Organization: SPS Hospitals
Department: Quality Assurance
Location: Ludhiana, Punjab
Reports To: Head – Quality Assurance
Employment Type: Full-Time
Position Summary
The Executive – Quality Assurance will support the implementation, monitoring, and continuous improvement of quality systems and patient safety initiatives across the hospital. The role involves ensuring compliance with NABH/JCI standards, conducting audits, coordinating quality indicators, managing documentation, and supporting departmental quality improvement activities.
Key Responsibilities
Quality Management & Compliance
- Assist in implementation and monitoring of hospital quality assurance programs.
- Ensure compliance with NABH, JCI, and internal quality standards.
- Coordinate departmental audits and quality assessments.
- Maintain quality documentation, SOPs, policies, and protocols.
- Support preparation for accreditation and surveillance audits.
Patient Safety & Risk Management
- Monitor patient safety indicators and incident reporting systems.
- Participate in root cause analysis (RCA) and corrective/preventive actions (CAPA).
- Track adverse events, near misses, and quality improvement initiatives.
- Promote a culture of patient safety and continuous improvement.
Data Analysis & Reporting
- Collect, analyze, and maintain quality metrics and departmental KPIs.
- Prepare MIS reports, dashboards, and presentations for management review meetings.
- Monitor clinical and non-clinical quality indicators.
Training & Coordination
- Coordinate quality-related training programs and awareness sessions.
- Support departments in implementation of quality initiatives.
- Conduct orientation sessions on quality standards and protocols for staff.
Documentation & Process Improvement
- Ensure timely documentation and record maintenance.
- Participate in process mapping and workflow improvement activities.
- Assist in policy revision and standardization of procedures.
Required Qualifications
- MHA / Master's degree in Healthcare Management, Hospital Administration, or a related field.
- Certification in NABH/JCI quality standards will be an advantage.
- 1–3 years of experience in hospital quality assurance or healthcare operations preferred.
