Vice President, System Quality, Patient Safety and Infection Prevention
September 26, 2018
Full Time - Experienced
Hospital, Public and Private
Vice President, System Quality, Patient Safety and Infection Prevention
This position reports directly to the System Senior Vice President and Chief Quality and Safety Officer, Dr. Sam Flanders. (Note, Dr. Flanders reports directly to the Chief Executive Officer, Mr. John Fox.)
Beaumont Health is Michigan’s largest health system. The heath system was formed in 2014 to provide patients with compassionate, extraordinary, high quality care. With eight hospitals, 174 health centers, nearly 5,000 physicians and 38,000 employees, Beaumont Health contributes to the health and wellness of residents throughout southeast Michigan and beyond.
John T. Fox, President and Chief Executive Officer
John D. Lewis, Board Chairman
Annual service statistics
Beaumont hospital bed count
Total beds 3,337
Other facilities and services
174 outpatient sites include:
emergency and urgent care centers
senior living and nursing homes
wellness and fitness centers
home care and hospice
multistate medical transportation business
Medical school affiliations
Oakland University William Beaumont School of Medicine
Michigan State University College of Osteopathic Medicine
Wayne State University School of Medicine
Graduate Medical Education
870 residents and fellows
86 residency and fellowship programs
Beaumont Health provides outstanding, high quality care at an affordable cost. It is innovative in its care delivery and is quickly adapting to the new and exciting challenges in the healthcare industry as a result of healthcare reform, providing the full continuum of care. Beaumont Health is nationally recognized and has received numerous awards and distinctions:
U.S. News & World Report
Beaumont- Royal Oak ranked as the #1 hospital in Michigan, with 10 nationally ranked specialties (Gastroenterology, Geriatric, Gynecology, Heart/ Heart Surgery, Diabetes/Endocrinology, Kidney, Neurology/Neurosurgery, Orthopedics, Respiratory Disorders/Pulmonology and Urology)
Beaumont-Troy is nationally ranked in three specialties Geriatric, Diabetes/Endocrinology, Disorders/Pulmonology
Beaumont-Grosse Pointe is named as high-performing in Respiratory Disorders/Pulmonology
Beaumont-Dearborn and Beaumont-Wayne are ranked among the top 25 health care facilities in Michigan
The Joint Commission
Beaumont-Royal Oak: Comprehensive Stroke Center, Gold Seal of Approval for total knee and total hip replacement, Chest Pain Center accreditation, “Top Performer on Key Quality Measures”
Beaumont-Troy: Primary Stroke Center, Chest Pain Center Accreditations, “Top Performer on Key Quality Measures”
Beaumont-Grosse Pointe: Primary Stroke Center, Chest Pain Center Accreditations, “Top Performer on Key Quality Measures”
Beaumont- Dearborn, Gold Seal of Approval for total joint replacement program
Beaumont-Taylor: “Top Performer on Key Quality Measures”
Beaumont- Wayne: “Top Performer on Key Quality Measures”
Vizient (formerly University Health System Consortium)
Beaumont-Royal Oak: Quality Leadership Award, listed in Top Ten academic medical centers in the country for Quality for multiple years.
Becker’s Hospital Review
“100 Integrated Health Systems to Know”
Beaumont- Royal Oak: 100 Great Hospitals
American Nurse Credentialing Center
Beaumont- Royal Oak and Beaumont-Troy: Magnet Recognition
Beaumont-Troy and Ambulatory Care Centers: Stage 7 Certification
American College of Radiology
Beaumont- Royal Oak: Center of Excellence in Breast Imaging
Beaumont- Troy: center of Excellence in Breast Imaging
American College of Surgeons
Beaumont-Royal Oak: Level 1A Bariatric Surgery Center: Level I Trauma Center; Level 1 Accredited Educational Institute (Marcia & Eugene Applebaum Surgical Learning Center); National Accreditation Program for Breast Centers and Commission on Cancer accreditation
Beaumont –Troy: National Accreditation Program for Breast Centers
2014 Governor’s Award of Excellence
Beaumont- Dearborn and Beaumont- Wayne
Southeast Michigan has one of the most diverse ethnic populations in the country as well as some of the most prestigious neighborhoods and communities. Oakland County is the third wealthiest county in the U.S., and one of only a few in the country with a AAA bond rating. The Metropolitan Detroit area is historically famous for having “put the world on wheels”. It is the world’s leading area for automotive research and safety with all Japanese, Chinese and Indian auto manufacturers along with U.S. companies having major R&D facilities in southeast Michigan.
