Medical-Surgical/ICU Director

Position Summary

The Medical-Surgical/ICU Director provides clinical, operational, and administrative leadership for the Medical-Surgical and Intensive Care Unit. The Director is responsible for maintaining safe and effective patient care, appropriate staffing, employee development, budget oversight, regulatory compliance, quality improvement, and overall departmental performance.

The Director promotes evidence-based, patient-centered nursing practice and establishes a culture of accountability, collaboration, safety, and continuous improvement. The position works closely with hospital leadership, physicians, nursing staff, Quality, Infection Prevention, Case Management, Human Resources, and other departments to ensure the delivery of high-quality inpatient services.

The Director is accountable for departmental performance indicators including staffing and productivity, patient outcomes, readmissions, patient transfers, mortality, average length of stay, patient safety, employee competency, regulatory readiness, and patient experience.

Essential Duties and Responsibilities

• Department Leadership and Operations

Direct the daily clinical and administrative operations of the Medical-Surgical and ICU departments.

Ensure appropriate staffing and nursing assignments based on patient census, acuity, staff competency, and operational requirements.

Develop and maintain department schedules and monitor overtime, agency utilization, call coverage, and other staffing expenses.

Review and approve employee timecards and ensure timely and accurate payroll-related documentation.

Maintain appropriate communication and collaboration among nursing staff, physicians, ancillary departments, and hospital leadership.

Maintain departmental equipment, supplies, work orders, and other operational resources.

Provide direct clinical assistance or leadership support when patient acuity, staffing needs, emergencies, or departmental conditions warrant.

• Staff Leadership and Development

Recruit, orient, supervise, coach, and evaluate nursing and support personnel.

Conduct timely employee performance evaluations and provide ongoing feedback and professional development.

Address employee performance, attendance, conduct, and competency concerns in collaboration with Human Resources.

Ensure completion and documentation of required orientation, annual education, competencies, certifications, and clinical training.

Promote staff engagement, professional accountability, teamwork, retention, and a positive workplace culture.

Develop leadership capabilities among charge nurses and other designated clinical leaders.

• Clinical Quality and Patient Safety

The source description specifically assigns the Director responsibility for metrics such as 30-day readmissions, mortality and transfers, swing-bed admissions, average length of stay, census/utilization measures, and National Patient Safety Goal compliance.

Monitor clinical outcomes and departmental quality indicators.

Analyze patient safety events, adverse outcomes, near misses, medication events, falls, hospital-acquired conditions, readmissions, and other quality indicators.

Develop and implement performance improvement initiatives based on identified trends.

Ensure compliance with medication safety, infection prevention, patient identification, fall prevention, and other patient safety practices.

Collaborate with Quality, Infection Prevention, providers, pharmacy, Case Management, and other departments on corrective and preventive actions.

Participate in root cause analyses and performance improvement activities as assigned.

Present departmental quality and performance data to appropriate hospital committees and leadership.

• ICU Clinical Oversight

Provide leadership for the safe management of critically ill and higher-acuity patients.

Ensure ICU nurses maintain required competencies for critical-care nursing responsibilities.

Maintain appropriate clinical standards for cardiac monitoring, emergency response, medication administration, patient deterioration, transfer, and other critical-care processes.

Ensure appropriate escalation of care and timely transfer of patients when the required level of care exceeds hospital capabilities.

Collaborate with physicians, respiratory therapy, pharmacy, laboratory, radiology, and other clinical disciplines supporting critically ill patients.

Maintain departmental readiness for emergency and rapid-response situations.

• Discharge Planning and Readmission Prevention

The attached description places significant emphasis on safe transitions of care, post-discharge follow-up, and reducing avoidable readmissions and emergency-department utilization.

Oversee nursing components of discharge planning and transitions of care.

Work with providers, Case Management, Social Services, and other disciplines to identify and resolve barriers to safe discharge.

Monitor compliance with discharge instructions, patient education, medication reconciliation, and follow-up requirements.

Support post-discharge follow-up processes as assigned.

Develop initiatives designed to reduce avoidable readmissions and unnecessary emergency department visits.

• Regulatory Compliance

Maintain departmental compliance with applicable federal and state requirements, hospital policies, professional nursing standards, and accreditation requirements.

Maintain continuous readiness for CMS, state, accreditation, and other regulatory surveys.

Review and update departmental policies, procedures, protocols, and standards of care.

Ensure required clinical documentation, competencies, licenses, certifications, and departmental records remain current.

Participate in regulatory surveys, audits, investigations, corrective action plans, and performance improvement activities.

Educate staff regarding regulatory changes, patient safety requirements, and hospital policies.

• Financial and Resource Management

Develop, manage, and monitor annual departmental operating and capital budgets.

Monitor labor costs, overtime, staffing productivity, supplies, equipment, and other expenditures.

Evaluate staffing and resource utilization relative to patient census and acuity.

Identify opportunities to improve efficiency while protecting patient safety and quality.

Participate in capital equipment planning and recommendations.

Maintain appropriate supply and equipment levels to support clinical operations.

• Performance Improvement and Reporting

Collect, review, analyze, and report departmental operational and clinical data.

Establish measurable department goals aligned with hospital strategic and quality objectives.

Monitor trends and initiate corrective action when performance falls below established expectations.

Participate in Utilization Review, Quality, Patient Safety, and other assigned hospital committees.

Communicate departmental performance, staffing concerns, quality issues, resource needs, and operational risks to senior leadership.