jobboard3

RN Clinical – GI Endoscopy Center HC2 – Full Time 12 Hour Rotating Shift (Non-Exempt) (Union) – (Los Angeles, California, United States)

As an integral part of the interdisciplinary team, the Registered Nurse utilizes the nursing process to provide therapeutic care to patients. The Registered Nurse is accountable for the coordination of patient care and education to the patient and family in accordance with the standards, policies, and practices in a compassionate, supportive, and therapeutic environment.The Registered Nurse utilizes the nursing process (assess, plan, implement and evaluate) to provide safe, quality care to the GI patients. He/she works collaboratively with the nursing staff, medical staff and all members of the health care team. He/she demonstrates professionalism through supervision of the RN Manager/Director.Essential Duties:The Endoscopy Registered Nurse (RN) manages a variety of complex patient populations by utilizing methodical and evidence-based scientific practice standards. The Endoscopy RN manages the patient by maintaining physiological and behavioral functions, as well as, providing psychological and sociological support to the patient and family during the recovery process The priority of the Endoscopy RN is toward improvement and/or maintenance of the patient’s pre-procedural state.Consistently transfers scientific knowledge in applying the nursing process.Formulates care plan for direct and indirect care.Performs skills essential to nursing action to be taken.Explains health treatment and teaches client and family.Adheres to universal patient safety goals in all areas of practice. (Example: Universal Protocol)Performs a thorough pre-op assessment.Coordinates patient flow, prioritizes nursing activities according to patient needs and the Endoscopy schedule.Performs proper use of pre-op equipment (I-stat, Accu-Check, computer). Follows proper procedures in documentation, quality control and care of equipment.Performs post-op calls within 24-48 hours of surgery. Take corrective action as needed.Performs hand-off communication to all staff regarding patient care.Provides appropriate care to all patients undergoing anesthesia (general, MAC, Moderate sedation).Performs discharge by criteria Stage I & II.Delegates tasks to others based on scope of practice, preparation and capability.Evaluates effectiveness of care and modifies plan, observes modifications and interprets information.Acts as patient advocate by initiating action to advanced plan of care.Initiates and supports change decisions.Participates in the development of professional practice, i.e., nursing committees, research, policy development/review, unit based improvement projects (internal and external).Demonstrates knowledge about current policies and shares awareness about new trends/technology.Provides appropriate age-specific care to patients.Utilizes the six core steps (data collection, data assessment and nursing diagnosis, plans, implements, evaluates and patient teaching) to manage the patient’s condition.Collaborates with physician, co-workers and other ancillary staff to provide circulating or technical assistance during Endoscopy procedures.Utilizes policies and procedures to support the RN’s scope of practice.Assists in establishing and maintaining performance improvement and quality control activities to support the department, as well as, the hospital.Assists in providing orientation, training and continuing education for the staff.Adheres to governing regulations such as hospital policies, Title 22 and JCAHO.Competent in utilizing Cerner Millenium to place physician orders.Is a team player and possesses a positive attitude.Follows the Policy and Procedure for Moderate Sedation.Performs GI diagnostic testing as assigned.Performs on call duties on rotation.Performs other related duties as assigned.Required Qualifications:Req Bachelor’s degree Nursing Degree in Nursing (BSN) *Grandfathered from BSN if hired prior to 12/2019Grandfathered from BSN if hired prior to 12/2019Req 1 year Prior GI LAB experience or one year in a high acuity Intensive Care setting immediately prior to applicationReq Must have excellent communication skills, including the ability to speak, read and write English proficiently.Req Knowledge of medical procedures and conditions and ability to understand, follow and successfully perform duties, including whole blood collection, and apheresis procedures, in accordance with administrative and clinical policies, regulations and procedures.Req Committed to excellence in patient care and customer service.Req Demonstrates ability to work independently with minimal direction and supervision.Preferred Qualifications:Pref Moderate Sedation administration experience preferred.Required Licenses/Certifications: Req Registered Nurse – RN (CA Board of Registered Nursing)Req Basic Life Support (BLS) Healthcare Provider from American Heart AssociationReq Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)Req Advanced Cardiovascular Life Support (ACLS) Healthcare Provider from American Heart AssociationThe hourly rate range for this position is $52.24 – $85.69. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

LVN/LPN – LV Family Medicine Clinic – Full Time 10 Hour Days (Non-Exempt) (Non-Union) – (Las Vegas, Nevada, United States)

