Description

The Performance Improvement Coordinator II has accountability for the monitoring, implementation and evaluation of process and programs to meet regulatory, accreditation and standards of practice with defined evidence-based practices through chart review process and data abstraction in accordance with benchmarking organization’s methodology.

Core Competencies

Conducts concurrent chart reviews to identify potential quality of care issues and works corroboratively with direct care givers when possible. Assesses documentation of care according to specific guidelines thereby promoting consistency in methodology and validity of the resulting data. Works collaboratively with the Health Information Management team and staff to promote cooperation and understanding of the data collection process Assists in developing and maintaining current policies and procedures, which will promote consistency in data collection, analysis and reporting systems. Assesses potential or known future changes in data collection, submission and reporting to benchmarking organizations and collaborates with appropriate internal management and staff to develop immediate strategies for compliance. Assists in the development of communication tools which promote understanding of the benchmark reports and how the data applies to each discipline’s practice; thereby promoting ownership of the outcomes and buy-in to seek improvement. Elevates outcomes through solicited feedback to encourage continuous improvement. Educates staff on requirements of the Hospice Item Set (HIS) and implications for publicly reported outcomes when documentation is not congruent. Reviews all Hospice Item Set (HIS) assessments at all time points and ensures accuracy prior to transmission to CMS. Collects data related to compliance with federal, state, and The Joint Commission regulations and standards for hospice agencies. Works in collaboration with agency manager and Educator to educate and provide in-services for staff development related to Hospice Item Set (HIS). Demonstrates Hospice specific competencies.