Duties:

VA offers a comprehensive total rewards package: VA Nurse Total Rewards Duties for this position include, but are not limited to: The Assistant Chief of QSI Service is a self-directed nursing professional who supervises numerous assigned QSI staff (Quality Consultants/Specialist and Program Analyst, Accreditation Specialist, Peer Review Specialist, and Risk Management Specialist), assesses plans, implements, coordinates, monitors and evaluates the quality and safety of the delivery of care for the organization.

Assumes a leadership role in facilitating regulatory compliance for internal and external oversight bodies (i.e., The Joint Commission (TJC), Commission on Accreditation of Rehabilitation Facilities (CARF), Veterans Health Administration (VHA) Directives and Handbooks, etc.), Occupational Safety and Health Administration (OSHA), Office of the Medical Inspector (OMI), Office of the Inspector General (OIG), and VHA performance measures, supporting performance improvement work, and supporting and guiding the work of committees or governance structure.

The Assistant Chief of QSI ensures that services have systems and processes in place to provide safe, quality care that is consistent with external benchmarks.

Leads performance improvement initiatives by identifying quality metrics, trending data, maintaining the QSI dashboards, and acts as a subject matter expert in data analysis and data display.

Consults and acts as a resource to leadership and staff in standards interpretation implementation, patient safety, risk management, peer review and re-design of processes and structures to improve care outcomes.

Develops and implements policy and procedures, collaborates with service departments, and works toward meeting the strategic plan of the organization.

The Assistant Chief of QSI oversees monitoring of corrective actions from survey findings and assists services who are performance outliers.

Provides oversight for programs such as Accreditation Tort Claims, Risk, and Peer Review Program processes.

Responsible for completing clinical quality reviews, clinical data analysis, and identifying opportunities for improvement.

Contributes ideas and recommendations for the developing standards of care, policies, and objectives for the enhancement of QSI functions organizational-wide.

Assists in policy-making activities as related to patient safety and quality of care as well as the overall functioning of administrative and clinical programs.

Collaborates with other health care staff or Interdisciplinary Teams (IDT) to establish and maintain programs that cross service and/or discipline lines and influence organizational mission and health care.

Demonstrates the knowledge and skills necessary to communicate and interact appropriately and courteously with all internal and external customers and to maintain confidentiality of patient/employee information electronically, verbally, and written.

The Assistant Chief of QSI collaborates with the Accreditation Coordinator for the coordination of accreditation readiness activities focused on standards compliance, education of staff on standards, VHA requirements, and customer satisfaction for internal and external stakeholders.

Influences care outcomes by collaborating with members of numerous interdisciplinary teams.

Core elements of performance include knowledge and active participation in unit/program level quality improvement and patient safety processes and initiatives as well as customer service programs.

Leads QSI staff through performance evaluations, promotes and supports High Reliability Organizational (HRO) principles and activities for cultural changes, and change management principles.

The Assistant Chief of QSI supports the Chief with all QSI programs/practices in his/her absence.

Pay: Competitive salary, regular salary increases, potential for performance awards Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Licensure: 1 full and unrestricted license from any US State or territory Work Schedule: Monday - Friday, 8:00am - 4:30pm, subject to change based on the needs of the facility.

Telework: Not available. Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not authorized. Permanent Change of Station (PCS): Not authorized.