Susan Bujan Email and Phone Number

Performs quality improvement work with designated Texas and Arkansas hospitals participating in the Partnership for Patients Hospital Improvement Innovation Networks (HIINs). Includes engaging hospitals, providers, and communities to implement best practices with the end results anticipated reduction in all-cause hospital-based harm and preventable readmissions for patients. Develops and/or presents healthcare education programs related to quality improvement measures and initiatives.

Network Director of Quality, Accreditation, and Risk Management (2013-2016)New director role combining accreditation and risk management services for the Seton Healthcare Family. Directed risk, accreditation, quality, claims, event management, and policy and procedures for the Seton enterprise system. • Redesigned and implemented event review process for managing significant events. Provided oversight and guidance to event analysis and the development of clinical risk reduction strategies. Resulted in streamlined processes, improved standardized reporting, decreased variation in practices, and downward trend in severity of outcomes.• Achieved loss rate as one of best among all Ascension Health acute care hospitals. Continued decreased trends in claims with increased growth in Seton systems.• Collaborated with the development and streamlining of organizational policy and procedure management system for the enterprise system.

New director role that provided oversight, strategic planning, coordination, and implementation of accreditation, certification, and regulatory standards compliance for the Seton Healthcare Family. Fourteen years of survey coordination resulting in numerous successful accreditations, certifications, licensing, and regulatory surveys.• Designed and implemented systems to support the expansion of network growth including growing from four acute care hospitals to 11 hospitals. Coordinated regulatory requirements for opening of three new acute care hospitals. Successful acquisition for additional four hospital facilities. • Participated in development of long and short-term strategic business operating plans, and goals related to four Magnet Certifications, patient safety initiatives, business development, new hospitals, and new service lines.• Aligned quality initiatives by connecting site and network strategies through the development of network accreditation readiness structure. Included program development, streamlined and strengthened policies, development of competencies and implementation of accreditation survey readiness processes.• Partnered in the design and implementation of the Chart Audit tracking system, Nursing Performance Improvement Plan and Dashboard; consulted on patient electronic medical record team design, development, and successful implementation.

New director role consolidated all women’s services under one director. Directed operational and fiscal management for labor/delivery, mother/baby, antepartum, transition nursery, level III-neonatal intensive care (NICU), perinatal outreach, parent education, lactation services, and neonatal/perinatal transport. Delivery volume over 500/month; managed 300+ FTEs. • Redesigned services to single room maternity care. Achieved decreased length of stay, streamlined admission process, improved discharge processes and decreased admissions.• Achieved staffing and financial targets. Stabilized staffing gaps in labor/delivery; coordinated development of perinatal orientation/education pathways, resulting in decreased turnover.• Successfully implemented new electronic medical record in labor/delivery and mother/baby.• Successfully redesigned, renovated and expanded level III-NICU from 28 beds to 45 beds. • Developed Case Management Pathways, redesigned clinician role, and aligned with acquisition of the Children’s Hospital of Austin NICU and Brackenridge Hospital Women’s Services into the Seton system.