MercyOne Siouxland Medical Center - Sioux City, IA

Director of Quality

Job Summary

Director of Quality

We are looking for a candidate with leadership qualities to step into the role of Director of Quality in Sioux City, Iowa. You will run the quality program for Siouxland Medical Center, a 238 bed facility. 

You will need a Master’s degree in Healthcare Administration, Business, Nursing or related field, along with 5 to 7 years of related clinical or patient care experience with a minimum of 3 to 5 years of previous management experience in the area of quality management, project management, patient safety, performance improvement or healthcare informatics, and in the Joint Commission survey preparation.

Mercyone Siouxland Medical Center

MercyOne has more than 20,000 colleagues, with 420 care locations, clinics, medical centers and affiliates across the state of Iowa and beyond. MercyOne Siouxland is a proud member of Trinity Health, and is also home to the only Level II Trauma Center, and provides a vital, lifesaving link to rural areas via MercyOne Air Med, the area’s helicopter ambulance service.

About the town

Sioux City, IA


Public Schools




Good for Familes




Cost of Living


Outdoor Activities


Crime & Safety








Health & Fitness



Leapfrog Hospital Safety Scores

MercyOne Siouxland Medical Center

MeasureThe Hospital’s ScoreWorst Performing HospitalAvg. Performing HospitalBest Performing HospitalData SourceTime Period Covered
Dangerous object left in patient’s body What’s This?0.1370.3590.020.000CMS07/01/2017 – 06/30/2019
Air or gas bubble in the blood What’s This?0.0000.036.00040.000CMS07/01/2017 – 06/30/2019
Patient falls and injuries What’s This?0.8201.7780.420.000CMS07/01/2017 – 06/30/2019
Infection in the blood What’s This?1.7833.4200.810.000CMS04/01/2019 – 12/31/2019 and 07/01/2020 – 9/30/2020
Infection in the urinary tract What’s This?0.7102.6440.750.000CMS04/01/2019 – 12/31/2019 and 07/01/2020 – 9/30/2020
Surgical site infection after colon surgery What’s This?0.0002.8870.800.000CMS04/01/2019 – 12/31/2019 and 07/01/2020 – 9/30/2020
MRSA Infection What’s This?0.8873.0550.840.000CMS04/01/2019 – 12/31/2019 and 07/01/2020 – 9/30/2020
C. diff. Infection What’s This?0.6691.9490.540.000CMS04/01/2019 – 12/31/2019 and 07/01/2020 – 9/30/2020
Death from treatable serious complications What’s This?175.14206.08159.6795.65CMS07/01/2018 – 12/31/2019
Harmful Events What’s This?0.943.351.000.60CMS07/01/2018 – 12/31/2019
      Dangerous bed sores What’s This? *0.158.800.580.04CMS07/01/2018 – 12/31/2019
      Collapsed lung What’s This? *0.190.480.230.12CMS07/01/2018 – 12/31/2019
      Falls causing broken hips What’s This? * – 12/31/2019
      Blood Leakage What’s This? *3.015.582.541.26CMS07/01/2018 – 12/31/2019
      Kidney injury after surgery What’s This? *1.153.451.420.58CMS07/01/2018 – 12/31/2019
      Serious breathing problem What’s This? *6.8917.095.181.66CMS07/01/2018 – 12/31/2019
      Dangerous blood clot What’s This? *4.248.413.611.65CMS07/01/2018 – 12/31/2019
      Sepsis infection after surgery What’s This? *4.199.734.962.31CMS07/01/2018 – 12/31/2019
      Surgical wound splits open What’s This? *0.951.540.860.57CMS07/01/2018 – 12/31/2019
      Accidental cuts and tears What’s This? *1.993.971.210.37CMS07/01/2018 – 12/31/2019
* This measure is a part of the Harmful Events Composite and is not used for scoring.

Process measures include the management structures and procedures a hospital has in place to protect patients from errors, accidents, and injuries.

