Director of Emergency Room (ER)

JOB SUMMARY

Under the general direction of the Chief Nursing Officer, the Director of Emergency Room provides strategic, clinical, and operational leadership for the Emergency Room Department. The Director is accountable for safe, efficient, high-quality emergency care; departmental staffing and scheduling; employee selection, orientation, competency, performance management, and development; patient flow; regulatory readiness; quality outcomes; patient experience; fiscal stewardship; and continuous improvement. The Director establishes departmental goals, policies, workflows, and performance expectations; monitors clinical and operational results; and implements corrective actions when standards are not met. This role collaborates with physicians, advanced practice providers, nursing leaders, ancillary departments, outside agencies, and interdisciplinary partners to ensure coordinated care and effective emergency operations. The Director maintains compliance with applicable federal, state, and local requirements, CMS Conditions of Participation, The Joint Commission standards, EMTALA, Georgia emergency behavioral health hold requirements, organizational policies, and professional nursing standards. The position requires visible leadership, sound judgment, confidentiality, accountability, effective communication, and the ability to lead in a fast-paced emergency care environment.

STANDARDS OF PERFORMANCE

Clinical Coordination and Patient Care

•  Coordinates the functions and activities of nurses and other healthcare professionals involved in patient care during assigned shifts.
•  Accepts patient care assignments as needed and supports safe, timely, and effective care delivery in the Emergency Room Department.
•  Coordinates care with physicians, laboratory, cardiopulmonary, therapy, social work, and other members of the healthcare team.
•  Monitors patient status, identifies changes or concerns, communicates with providers, and reviews medical records to assess progress or areas requiring follow-up.
•  Identifies issues that may place patients at risk for complications, readmissions, or delays in care.
•  Facilitates the admissions process, including timely transition from the Emergency Room to a Med/Surg bed within 30 minutes of provider order entry unless otherwise indicated.

Leadership, Staffing, and Staff Development

•  Department Leadership and Accountability: Directs all Emergency Room clinical and operational functions, establishes departmental priorities, maintains clear accountability, and ensures reliable execution of organizational initiatives.
•  Staffing and Scheduling: Develops staffing plans and schedules, monitors productivity and skill mix, ensures adequate coverage, and responds to census, acuity, and operational needs.
•  Recruitment and Retention: Leads recruitment, interviewing, selection, onboarding, retention, succession planning, and workforce development for the department.
•  Orientation, Education, and Competency: Ensures effective orientation, annual education, competency validation, preceptor development, and training for new equipment, procedures, and practice changes.
•  Performance Management and Employee Relations: Sets performance expectations; completes evaluations; provides coaching and recognition; addresses conduct, attendance, competency, and performance concerns; and administers corrective action in collaboration with Human Resources.
•  Budget and Resource Stewardship: Develops and manages the departmental operating budget, monitors labor and supply expenses, evaluates variances, and implements responsible cost-control measures without compromising care quality or safety.

Compliance, Documentation, and Safety

•  Ensures nursing care is provided in accordance with hospital policies and procedures, established nursing standards of care and practice, and State of Georgia requirements.
•  Supports compliance with required documentation, including restraints, stroke care, triage, transfers, and other applicable Emergency Room documentation requirements.
•  Studies and supports Joint Commission standards applicable to the department and helps ensure ongoing compliance.
•  Promotes adherence to infection control, OSHA, safety, and internal monitoring requirements within the Emergency Room Department.
•  Supports internal control and monitoring processes to help ensure and enforce compliance.

Patient Experience and Communication

•  Builds supportive relationships with patients and families and provides emotional support during illness, emergencies, or stressful situations.
•  Meets with patients and families to assess needs, address concerns, and help resolve issues or complaints.
•  Promotes excellent customer service and works with the DON Clinical Lead, Compliance Officer, and Risk Management to address complaints and concerns as appropriate.
•  Serves as a staff resource and models commitment to the organization’s vision, mission, and values in support of excellent patient experience and clinical outcomes.

Rounding, Communication, and Daily Operations

•  Conducts daily patient rounding, monthly staff rounding, and lead shift huddles to review patient census, operational concerns, and potential issues.
•  Supports effective communication among staff, providers, and interdisciplinary team members to promote continuity of care and efficient patient flow.
•  Fosters a positive Emergency Room work environment that promotes teamwork, calm communication, and low noise levels.

Quality Improvement and Additional Duties

•  Actively participates in quality improvement and risk management activities at the unit level.
•  Participates in assigned committees and supports Hospital and Nursing Unit quality improvement goals.
•  Performs other duties as assigned.

Minimum Level of Education: Bachelor of Science in Nursing from an accredited program required. Master’s degree in nursing, healthcare administration, business administration, or a related field preferred.

Formal Training: Demonstrated ability to lead, plan, organize, and evaluate comprehensive Emergency Room operations. Must effectively manage staffing, budgets, productivity, quality metrics, regulatory compliance, employee relations, patient flow, and interdisciplinary collaboration. Requires strong clinical judgment, conflict resolution, change management, data analysis, communication, and decision-making skills, with the ability to present complex information clearly to staff, medical leadership, and executive leaders. Delegates responsibilities appropriately, with the necessary authority, while maintaining overall accountability for assigned tasks. Identifies concerns in a timely manner, develops and implements effective solutions, evaluates outcomes, and adjusts plans as needed. Demonstrates effective leadership by collaborating with clinical staff, delegating based on individual skill levels, and modeling appropriate professional behavior. Maintains strong organizational and time management skills.

Licensure, Certification, Registration: Current, unencumbered Georgia Registered Nurse license required. Must obtain BLS, PALS, and ACLS certification within 30 days of hire. TNCC, Neonatal Resuscitation Program (NRP), and NIH Stroke Scale certification are strongly preferred within six months of hire.

Work Experience: At least five years of progressive nursing experience, including a minimum of three years of emergency or critical care experience and two years of formal nursing leadership or management experience, required. Experience leading departmental operations, quality improvement, staffing, employee performance, and regulatory readiness strongly preferred.

Computer Skills: Proficient computer skills required, including effective use of Microsoft Outlook, Word, Excel, and PowerPoint. Must be able to navigate and document accurately in the electronic medical record (EMR), review patient information, enter required documentation, and use electronic systems to support safe and efficient patient care.