Emergency Department Manager

Description

The Emergency Department (ED) Manager is responsible for the overall management and daily operation of the CRMC Emergency Department, with direct authority over ED nursing operations, staffing, scheduling, workflow, clinical practice, competency validation, education, performance, and personnel accountability. Under the direction of the Director of Nursing (DON) and Administration, the ED Manager works collaboratively with physicians, hospital leadership, Quality, Human Resources, Infection Prevention, Case Management, and other departments to ensure safe, efficient, compliant, and patient-centered emergency services.

Within delegated authority, the ED Manager may make routine operational and staffing decisions necessary for safe and effective ED operations. Matters requiring executive, medical staff, Human Resources, or governing-body authority shall be escalated through the appropriate chain of command.

• AND RESPONSIBILITIES 1. Emergency Department Operations The ED Manager shall:
• Direct daily ED nursing operations, workflow, patient throughput, assignments, staffing deployment, and operational readiness.
• Evaluate and improve ED safety, efficiency, patient flow, and quality of care.
• Maintain effective processes for triage, assessment, treatment, stabilization, admission, discharge, and transfer.
• Coordinate patient flow and operational issues with ED physicians and other departments.
• Ensure necessary equipment, supplies, medications, emergency carts, and resources are maintained and available.
• Identify operational barriers and implement corrective actions, collaborating with the DON and Administration when appropriate.
• Participate in developing, implementing, and enforcing ED policies, procedures, workflows, protocols, and standards.
• Ensure staff comply with hospital policies, physician orders, nursing standards, and approved clinical procedures.
• Maintain readiness for regulatory surveys, audits, accreditation reviews, and emergency preparedness activities, including HICS as assigned. 2. Staffing and Scheduling Authority The ED Manager has primary responsibility for ED nursing staffing and shall:
• Develop, maintain, and approve nursing schedules based on patient needs, staffing plans, budget expectations, and applicable requirements.
• Determine daily assignments and adjust staffing based on patient volume, acuity, competency, and operational needs.
• Approve routine schedule changes, shift trades, and staffing adjustments consistent with CRMC policy.
• Manage call-offs, staffing shortages, and replacement coverage.
• Monitor and manage appropriate use of overtime, registry/agency, per-diem, and other staffing resources.
• Assign and reassign nursing personnel based on qualifications, competency, acuity, scope of practice, patient safety, and operational needs.
• Monitor attendance, punctuality, scheduling compliance, meal/rest periods, and staffing expectations.
• Identify staffing needs and make recommendations regarding recruitment, retention, vacancies, and staffing levels.
• Participate in interviewing and selecting ED nursing personnel with Human Resources, the DON, and Administration.
• Maintain staffing records and report significant staffing concerns to the DON and Administration. 3. Clinical Competency and Nursing Practice The ED Manager is directly responsible for monitoring and validating ED nursing competencies and shall:
• Maintain an ED nursing competency program in coordination with the DON and appropriate departments.
• Ensure staff demonstrate competency before independently performing specialized clinical duties.
• Conduct or coordinate initial, annual, and ongoing competency assessments and maintain required documentation.
• Identify clinical or performance deficiencies and initiate education, remediation, supervision, or competency reassessment.
• Restrict independent performance of clinical skills when competency has not been demonstrated or a reasonable patient-safety concern exists, pending evaluation and escalation.
• Ensure required licenses and certifications remain current.
• Coordinate remedial education and competency validation when deficiencies are identified.
• Provide or coordinate continuing education based on departmental needs, incidents, audits, regulatory findings, and changes in clinical practice. Competencies may include emergency assessment and triage, recognition of deterioration, emergency medications, IV therapy, blood administration, cardiac monitoring, EKGs, stroke and sepsis response, respiratory emergencies, behavioral health, emergency transfers, pediatric care, trauma, resuscitation, point-of-care testing, infection prevention, ED equipment, and clinical documentation. 4. Personnel Management and Accountability As the immediate management-level supervisor for assigned ED nursing personnel, the ED Manager shall:
• Establish performance expectations and hold staff accountable.
• Provide coaching, counseling, education, and performance feedback.
• Complete employee evaluations in accordance with CRMC policy.
• Promptly address conduct, policy violations, performance deficiencies, attendance concerns, and clinical-practice issues.
• Appropriately document counseling and performance concerns.
• Initiate or recommend corrective or disciplinary action in collaboration with the DON, Administration, and Human Resources.
• Develop and monitor performance improvement plans when indicated.
• Immediately address unsafe nursing practices.
• Ensure staff practice within applicable licensure, certification, competency, and scope of practice.
• Participate in investigations involving nursing practice, medication errors, patient-care concerns, employee conduct, and departmental incidents.
• Maintain confidentiality and promote professional communication, teamwork, accountability, and respectful conduct. 5. Quality, Patient Safety, and Regulatory Compliance The ED Manager shall participate in CRMC Quality Assessment and Performance Improvement activities and shall:
• Monitor ED quality and patient-safety indicators.
• Review incidents, medication errors, near misses, complaints, transfers, adverse events, and identified trends.
• Participate in investigations, root cause analyses, corrective-action plans, and performance-improvement projects.
• Conduct or oversee ED nursing audits.
• Develop and monitor corrective actions for identified deficiencies or unfavorable trends.
• Promptly report significant clinical, operational, regulatory, or patient-safety concerns through the appropriate chain of command.
• Ensure compliance with applicable federal and California requirements, Conditions of Participation, accreditation standards, EMTALA, infection-prevention requirements, hospital policies, and professional standards.
• Assist with Plans of Correction and regulatory responses involving the ED.
• Maintain continuous survey readiness. 6. Patient Flow, Admissions, and Transfers The ED Manager shall:
• Monitor ED length of stay, throughput, admissions, and transfers.
• Collaborate with ED physicians, hospitalists, Case Management, Nursing Administration, and receiving facilities regarding patient disposition.
• Ensure appropriate nursing documentation of transfer activities and required patient information.
• Monitor admission and transfer delays and escalate barriers through the appropriate chain of command.
• Ensure staff understand and comply with applicable EMTALA responsibilities.
• Evaluate nursing workflows affecting door-to-provider time, diagnostic testing, treatment, admission, discharge, and transfer. 7. Orientation and Staff Development The ED Manager shall:
• Develop and maintain ED-specific nursing orientation requirements.
• Assign appropriate preceptors and monitor new-hire progress.
• Determine readiness for independent assignment.
• Extend orientation or require additional training when competency has not been demonstrated.
• Ensure completion of mandatory education.
• Identify educational needs based on audits, incidents, clinical trends, regulatory findings, and staff performance.
• Conduct staff meetings and education as needed.
• Maintain records of orientation, education, and competency validation. Requirements