In addition to its proud history related to the automotive industry, southeast Michigan offers much more. As an international city bordering Canada, Detroit provides many community services and employment opportunities to the Canadian market. Further, the area boasts talent, resources, and cutting edge facilities to drive innovation toward the future, including an academic research triangle of Michigan State, University of Michigan and Wayne State University, as well as high-tech “Automation Alley” - a parallel to Silicon Valley and Route 128. Southeast Michigan also offers much in recreation and the arts. The Great Lakes account for 20% of the world's fresh water and offer endless miles of coastline with beautiful beaches, serving as a major resort destination. Michigan has the third most golf courses nationally and prestigious country clubs that have hosted numerous US Opens, PGAs, and the Ryder Cup. The area is culturally rich which includes a nationally renowned art institute, symphony, orchestra, and museums, as well as a wine region growing nationally in reputation. On the business front, Detroit has earned its place as a global leader and continues to revitalize:
The automotive companies are growing (both General Motors and Ford Motor Company increased plant productions in the area).
Marathon Oil is investing $2.2 billion in a Detroit area plant.
General Electric increased the size of its footprint in Van Buren Township.
Blue Cross/Blue Shield recently moved its offices to the downtown Detroit area.
Campbell Ewald Advertising is investing $75M to move its offices/employees to Detroit.
Dan Gilbert, Detroit area businessman and entrepreneur, and founder of Quicken Loans, has purchased 60+ office buildings in Detroit and over 2.6M square feet of commercial space, investing $1B in development. The company has been selected numerous times as one of America’s Best Companies To Work.
Detroit is also a major sports town with an exciting history and an exciting future. Detroit’s professional sport teams are exceptional, ranking third behind New York and Boston in sports championships. College sports are a major influence in the area as well with Big 10 powers Michigan and Michigan State in nearby Ann Arbor and East Lansing, respectively. The entire southeastern Michigan area is rich not only the availability of cultural activities, but in its history and plans for the future as well. For additional information on Detroit, southeast Michigan, and the entire region, you can visit the following web sites: www.detroitchamber.com, www.michigan.com, and www.michigan.org.
The role and responsibilities of the Vice President, System Quality, Patient Safety and Infection Prevention include:
Working directly with and under the direction of the System Senior Vice President and Chief Quality and Safety Officer to:
Align and manage the quality and safety infrastructure for Beaumont Health with the philosophy of local, accountable quality/safety leadership in each Division with central coordination.
Establish targets and priorities for quality and safety metrics, including regular monitoring of external agency (CMS, Joint Commission, payers and others) expectations.
Continuously monitor and improve the performance of BH vs. established targets including Pay for Performance programs.
In collaboration with Risk Management, support and communicate the Serious Safety Event process including event reporting, Disclosure, Root Cause Analysis, action plan development and ongoing monitoring to ensure effectiveness of countermeasures.
Establish systems for collecting, analyzing and acting upon variance reports submitted by staff, students and physicians.
Provide education and coaching in quality and performance improvement for the BH organization.
Support the accreditation activities of BH via provision of data and Performance Improvement assistance.
Establish the department as a resource to others and a driver of organizational performance that is built on relationships and a shared vision of excellence; an environment of achievement and local accountability and avoiding a policing approach.
Working directly with executives at all levels of the corporation, including physicians and physician leaders in setting the Quality and Safety strategy.
Develop Quality and Safety content for the Quality and Safety Committee of the Board of Directors, including making regular presentations to this group.
Representing the Sr. Vice President at operational and strategic meetings with both senior hospital leaders and corporate administration.
Coordinating the Quality and Safety programs across Beaumont Health, including hospitals, ambulatory sites and Physician Practices.
Directing responsibility for compliance to Center for Medicare Services (CMS), Blue Cross Blue Shield of Michigan (BCBSM), The Joint Commission (TJC) and any other external data submission activities relating to Quality and Safety.
Ensuring compliance with CMS annual Hospital Inpatient and Outpatient Quality Reporting Programs and BCBSM pay for performance initiatives.
Leading and aligning Patient Safety activities across the BH system, including;
Coordination and oversight of Root Cause Analysis and impact
Assessment of Culture of Safety with associated follow-up and support
Promotion and education of a Just Culture at BH to ensure a strong safety culture.
Representation/consultation on all divisional Quality and Safety Committees
Assuring ongoing involvement in National and Local Patient Safety Initiatives such as Keystone, IHI, and Partnership for Patients
Providing administrative support to the Infection Prevention and Control department and serving as the Administrative lead for the Infection Prevention and Control Integration Council.