MeasureThe Hospital’s ScoreWorst Performing HospitalAvg. Performing HospitalBest Performing HospitalData SourceTime Period Covered
Doctors order medications through a computer What’s This?70585.77100Imputation Model AppliedNot Applicable
Safe medication administration What’s This?100583.25100Imputation Model AppliedNot Applicable
Specially trained doctors care for ICU patients What’s This?50562.82100Imputation Model AppliedNot Applicable
Effective leadership to prevent errors What’s This?Declined to Report46.15116.85120.002021 Leapfrog Hospital Survey2021
Staff work together to prevent errors What’s This?Declined to Report0.00116.49120.002021 Leapfrog Hospital Survey2021
Enough qualified nurses What’s This?Declined to Report17.6598.16100.002021 Leapfrog Hospital Survey2021
Handwashing What’s This?Declined to Report1574.361002021 Leapfrog Hospital Survey2021
Communication with nurses What’s This?887391.1098CMS01/01/2019 – 12/31/2019
Communication with doctors What’s This?888091.0098CMS01/01/2019 – 12/31/2019
Responsiveness of hospital staff What’s This?806084.3894CMS01/01/2019 – 12/31/2019
Communication about medicines What’s This?715377.6692CMS01/01/2019 – 12/31/2019
Communication about discharge What’s This?876786.5196CMS01/01/2019 – 12/31/2019

Hospital Leadership

MEET THE staff

Lauren Kujawa, SHRM - SCP

Talent Sourcing Partner

Diane Brieksat

VP Professional & Quality Services

Official job description

Director of Quality -


Under general supervision, is administratively responsible for the integration of all components involved in organizational and medical staff quality of care, safety, measurement, and informatics and performance improvement. Provides leadership and direction to the organization’s programs for Healthcare Informatics, Quality & Outcomes Management, Decision Support Analysis, Infection Prevention, Risk Management and Patient Safety. Will have oversight of The Joint Commission and state/federal accreditations ensuring compliance with all requirements and standards. Is instrumental in promoting quality of life for patients, personnel and the community served.

What you will do:

  • Supports the organization in achieving of strategic and operational goals for quality management and reporting, patient safety, performance improvement, and information management.
  • Serves as the in-house resource expert on JCAHO standards. Has overall responsibility of accreditation processes and regulatory programs.
  • Assesses compliance to the Joint Commission standards with recommendations for change. Evaluates effectiveness of monitoring system annually.
  • Serves as the liaison to Trinity Health for all regulatory and accreditation matters. Works with Trinity Accreditation and Regulatory Services in preparing/maintaining compliance for Mercy-Sioux City respective to all regulatory bodies
  • Functions as a liaison to support multidisciplinary process improvement teams.
  • Provides summarized reports regarding performance improvement events and activities to the Board, Quality Committee, Hospital Administration, Medical Staff and appropriate committees on a regular basis.
  • Facilitates and promotes best practice research utilization in development and implementation of standards, policies, and procedures to support quality and safety of patient care services.
  • Ensures compliance with all regulatory and accrediting bodies for quality outcomes tracking/reporting, performance improvement, patient safety, risk management, infection control, clinical documentation, and medical staff credentialing and reappointment.
  • Develops and implements the organization’s and medical staff’s quality improvement plan in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards.
  • Directs the development and implementation of systems, policies, and procedures for the identification, collection, and analysis of performance measurement data.
  • Develops and oversees a contemporary, efficient system of quality and safety measurement with timely and effective reporting to regulatory agencies, and to other internal and external audiences.
  • Directs programs, systems and processes for measurement, evaluation, and performance improvement by ensuring that all clinical departments receive relevant information regarding their outcomes of care, clinical processes and pertinent benchmarks.
  • Provides leadership and strategic direction for healthcare informatics programs, projects and services; evaluates periodic structured assessments and recommendations on the future direction for healthcare informatics.


What we are looking for:
Master’s degree in Healthcare Administration, Business, Nursing or related field required.
Requires a minimum of five to seven years of related clinical/patient care experience with a minimum of three to five years of previous management experience in the area of quality management, project management, patient safety, performance improvement and healthcare informatics, and in the Joint Commision survey preparation.
Demonstrated leadership skills in program development and implementation
Must demonstrate a thorough understanding of Quality Improvement/Process Improvement concepts with knowledge of clinical and administrative issues currently affecting the health care industry.
Thorough knowledge of data management with demonstrated success in information management and reporting.
Strong quantitative and analytical skills with the ability to work under deadlines and handle multiple detailed-oriented tasks.
Requires ability to handle difficult situations given diverse perceptions and strong personalities in frequently stressful settings.