• Education
• Graduate of an accredited professional nursing program.
• Bachelor of Science in Nursing (BSN) at minimum; NP licensure preferred. Licensure
• Current, active, unrestricted California Registered Nurse license required. Experience
• Emergency Department nursing experience required.
• Minimum three years of acute-care nursing experience preferred.
• Emergency nursing leadership, charge nurse, supervisory, or management experience strongly preferred. Certifications Current certifications appropriate to the position and hospital requirements, including as applicable:
• Basic Life Support (BLS)
• Advanced Cardiovascular Life Support (ACLS)
• Pediatric Advanced Life Support (PALS) Additional emergency, trauma, stroke, behavioral-health, or other certifications may be required by CRMC policy or assigned responsibilities. KNOWLEDGE, SKILLS, AND ABILITIES The ED Manager must demonstrate:
• Strong knowledge of emergency nursing, patient safety, scope of practice, and delegation.
• Ability to evaluate clinical competency and nursing performance.
• Effective staffing, scheduling, and personnel-management skills.
• Ability to make timely operational decisions in a high-acuity environment.
• Knowledge of triage, stabilization, admissions, transfers, EMTALA, and applicable regulatory requirements.
• Ability to objectively investigate clinical and operational concerns.
• Strong leadership, communication, conflict-resolution, and coaching skills.
• Ability to analyze quality data and implement corrective actions.
• Sound professional judgment, confidentiality, and the ability to communicate expectations and hold staff accountable.