Quality-Registered Nurse

Job Description

Job Description

Description:

White Rock Medical Center is a community-based hospital located near the historic White Rock Lake community, that serves the Dallas, Garland, Mesquite and surrounding areas. We specialize in a wide range of services including comprehensive medical/surgical care, bariatric, cardiology, outpatient and emergency medicine.

Our mission is to deliver exceptional healthcare with compassion and excellence.

White Rock Medical Center is seeking compassionate, care-minded individuals to join our company and make a difference. As a member of the White Rock Medical Center team, you can advance your skills while working in a supportive and patient focused environment.

Apply today!
Why join White Rock Medical Center?

• Competitive salary and benefits/Company 401(k)
• Employee programs and events.
• Paid Time Off and 7 Company Holidays.
• Employer paid life insurance.
• Additional voluntary benefits such as STD, LTD, etc.

Job Summary

The Quality Nurse supports the hospital’s Quality and Patient Safety Program by assisting with data collection, performance improvement initiatives, survey readiness, and compliance with regulatory and accreditation standards. This role collaborates with clinical and non-clinical departments to promote quality outcomes, ensure patient safety, and maintain continuous readiness for CIHQ/Joint Commission, CMS, and state surveys.

Essential Functions

Quality & Patient Safety

• Monitor, track, and analyze quality and patient safety data, including core measures, infection prevention indicators, adverse events, and regulatory metrics.
• Assist in developing, implementing, and evaluating performance improvement (PI) projects.
• Support the hospital’s peer review, mortality review, and quality council processes.
• Educate staff and leadership on quality initiatives, best practices, and patient safety culture.
• Survey Readiness & Compliance
• Maintain continuous readiness for CIHQ/Joint Commission, CMS, and state regulatory surveys.
• Conduct tracer rounds, audits, and Environment of Care (EOC) rounds across clinical and non-clinical departments (nursing units, ancillary services, plant operations, EVS, security, dietary, etc.) to identify and correct compliance gaps.
• Provide coaching and education to staff and leaders on regulatory requirements and best practices.
• Assist with policy review and development to ensure alignment with accreditation and regulatory requirements.
• Maintain records, logs, and documentation for survey readiness and accreditation activities.

Data Management & Reporting

• Collect, validate, and submit quality reporting data to CMS, NHSN, CIHQ, state agencies, and other regulatory bodies as required
• Generate and maintain quality dashboards and scorecards for leadership, quality committees, and the governing body.
• Monitor hospital performance against benchmarks, patient safety goals, and regulatory indicators.
• Participate in root cause analyses (RCA) and assist in action plan development and follow-up.
• Collaboration & Education
• Partner with nursing, physicians, infection prevention, risk management, facilities/plant operations, and other hospital leaders to drive improvement efforts.
• Provide real-time feedback and coaching during rounds and audits
• Support hospital staff education related to quality, patient safety, environment of care, and regulatory standards.

Qualifications

Education & Experience

• Graduate of an accredited school of nursing; BSN preferred.
• Minimum 3 years of clinical nursing experience in an acute care hospital required.
• Experience in quality, patient safety, accreditation, or regulatory compliance preferred.
• Experience with CMS reporting requirements, NHSN surveillance and data entry, and hospital quality data reporting strongly preferred.

Licensure/Certification

• Current, unrestricted RN license in the State of Texas (or compact state).
• Certified Professional in Healthcare Quality (CPHQ) preferred or obtained within 2 years of hire.
• Skills & Competencies
• Strong knowledge of CIHQ/Joint Commission standards, CMS Conditions of Participation, and state regulatory requirements.
• Working knowledge of Environment of Care (EOC) standards across both clinical and non-clinical departments.
• Strong background in quality reporting, NHSN surveillance, CMS measure submission, and regulatory data validation.
• Excellent organizational and time-management skills with attention to detail.
• Strong analytical skills with ability to interpret and present data to leadership.
• Proficiency with Microsoft Office Suite, NHSN portals, CMS QualityNet, and quality data systems.
• Effective communication and interpersonal skills for working with physicians, staff, and leadership.
• Ability to function independently while collaborating in a team environment.

Physical & Working Conditions

• Hospital environment with frequent unit-based and departmental rounding (clinical & non-clinical).
• Extended periods of data review and computer work.
• Occasional evening or weekend work for surveys, projects, or staff education.