Why MercyOne Siouxland?
MercyOne Siouxland Medical Center is a 238-bed regional center that provides residents in a 33-county tri-state region an entire continuum of preventive, primary, acute and tertiary healthcare services. MercyOne Siouxland Medical Center is home to the only Level II trauma center in western Iowa – one of only four trauma care facilities in the state to receive verification from the American College of Surgeons – and MercyOne Air Med, a regional helicopter ambulance service.

About MercyOne and Trinity Health:
We are MercyOne: a connected system of health care facilities and services dedicated to helping you and your community live your best life.

More than 20,000 colleagues strong, our care providers and staff make your health and happiness their highest priority, so you can get well—and stay well. With 420 care locations, our clinics, medical centers and affiliates are never too far from home, allowing us to improve the lives of individuals and communities across the state of Iowa and beyond.

MercyOne Siouxland is a proud member of Trinity Health, one of the nation’s largest Catholic healthcare delivery systems, our network spans 22 states, 94 hospitals and 133,000 colleagues nationwide.

About Siouxland:
The tri-state region, referred to as Siouxland, is highlighted by safe and friendly communities, excellent schools and a mix of peaceful rural areas and vibrant city atmosphere where Iowa, Nebraska and South Dakota meet at the Missouri River.

Situated in the heart of Downtown Sioux City, MercyOne Siouxland Medical Center is also well positioned for urban living in any of the newly renovated apartment, downtown loft, or townhome living options. The downtown also features a historic district with excellent restaurants and social spots and you’ll just be steps away from the beautifully-renovated Warrior Hotel for dinner and the gorgeous Orpheum Theatre for entertainment.

The MercyOne Mission Defines Us:
MercyOne serves with fidelity to the Gospel as a compassionate, healing ministry of Jesus Christ to transform the health of our communities.

Our timeless values guide us:
Commitment to the Poor

Trinity Health’s Commitment to Diversity and Inclusion:
Trinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Trinity Health’s dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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Most frequent questions and answers

Yes. All of our open positions come with some sort of relocation allowance to help with the expenses of relocating. 

Yes. We will prep you for every interview you take. We know what our clients are looking for, so we will let you know what to expect and what experiences and accomplishments you should be sure to communicate to them in an interview.

Yes. If you connect us with another Infection Prevention professional that is interested in this position, and ultimately gets hired – we will send you a $500 referral bonus. 

Of course. We work to get you the highest possibly financial package – and communicate our progress throughout the process. We are financially incentivized to get you the most lucrative offer possible. 

Absolutely. We will review your resume before we submit it to the client to make sure it communicates everything it needs to.

First, everything we offer to our candidates is completely FREE. 

We operate as advisors and consultants for your Infection Prevention career. We’ve recruited in this industry for a long time and understand the profession as well as anyone.

If you decide you’d like us to represent you and apply for a position, the first thing our team will do is examine your resumé closely. We will fix up your resumé to ensure it communicates exactly what our client is looking for – demonstrating not only what you’ve been responsible for in previous Infection Prevention positions, but also how effective you’ve been in those roles. 

We have direct access to the hiring managers in the positions we search on which allows us to present your resumé directly to them, knowing exactly what they want to see in a candidate. We will keep you in the loop when this happens and what their initial feedback is. No more waiting in the dark hoping to hear back from HR.

Because of our relationships with the hiring manager, we have the ability to make a case for them to speak with you. It also allows us to get quick, honest feedback following each interview you have. And we will provide that feedback to you, good or bad.

In addition to preparing your resumé and presenting directly to the hiring manager, we also will prep you for each and every interview. Again, we know what our clients are looking for, so we will let you know what to expect and what experiences and accomplishments you should be sure to communicate to them in an interview.

In terms of the interview process, we’ll work with you and the client to get those scheduled during a time that makes sense for you.

Perhaps the most beneficial piece of being represented by Clutch Recruitment is that we’ll negotiate an offer for you – securing the highest possible offer the client can make. Don’t worry about your salary demands rubbing your future employer the wrong way;  we do all of that for you, ensuring a completely fair offer, without the awkwardness that potentially comes with it. We are financially incentivized to get you the highest possible offer, and we will ensure that happens.

Once you accept an offer, our work doesn’t stop. We’ll be there to talk you through your resignation and prepare you for how to handle a counter offer, along with all other complications that may arise. 

We have a large in house sourcing team that collects information from various databases online including LinkedIn, certification boards, and professional associations. 

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