Position Summary The Discharge Planning / Quality Assurance (QA) Nurse is responsible for coordinating safe, timely, and effective patient discharge planning while supporting the hospital’s clinical quality, regulatory compliance, and patient-care standards. This position works collaboratively with physicians, nurses, case managers, social workers, patients, families, and post-acute care providers to ensure appropriate transitions of care.
The nurse will also participate in clinical quality assurance activities, including chart review, identification of care gaps, monitoring of documentation and discharge processes, and development of recommendations to improve patient outcomes and regulatory compliance.
Essential Duties and Responsibilities
Discharge Planning
- Assess patients’ discharge needs throughout the hospitalization and identify barriers to a safe and timely discharge.
- Collaborate with physicians, nursing staff, case management, social services, therapy, pharmacy, and other interdisciplinary team members.
- Develop and coordinate individualized discharge plans based on the patient’s medical, functional, psychosocial, and post-acute needs.
- Assist with coordination of home health services, durable medical equipment, skilled nursing facilities, rehabilitation, hospice, outpatient services, and other community resources.
- Communicate discharge plans and follow-up needs clearly to patients and families and provide appropriate education.
- Ensure patients and caregivers understand medications, appointments, treatment plans, warning signs, and follow-up instructions.
- Identify high-risk patients and coordinate appropriate transition-of-care interventions.
- Monitor barriers to discharge and communicate unresolved issues to the appropriate members of the care team.
- Promote appropriate utilization of hospital and post-acute resources.
- Support efforts to reduce avoidable readmissions and emergency department visits.
- Ensure discharge planning activities are appropriately documented in the medical record.
Quality Assurance / Clinical Quality
- Conduct medical record reviews to assess compliance with hospital policies, clinical standards, regulatory requirements, and documentation expectations.
- Monitor the quality and completeness of nursing and discharge-related documentation.
- Identify trends, gaps, variances, and opportunities for improvement in patient care and discharge processes.
- Participate in quality improvement initiatives and performance improvement projects.
- Assist with monitoring quality indicators, patient outcomes, readmissions, and other designated clinical metrics.
- Review cases for potential quality concerns and escalate significant findings according to hospital policy.
- Assist with preparation for accreditation, regulatory, and compliance reviews.
- Participate in audits and follow-up activities related to identified deficiencies.
- Provide education and feedback to clinical staff regarding documentation, discharge planning, patient safety, and quality standards.
- Maintain confidentiality and ensure compliance with HIPAA and applicable federal and state regulations.
Qualifications
Required
- Current, unrestricted Registered Nurse (RN) license in the state of practice.
- Associate Degree in Nursing (ADN) required; Bachelor of Science in Nursing (BSN) preferred.
- Minimum of 2–3 years of clinical nursing experience, preferably in an acute-care hospital.
- Experience with discharge planning, case management, utilization review, quality assurance, or care coordination preferred.
- Strong knowledge of nursing standards, patient safety principles, and healthcare documentation.
- Excellent communication, organization, critical-thinking, and problem-solving skills.
- Ability to work independently while functioning effectively as part of an interdisciplinary team.
- Proficiency with electronic medical records (EMR/EHR) and Microsoft Office or comparable software.
Preferred
- BSN or higher nursing degree.
- Certification in case management, such as CCM, ACM, or a comparable credential.
- Certification or formal training in healthcare quality, such as CPHQ, preferred.
- Experience with hospital accreditation and regulatory standards.
- Knowledge of Medicare, Medicaid, insurance requirements, and post-acute care services.
- Experience with quality improvement methodologies and clinical audits.