Functions and Responsibilities Include:
Blue Cross Blue Shield of Michigan (BCBSM) Collaborative Quality Initiatives (CQIs)
Pay for Performance Programs including BCBSM, VBP, HAC and HRRP
Public Reporting of Quality Data
System coordination of Infection Prevention activities
Patient Safety system coordination including Culture of Safety, Event Reporting, Serious Safety Event process and Just Culture
Other quality/safety collaborative activities including Michigan Hospital Association Keystone Patient Safety Programs
Beaumont Health is seeking a leader to serve as Vice President, System Quality, Patient Safety and Infection Prevention. They will be responsible for the following essential functions:
The incumbent works very closely with the System and Divisional Quality Directors/Senior Directors and the System Senior VP, Chief Quality & Safety Officer to oversee the above noted Quality and Safety efforts of the Beaumont system. Activities include Leadership of all the Quality and Patient safety initiatives undertaken by Beaumont Health.
Direct responsibility for the management and development of four Senior Directors (direct reports) who help coordinate quality, patient safety, and infection prevention initiatives throughout the health system.
Work with local sites to design and implement rapid cycle performance improvement programs to ensure excellent performance on external measures and P4P programs.
Strategic preparation for new and revised external measures.
Role is very instrumental in regulatory processes such as validation and reporting compliance
Assist with development of data collection tools, databases, and report generation and dissemination.
Manage the system initiatives as they relate to Quality and Safety, ensuring appropriate staffing, reporting, compliance and requirements.
Creating and preparing regular reports for the board and board quality committee, including making regular presentations to the board quality committee, as well as to leaders at all levels of the organization.
Working directly with the Chief Quality and Safety Officer and the Quality and Safety Committee of the Board Chairperson to staff the board quality committee, developing content, preparing materials and provide presentations/education.
Additional responsibilities and requirements:
Supports the Mission, Value and Vision of Beaumont Health (BH). Demonstrates personal commitment through active involvement in the performance improvement process.
Exhibits excellent customer service skills and behaviors toward internal and external customers and co-workers. Promotes positive public relations with patients/residents, family members, guests, and others.
Supports and adheres to all Beaumont Health’s customer service, service excellence, and performance standards. Supports and participates in all required compliance standards that may be department specific and/or identified by the organizations including in-service training, acceptable attendance, uniform and dress code.
Adheres to HIPAA requirements and maintains confidentiality of all data, including patient/resident, employee and operations information.
Supports and participates in a collaborative team-oriented environment – cooperates and works together with all co-workers, plans and completes job duties, uses appropriate communications in sensitive and emotional situations and follows up as appropriate regarding reported complaints, problems and concerns.
Supports, cooperates with and demonstrates safe work practices and attitudes, follows safety rules – including universal precautions - reports and prevents/corrects unsafe conditions and behaviors, and participates in organizational and departmental safety programs.
Completes all required compliance standards that may be department specific and/or identified by the organization.
Maintains current nursing (and/or other) licensure, registration and/or certification, as applicable, at all times.
Skills / Attributes / Experience
Work Experience: Minimum ten years related work experience with demonstrated quality / performance improvement expertise. Must have a proven track record of success in leading the quality, safety, and/or infection prevention functions, with significant measurable improvements achieved during his/her tenure. Must have deep knowledge of current healthcare environment as it relates to quality and safety (compliance, reporting requirements, trends, etc.)
Health System Experience: Experience working in a large, complex, multi-site integrated health system is strongly preferred. The VP must be able to successfully work in a highly matrixed environment, and be able to build strong relationships throughout the health system at all levels.
Communication Skills: Must have strong written and verbal communication skills, and be comfortable working with diverse groups of people in a variety of settings. The VP will have significant interaction with the Quality Committee of the Board and must have the skills and maturity to successfully engage with Board members and senior executives.
Trust and Integrity: The VP must have unwavering integrity, be highly ethical, and serve as a role model to others. He/She will need to establish trust and credibility throughout the organization.
Highly Collaborative: The VP will be a collaborative, team-oriented leader who is highly passionate about quality and safety. Confident, yet humble. Puts the needs of the organization and team, above own self-interests.
Other Requirements: Demonstrated advanced competence in rapid-cycle performance improvement projects. Excellent data interpretation and problem-solving skills. Ability to lead through coaching, influence and collaboration. Ability to work well with physicians, clinicians and administrators at all levels of the organization. Knowledge of computers and Microsoft Office products including familiarity with use of databases. Working knowledge of CMS requirements and related elements.
Bachelor’s degree in Nursing required.*
Master’s degree strongly preferred.
* Will consider other direct patient care disciplines with strong, broad-based clinical exposure and experience.
Internal Number: 510223869
About Korn Ferry
Korn Ferry is a global organizational consulting firm. We help clients synchronize strategy and talent to drive superior performance. We work with organizations to design their structures, roles, and responsibilities. We help them hire the right people to bring their strategy to life. And we advise them on how to reward, develop, and motivate their people. Our 7,500 colleagues serve clients in more than 50 countries. We offer five core solutions.• Organizational Strategy• Assessment and Succession• Talent Acquisition• Leadership Development• Rewards and Benefits