Nursing Careers Beyond the Bedside
Cindy Mehallow | Monster Contributing Writer
“Is there a better way of doing this?” Nurses involved in quality improvement constantly ask that question as they review a health care institution’s methods and processes. Their work is evidence-based and outcome-focused. By studying patient populations, they analyze systems to determine how to correct problems and improve quality of care. In short, they strive to prevent future problems by studying past mistakes.
Employers commonly look for a bachelor’s degree in a health care field and possibly a master’s. “Many facilities don’t require certification or even realize that it’s available,” says Joan Boldrey, RN, MEd, MS, a certified professional in health care quality (CPHQ). Employers that do know about certification consider it “the gold standard,” says Boldrey, senior market medical expense management specialist for UnitedHealthcare in Urbandale, Iowa, and a board member of the Healthcare Quality Certification Board, which oversees CPHQ testing.
Closely tied to quality improvement, risk managers also search for the root causes of mistakes to help improve systems and processes. With the upsurge in medical malpractice suits, opportunities for risk managers are increasing at hospitals, insurance companies, ambulatory-care surgical centers, long-term-care facilities and home-care companies.
Working with top medical and administrative staff members, risk-management nurses review patient records before and after lawsuits are filed. These pressure-cooker jobs require immense patience, tact and political savvy plus excellent communication and writing skills. “Risk managers need to be leaders with good conflict-resolution skills,” says Kenneth Nanni, PhD, program director of the health care risk-management certification program at the University of South Florida Health Sciences Center.
Most risk-management nurses hold at least a bachelor’s degree and risk-management certification, which is available from the American Hospital Association Certification Center, the American Board of Quality Assurance and Utilization Review Physicians and colleges, such as the University of South Florida.
Experienced nurses can fill these other nonclinical positions typically found in hospitals:
• Chart Auditors: Financial chart auditors review patient charts after discharge to ensure appropriate documentation for proper billing and coding. Others work in quality management.
• Patient Advocates: Working on the customer-service front lines, patient advocates handle patient complaints.
• Mentors or Preceptors: More and more hospitals are creating formal positions for experienced nurses to guide new nurses through that critical first year on the job.