Oversee the quality of patient care in the hospital. Duties include handling case assignments assessing treatment plans, and communicate with CRM to ensure patients are well informed regarding their care and treatment options. Goal is to ensure that patients receive the best health and services needed.
Ensures reports are medico legally accurate.
Audit and report doctors’ compliance to CPGs as clinical variance percentage.
Ensure the severity of illness and level of services provided are accurately reflected in the medical record.
Investigation of Customer complaints regarding poor standards of service.
Assessing quality of outcome through event reporting and through customer complaints is only a small part of medical audit.
Root cause analysis of failure, can be of low CVP, not complaint, not adherent to care, low flow.
Extract and send CRM leads.
Communicate with CRM about the suggested specialties to work on it with required data (patient name and file number) based on decline in specialties.
Develop daily and monthly audit plans for Clinical Auditing Assignees.
Ensure performing daily clinical audits according to the audit plans with priority review for identified high risk patients according to high risk patient policy

Clinical Case Review lead