Director of Nursing - Ambulatory Practice

Summary:

The Director of Nursing Practice Ambulatory is responsible for developing, implementing, and evaluating evidence-based nursing practices in clinic settings, under the guidance of the Chief Nurse Executive and in collaboration with various healthcare leaders. This role oversees the quality, safety, and practice standards of ambulatory nursing and support staff, fosters a resilient workforce, and recognizes the role of patient specific care needs driving resource utilization. The Director, Nursing Practice Ambulatory collaborates with Ambulatory leadership, educational resources, and multi-disciplinary teams, including ancillary services, inpatient and procedural teams, rehabilitation, and case management, and community services to implement projects that enhance care quality across the healthcare continuum. Key responsibilities include planning and integrating services, improving care delivery, maintaining quality control, ensuring staff training, and managing resources. The role also involves exploring innovative care models and coordinating workforce development with institutional and local educational and health organizations. The position oversees a matrix reporting structure involving over 1000 full-time employees across more than 100 departments and 25 service lines.

Scope: 

Responsibilities:

Administrative Oversight

• Oversees the education and development of ambulatory clinical staff throughout the course of hire including new hires and seasoned employees.
• Ensures that employee training curriculums meet the needs of the scope of services performed and  follows evidence based practice guidelines.
• Manages and maintains the clinic profile for  all services delivered in the Ambulatory care setting.
• Assesses the standards and scope of nursing practices across ambulatory care areas to ensure that nursing and support staff are performing at their appropriate and optimal level of practice based on their job description and/or licensure.
• Reviews patient safety event and professionalism reports and escalates risk and associated mitigation strategies to relevant stakeholders including the training teams.
• Monitors audit reports to ensure quality of care and compliance to prepare for accrediting body and regulatory site visits.
• Collaborates with facility coordinators, Environmental Health and Safety, Compliance, Health Information Management teams, Ancillary service leaders to address issues and concerns affecting patient care and standards.
• Develops and reviews policies and procedures impacting the scope of work of nursing and support staff.
• Assists with creating standard workflow documents and delegated standing orders to ensure compliance with laws, regulations, and standards of practice. 
• Reviews requests for changes to services, equipment, and supplies impacting patient care.
• Participates in the development, upgrading, and uptake of features in the electronic health record (EHR). 
• Encourages nursing and support staff participation and activities in the Professional Governance Councils.

System Growth and Development

• Promotes the development of innovative patient care initiatives that support quality and patient safety initiatives while simultaneously standardizes care provided through the continuum of care within the health system.
• Supports nursing and healthcare research initiated through Professional Governance Councils such as he Ambulatory Professional Practice Council and Research and Innovation Council and encourages the publication and dissemination of findings. 
• Collaborates with other members of the care management team and physician leaders in the development, implementation, and evaluation of programs designed to improve, measure, and evaluate the quality of nursing services, patient outcomes, and the level of patient satisfaction.
• Uses data driven approaches to strategically collaborate with physician groups for the betterment of the Health System and its patients through incorporating innovative practices and research into practice. 
• Builds highly effective interdisciplinary teams to ensure seamless care delivery throughout the healthcare continuum working with transition of care teams, care management, social work, clinical staff, physicians, ancillary and emergency services. 
• Monitors financial and productivity trends and continually strive to improve service delivery and financial outcomes while remaining within planned annual operating and capital budgets and reduces waste. 
• Participates in evaluating, selecting, and integrating health care technology, information technology, medical devices, laboratory mechanisms, and pharmaceutical interventions, that support patient care needs.

Employee development, engagement, and management 

• Oversees the maintenance of mandatory licensure, certification, and registration of Ambulatory staff.
• Accountable to Employee Health initiatives and requirements.
• Supports retention efforts initiated through the Professional Governance Councils for Retention.
• Reviews job descriptions to ensure alignment with expectations and promotion potential.
• Maintains accountability for the recruitment, selection, retention, disciplinary processes, and mentoring. 
• Utilize and interest based process for problem solving and resolving issues with employees. 
• Advises leadership of personnel disciplinary actions in accordance with human resources policies and organization philosophy.
• Identifies talent, coaches, and mentors staff to their highest level of performance. 
• Assists in selecting relevant Key Performance Indicators (KPIs) for clinical staff.
• Provides oversight to leadership development programs and training ensuring contents are relevant and timely.
• Actively participates in the performance planning, competency, management, and individual development and growth process for direct reports.

Professional Development 

• Engages in continuous study, including best practices, to maintain the professional competence, knowledge, and skills necessary for the satisfactory performance of all assigned responsibilities. 
• Seeks out and participates development opportunities in areas identified through self-reflection.
• Develops and maintains professional and collaborative relationships throughout the health system.
• Establishes and maintain effective working relationships with local professional organizations and the communities served by the Healthsystem.

Vision and Planning

• Establishes goals, objectives and operational plans annually to support health system quality, safety, clinical resource utilization, service demands, customer service, financial, and outcome strategies.
• Assesses current ambulatory strategy and operations to determine nursing and support staff priorities for growth, divestiture, and expansion into new markets and product line while ensuring compliance with regulatory standards and scope of practice. 
• Proactively seeks out new and value-added ambulatory services while refining existing programs to meet the growing and ever-changing needs of the community. 
• Assesses organizational, divisional, and community needs and works with physician and ambulatory leadership to develop short term (i.e., standardization) and long range (i.e., transferability of structure and process) plans for nursing services. 
• Collaborates and initiates projects, programs, and system process that coordinate care among inpatient and outpatient care delivery settings incorporating health system assets and community assets.
• Ensures strategic initiatives and operations are following professional standards, applicable laws, accreditation/compliance/ regulatory requirements and support the Health System core values, mission, and strategic initiatives. 
• Establishes and maintains a pipeline for future employees by forging relationships with local schools.
• Actively researches trends in ambulatory service delivery and care coordination both locally and nationally to ensure innovative delivery (e.g., health care home, proactive  plan of care and follow-up, communication, information systems and transitions/hand-offs) to meet developing customer demands. 
• Assess the feasibility of re-inventing primary care delivery: a) first-contact care; b) coordinated care; c) comprehensive care; and d) sustained personal relationships that position the Health System as a leader in coordinated health care focused on acute/chronic treatment and preventive services.
• Explore/recommend models of care delivery that emphasize principles of health behavior/health     promotion in primary prevention activities within current and proposed care settings.
   

Minimum Qualifications:

• Master's degree in Nursing, MBA, MHA or related field plus five (5) years of progressive nursing leadership.
• BSN and a valid Texas RN license or eligibility to apply for a Texas nursing license. 
• Certification in nursing administration or nursing specialty.

Preferred Qualifications: 

• Doctorate in health-related field (e.g., health services, public health, nursing, preventive medicine, etc.) plus five years of clinical experience.
• Diverse management and leadership background in ambulatory healthcare settings.
• Strong project management skills.
• Ten (10) years in a senior leadership role, preferably in an academic medical center and matrix reporting structures. 
• Effective verbal and written communication skills.