Director Infection Control

Under the supervision of the Director of Quality, the Infection Control Director is responsible for the development, implementation and review of the infection prevention and control program for the organization. Develops and maintains the policies and procedures to support successful quality /patient safety outcomes and ongoing improvement in the delivery of healthcare to patients, identification of areas of opportunity, and coordination and execution of regulatory compliance programs as related to Federal, State and other agencies.

Provides ongoing surveillance of infectious diseases present in the hospital and takes appropriate steps to contain and prevent the acquisition and transmission of infectious agents in accordance with CDC guidelines and hospital policies. Provides orientation to new staff associates regarding infection control principles and provides ongoing education and resources for patient care units.

6. Develops and maintains effective working relationships with patients, families, volunteers, visitors and other health care members

7. Develops and maintains the infection prevention and control program policies and procedures governing control of infections/communicable diseases.

8. Responsible for the development and implementation of the annual Infection Control Plan and Infection Control Policy Manual of all policies and procedures.

9. Implements and manages the infection prevention and control program performance improvement initiatives.

10. Develops and maintains a system for identifying, investigating and controlling infections/communicable diseases.

11. Develops and maintains reporting systems and databases in order to provide clinical data regarding all aspects and processes of infection/communicable diseases; as well as required Quality/Risk computer documentation systems as required. Maintains comparative data systems and assists with benchmarking analysis.

12. Performance of process evaluation and qualitative/quantitative and benchmarking analysis for organization wide infection prevention and control improvement opportunities

13. Performance of workflow analysis and deployment of business improvement activities related to infection control through the use of information systems (integration of computational and graphical methods).

14. Ongoing development, education and maintenance of organization wide performance improvement processes, evaluations and tools related to infection control through regular interaction with department directors, staff and physicians.

15. Ensures the reliability and maintainability of organization infection control data and collection practices by active participation and leadership in infection prevention and control performance improvement efforts. Provides support and leadership for departments as needed.

16. Facilitates the organization committees for infection prevention and control performance improvement.

17. Participates in strategies to improve department service outcomes and decrease facility risk through appropriate documentation, variance reporting, and use of chain of command.

18. Performs daily surveillance through reports and rounding related to infection prevention and control compliance.

19. Completes mandatory in-services, maintains competency in computer skills, further develops and enhances skill levels and competencies as relates to position.

20. Responsible to maintain current knowledge of regulatory standards with outside entities including but not limited to practice expectations, OSHA, APIC, TJC, NHSN, CDC and CMS. Facilitate implementation of practices, promote and monitor compliance as required. Responsible for reporting of agencies along with the Director/VP of Quality to ensure compliance with reporting systems.

21. Adopts a plan for personal & professional development.

22. Enhances professional growth and development through attendance at education programs.

23. Provides the clinical and financial data that support the Organizational vision, strategic plan and performance improvement goals.

24. Uses current literature and resources to identify current concepts and evaluates their usefulness in improving patient outcomes

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