Date: December 2013 Job Title : Registered Nurse Quality Improvement Coordinator West Department Location Reporting To Direct Reports : Primary Health Care Nursing Development Team : Waitemata District Health Board Waitakere Hospital : Primary Health Care Nursing Director : Nil Functional Relationships with : Internal WDHB Primary health Care Nursing Development team WDHB Provider Arm Diabetes Service WDHB Funding and Planning Team Professional Leaders Awhina Health Campus teams External Primary Health Organisation's General Practices in the West West Diabetes working group West Auckland Network Clinical Director Northern Region Diabetes Network ADHB / Auckland PHO Long term Condition Quality Improvement coordinator team Purpose : The overall purpose of the West Quality Improvement Team for Diabetes and Cardiovascular Risk is to provide strong clinical leadership to Primary Care Practices across the continuum of care that optimizes health outcomes improve service delivery for people with diabetes and cardiovascular risk within the West Auckland locality reduce health disparities, within the resources available. This will include collecting and reporting measures; implementing changes to systems and processes using evidenced based best practice, to achieve improved health outcomes for people with Diabetes and Cardiovascular long term conditions Waitemata District Health Board -POSITION DESCRIPTION - Page 1
KEY RESPONSIBILITIES 1. Participate in strategic analysis and planning for the west locality 2. Engage with and support of local general practices 3. Up-skill and provide ongoing support for improved diabetes care by general practice staff through team work, leadership and quality systems. EXPECTED OUTCOMES Identify key clinical improvement areas in line with Northern Regional Diabetes Network guidance Assessment and analysis of practice needs and identification of problems or issues with existing clinical services. Contribute to programme development to support improved diabetes care including education and selfmanagement programmes. Provide a range of services to support assigned Primary Care Practices to implement quality improvements in the care and management of people with diabetes. Builds and maintains positive, productive working relationships through an effective and efficient service. Work with PHOs and the West Auckland Network to identify Practices requiring targeted assistance to increase in the number of annual reviews. Support the use of a population audit tool that enables practices to collect, use and report data to monitor improvement. Provide benchmarking and feedback to practices on their performance. Supporting the development of tailored practice improvement plans in collaboration with key stakeholders within the general practice. Work with practices to enhance their systems and processes to facilitate an integrated patient journey e.g. recalls, referrals, nurse led clinics. Strengthen existing Nurse led clinics and support the development of further Nurse led clinics. Work with practices and PHOs to develop a diabetes registry that is regularly updated. Form supportive learning collaborative's between practices. Improve integration between Primary and Secondary providers by Working as a liaison or a point of contact to facilitate communication. Provide advice for referral to diabetes support services i.e. self-management education and retinal screening. Increase the use of best practice guidelines. Contribute to the development and implementation of clinical pathways for people with diabetes. Contribute to the review of the current system and contribute to the development of future systems to improve care. Provide coaching and mentoring to practice teams to enable self-directed Plan, Do, Study, Act cycles (PDSA). Increase the utilisation of the wider interdisciplinary team. Waitemata District Health Board -POSITION DESCRIPTION - Page 2
KEY RESPONSIBILITIES 4. Engage with Whanau Ora services 5. Contribute to development of locality models of care EXPECTED OUTCOMES Provision or facilitation of continuing clinical education programmes to increase capacity of primary care teams. Provide cluster education as cluster networks develop Act as a resource person for nurses and practitioners Identify and engage with Maori networks and Whanau Ora services that can assist in programme improvements Ensure programme resources are appropriate for intended audiences Equality of outcomes for Maori, Pacific and other people with high clinical need. Provide clinical advice and input into the design and management of locality-based diabetes services and care models. 6. Other Contribute to relevant groups and committees West Diabetes working group Other activity in relation to the Primary Care strategic plan and direction. Behavioural Competencies Adheres to Waitemata District Health Board s commitment to Best Care for Everyone and the organisational values of: Everyone matters With compassion Connected Better, best, brilliant Behavioural Competencies Communicates and works cooperatively Is committed to learning Is transparent Is customer focused Works in partnership to reduce inequality in outcomes Behaviour Demonstrated Actively looks for ways to collaborate with and assist others to improve the experience of the healthcare workforce, patients & their families and the community & iwi. Proactively follows up development needs and learning opportunities for oneself Communicates openly and engages widely across the organisation. Enacts agreed decisions with integrity. Responds to people s needs appropriately and with effective results Identifies opportunities for innovation and improvement Works in a way that: Demonstrates awareness of partnership obligations under the Treaty of Waitangi. Shows sensitivity to cultural complexity in the workforce and patient population. Waitemata District Health Board -POSITION DESCRIPTION - Page 3
Improves health Prevents harm Ensures service provision that does not vary because of people s personal characteristics. Work practices show a concern for the promotion of health and well-being for self and others. Follows policies and guidelines designed to prevent harm. Acts to ensure the safety of themselves and others. VERIFICATION: Employee: Manager: Date: Review Date: Note: This job description forms part of an individual s contract of employment with WDHB and must be attached to that contract. Waitemata District Health Board -POSITION DESCRIPTION - Page 4
PERSON SPECIFICATION Qualifications Experience Skills/Knowledge/Be haviour Expectations NZ Registered Nurse with current Practicing certificate Current driver s license Post registration education in diabetes management Highly desirable Post-graduate diploma in nursing, diabetes, quality improvement, change management, coaching or mentoring Certificate in a self-management model of care Minimum of five years Practice Nurse / Primary Care experience Demonstrated experience in providing support to primary care, diabetes care, quality improvement, change management, coaching or mentoring Highly desirable Demonstrated experience developing and implementing change / transformation Experience evaluating and reporting on impact of clinical improvement initiatives Excellent interpersonal and communication skills both verbal and written Ability to work independently and as part of an interdisciplinary team. Ability to work effectively and competently with the General Practice team including General Practitioners, Nurses and Practice Managers. Demonstrated diabetes knowledge and skills Sound understanding of best practice guidelines for diabetes care and the ability to translate this into practice Knowledge of quality improvement and change management techniques Understanding of Te Tiriti o Waitangi Computer literate: proficient in Windows 2000, MS Word and other Microsoft Office applications Knowledge of PMS and web based and clinical audit tools. Experience of education principles and approaches Whole-brain thinking: analytical, holistic, interpersonal, and implementing Knowledge of data analysis Waitemata District Health Board -POSITION DESCRIPTION - Page 5