Nursing Administrator – Clinical Operations & Quality

Department: Clinical Operations | Function: Central Nursing Administration & Clinical Quality | Reports to: Head – Clinical Operations / Designated Senior Management | Location: Head Office | Experience: 10 years | Industry: Hospitals / Healthcare

1. Role Objective

Establish, implement, monitor and continuously improve nursing administration and bedside-care standards across existing units and new facilities.

From Head

Office, oversee manpower, staffing ratios, competencies, rosters, workflows, training, documentation, patient safety and NABH compliance. Work with unit teams and hospital leaders using audits, analytics, KPIs and dashboards to identify gaps, intervene in critical issues, drive corrective action and ensure consistent organisation-wide standards.

2. Key Responsibilities

A. Central Nursing Administration & Standardisation

Develop and implement common nursing policies, protocols, SOPs and operational guidelines for all units, including new hospitals.

Define unit structures, reporting lines, accountability and supervisory responsibilities; conduct periodic compliance reviews and identify gaps.

Coordinate with unit heads, Nursing/Medical Superintendents, HR, Clinical Quality and other departments; resolve, escalate and close critical operational issues.

B. Nursing Manpower Planning & Staffing Standards

Plan nursing manpower based on bed strength, occupancy, workload, specialties, and expansion while ensuring safe staffing levels as per regulations

Define nurse-to-patient ratios, staffing benchmarks, and clear roles for nursing and support staff across all units.

C. Nursing Rostering, Deployment & Competency Management

Standardise roster preparation and monitoring, ensuring skill-based staffing in critical care, emergency, HDU, and other high-risk areas

Align staff deployment with qualifications and competencies,



manage shifts and replacements, monitor roster adherence, and ensure appropriate duty allocation.

D. Nursing Procedures & Bedside Care Management

Maintain a master list of procedures, care protocols and nursing responsibilities; standardise bedside care, rounds, monitoring, handovers, shift reports and documentation.

Review quality through clinical rounds, audits, record reviews and direct observation; address deviations through corrective/preventive action and update procedures with clinical leaders/subject experts.

E. Training, Competency Development & Clinical Learning

Develop and implement training and competency programmes for nursing staff and medical attendants, covering patient safety, communication, medication, infection control, documentation, emergency response, and incident reporting, with regular assessments to ensure protected practice.

F. NABH Accreditation & Clinical Quality Compliance

Lead nursing preparation, implementation and monitoring for NABH accreditation/surveillance; translate standards into SOPs, checklists, documentation, training and measurable indicators.

G. Clinical Analytics, Performance Monitoring & MIS

Analyse medication errors, falls, pressure injuries, documentation gaps, complaints, staffing gaps and other indicators; track incident reporting, investigations and action closure; recommend process redesign/interventions.

H. Clinical Incident Reporting & Patient Safety

Standardise incident reporting, escalation, investigation,



and documentation; review nursing safety incidents, coordinate root-cause analysis and CAPA with Quality, verify effectiveness, and promote timely escalation, accountability, and learning.

I. Resident Doctor Coordination & Clinical Privileging

Monitor coordination among nurses, resident doctors and consultants during emergencies, handovers and deterioration; clarify escalation, responsibilities and communication protocols.

J. Payroll Structure, Productivity & Workforce Governance

Support HR compensation bands for nurses/attendants based on qualifications, experience, competencies and role; review manpower cost, overtime, absenteeism, productivity and utilisation.

K. New Hospital Commissioning &Operationalization;

Prepare manpower plans, SOPs, training, and readiness checklists; coordinate recruitment, credentialing, and competency assessments before launch.

Conduct pre- and post-launch reviews, close operational gaps, and ensure smooth service stabilisation.

L. Unit-Level Performance Review & Corrective Intervention

Conduct scheduled and risk-based facility visits to review nursing KPIs, staffing, audits, patient feedback, incidents, and training compliance; assess nursing leaders’ performance, implement time-bound corrective action plans, monitor closure and effectiveness, and escalate persistent non-compliance, staffing shortages, serious risks, and underperformance to senior management.

4. Qualification & Experience

· B.Sc. Nursing is preferred; M.Sc. Nursing, Hospital Administration or a relevant postgraduate qualification will be an advantage.

· Minimum 10 years of relevant experience in hospital nursing administration, nursing operations, clinical quality or multi-unit healthcare operations.

· Demonstrated practical involvement in NABH accreditation.

Work Location: In person

📌 Nursing Administrator – Clinical Operations & Quality (Varanasi)
🏢 Heritage Hospital
📍 Varanasi