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Category: Management
Facility: Ephraim McDowell Regional Medical Center
Department: 01 CLINICAL EFFEC
Schedule: Full-time
Shift: 1st
Hours: Varied
Job Details: Master's Degree

The Executive Director of Clinical Effectiveness serves as the executive owner to align Ephraim McDowell Health’s strategic vision for Medical Staff leadership and Performance Improvement.  Supports the medical staff governance and PI process and Medical Staff leadership development across the system.  Provides senior leadership for the development and implementation of clinical effectiveness and quality improvement systems across the entire health care delivery system to produce improved clinical and nonclinical outcomes/results related to service, outcome, and cost.  Provides leadership for the integration of quality principles and processes. The Executive Director must be a transformational leader to move the Organization towards new levels of excellence.  Recruits and develops staff with expertise in Quality Improvement science across the system.  Fosters a culture of quality and patient satisfaction through leadership, education, communication, recognition and reward across the system.  Ensures results within the health system for service excellence, clinical effectiveness, operational excellence, and safety serve internal and external customers’ needs.


Executive Director of Clinical Effectiveness is responsible to create, direct and lead all aspects of quality centered care. Responsibilities include setting, maintaining, and achieving clinical quality goals; ensuring all leaders and physicians are engaged in improving clinical outcomes; and implementing programs and initiatives to increase the clinical excellence of Associates and medical staff.  The Executive Director of Clinical Effectiveness provides strategic leadership for development and measurement of a system-wide approach to clinical quality improvement and medical safety focusing on evidence-based clinical practices. The Executive Director of Clinical Effectiveness will lead through influence, will establish consistency of outcomes, will develop guidelines on how patients move through the system efficiently and will enhance the alignment between medical staff and the Ephraim McDowell Health system.


Through both formal and informal linkages between key stakeholders (Board members, Medical Staff, Leadership, Associates, patients, and visitors), assures effective and collaboration relationships that foster teamwork and promotes evidenced-based practice across the system.  The Executive Director is responsible for setting goals and objectives for the development, establishment and coordination of customer satisfaction programs and initiatives throughout the Ephraim McDowell Health System to include patients, visitors, Associates, and physicians.  The incumbent works with Officers, Directors, and other leaders to identify opportunities, implement solutions, analyze data and process, monitors progress and evaluates effectiveness of facility-wide and system-wide performance improvement activities.  The Executive Director leads the Clinical Effectiveness Department including Infection Control Practitioners, Joint Commission Coordinator, data abstractors, Data Analyst and the Customer Relations Department including Patient Satisfaction Surveyor, Customer Relations Specialist, Medical Staff Services and Case Management. The incumbent Serves as the executive sponsor for the Quality of Care Committee of the Board, Leadership meeting, and the C.A.R. (Continual Accreditation Readiness) Committee.  Exhibits our F.I.R.S.T. values (Friendliness, Innovation, Respect, Service, and Trust). 


Computer literacy, highly-developed interpersonal skills, effective writing, public speaking, and presentation skills.  Analytical and problem-solving abilities.  Versed in statistical application and analysis.  Solid planning and Organizational skills.  Ability to work independently and via processes to affect outcomes.  Ability to design and implement focused studies. Ability to perform and teach statistical methodologies and to analyze, display, and interpret data.


Education:  Masters Degree in Nursing or other healthcare-related career/profession.


Experience:  Minimum of 10 years experience in an upper level leadership position in a medium-to-large healthcare system, hospital or medical center. Certification in healthcare quality management highly desirable.  Must be knowledgeable/certified in quality improvement and patient safety with a minimum of three years’ experience facilitating lean/six-sigma projects with demonstrated measurable results; a Black Belt certification is preferred. Experience with medical informatics and electronic medical record systems, a track record of transformational leadership and innovation, and the ability to build consensus and work in a team setting is essential. Minimum of five years experience reporting directly to a member of Senior Leadership (including medical staff leadership) with responsibilities for coordinating/leading/facilitating large-scale Organizational changes such as implementing a quality improvement process and other cultural/strategic change.



Current RN license in state of Kentucky or related clinical certifications and/or licensure.  Certification as Performance Improvement Specialist preferred.


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