The Licensed Vocational Nurse (LVN) is an individual with specific knowledge and technical skills to assist the Registered Nurse in providing care for a designated group of patients. The LVN utilizes the Nursing Process to provide therapeutic care to a specific population of patients, under the direction of the Registered Nurse.Assists in the implementation and evaluation of the delivery of patient care. Under guidance of clinical supervisor, registered nurse or physician, provides individualized, direct patient care to promote restoration of health and achievement of patient health goals. Performs nursing functions in accordance with departmental policies and procedures, established standards of nursing care and practices, and licensure limitations.Essential Duties:Accurately obtains and records patient vital signs. Under direction of registered nurse or physician, performs established techniques for administration of medications and parenteral fluids, and obtaining specimens. Responds promptly in emergency situationsRecognizes changes in the patient’s physical and mental condition, takes appropriate action by notifying physician and/or nursing supervisor.Provides comprehensive medical record documentation that reflects all aspects of care provided during each encounter, including patient history, medication list, allergy list, and treatments and/or procedures. Accurately and completely documents data for billing purposes.Promotes security by alerting appropriate personnel for safety, fire and other unsafe situations. Reports any unusual occurrences to supervisorAssists with stocking supplies and cleaning rooms and equipment.Ensures patient charts are prepared prior to appointment including x-rays and pertinent lab work, makes arrangements to obtain any special equipment needed. Sets up exam rooms, assists physician with exams as needed, monitors patient flow.Performs venipuncture methods such as syringe, vacutainer, blood culture and fingerstick. Instructs patients regarding procedures including glucose tolerance preparation and proper specimen collection techniques. Provides patient care if fainting or loss of consciousness occurs.Assists in coverage for switchboard, appointment system, and reception area, as needed.Cleans, wraps and autoclaves instruments. Sets up surgical trays and assists surgeons during surgical procedures.Assists and/or transports patients to exam rooms or surgical suites. Takes specimens to laboratory and returns with reports.Maintains files and records, oversees equipment and office supply inventory. Photocopies, collates, faxes, distributes, mails, performs errands. Reads and prioritizes incoming mail. Handles or routes as appropriate.Performs other duties as assigned.Required Qualifications:Req High school or equivalentReq Specialized/technical training Graduate of an accredited Vocational Nursing ProgramReq Specialized/technical training Must have passed the NCLEX-PN licensing examinationReq 1 year Experience in an acute care or ambulatory care setting.Req Demonstrated intrapersonal skills and knowledge of patient care and/or needs.Req Must have keen observational, decision-making, and communication skills.Req Ability to follow orders and work under close supervision.Preferred Qualifications:Required Licenses/Certifications: Req Licensed Vocational Nurse – LVN (CA DCA) Valid California Vocational Nursing licenseReq Basic Life Support (BLS) Healthcare Provider from American Heart AssociationReq Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)Req BELOW APPLIES TO LAS VEGAS ONLY (Exempt from KMC Requirements above): ◦ – Licensed Vocational Nurse (LVN) – Valid Nevada Vocational Nursing license ◦ – Basic Life Support (BLS): Healthcare Provider from American Heart AssociationThe hourly rate range for this position is $22.00 – $34.18. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

RN Clinical – Newport Beach HemOnc Clinic – Full Time 8 Hour Days (Non-Exempt) (Non-Union) – (Newport Beach, California, United States)

As an integral part of the interdisciplinary team, the Registered Nurse utilizes the nursing process to provide therapeutic care to patients.As an integral part of the multidisciplinary team, the Registered Nurse utilizes the nursing process to provide therapeutic care to patients and their families in the outpatient setting with an emphasis on administering chemotherapy, biotherapy, blood products. The RN is also responsible to manage those patients who require acute care either prior to or instead of admitting the patient.Essential Duties:Follows policies and procedures: demonstrates ability to access online manuals and references.Transfers learned scientific knowledge into practical application in applying the nursing process.ASSESSMENT Appropriately completes nursing assessment and screening upon patient encounter via telephone or in clinic.DIAGNOSIS Interprets assessment information and formulates nursing diagnosis.PLAN Maintains problem list, medication list and allergies list when indicated.INTERVENTION Administers medications as ordered and completes re-assessments as indicated. Completes patient care procedures correctly per policy. Delegates tasks based on others’ scope of practice and competency. Acts as patient advocate.DOCUMENTATION Documentation is complete and correct on all encounters.EDUCATION Provides patient and family education as needed based on diagnosis or treatment plan.EQUIPMENT Maintain B/P machine. Correctly identifies and notifies appropriate department about defective equipment.COMMUNICATION Communicates effectively with all members of the healthcare team including the patient and family by: Appropriate patient/family interactions Effectively triages phone calls Utilizing e-mail system SBARORGANIZATION Manages time effectively. Able to organize and prioritize responsibilities. Takes meal breaks without incurring overtime.OBSERVES REGULATORY AGENCY REQUIREMENTS: National Patient Safety Goals Uses two patient identifiers Does not use unapproved abbreviations Uses procedural time out Uses appropriate communication between providers Completes medication reconciliation Maintains audible alarms Hazardous waste management Biohazard Medication Sharps HIPPA OSHA requirements (ie. No food or drink in clinical areas) JCAHO (continuous survey readiness Critical values are written, read back and shared with appropriate provider Dictated orders are written down, read back for validation, signed, timed and dated Maintains a safe work environment for self and others QUALITY MEASURES Identifies and participates in data collection and process improvementsPROFESSIONAL DEVELOPMENT Participates in professional hospital/nursing activities Relief charge nurse Nursing committees/councils Journal club Educational workshops Assist in the development or updating of patient education materialsAccepts and completes additional duties as assignedBonus Points Professional certification Other:Assesses a patient’s knowledge base/understanding of their diagnostic procedure.Plans, with the patient, the course of their testing/treatment in coordination with physician.Assists with the performance of cardiac diagnostic procedures in the Non-Invasive Cardiology Lab.Educates patient/patient’s family about procedure and treatment according to each patient’s individual needs and documents results.Documents accurately, on chart, procedures performed and patient’s tolerance.Performs other related duties as assigned.Required Qualifications:Req Bachelor’s degree Nursing Degree in Nursing (BSN) *Grandfathered from BSN if hired prior to 12/2019Req 1 year Experience in a related healthcare setting requiredReq Must have excellent communication skills, including the ability to speak, read and write English proficiently.Req Knowledge of medical procedures and conditions and ability to understand, follow and successfully perform duties, including whole blood collection, and apheresis procedures, in accordance with administrative and clinical policies, regulations and procedures.Preferred Qualifications:Pref Oncology strongly preferredPref Experience giving chemotherapy and/or other types of infusions is also highly desiredPref Specialty Certification Specialty certification in oncology is preferred.Pref ONS Chemotherapy & Biotherapy Preferred when eligibility criteria have been met.Required Licenses/Certifications: Req Registered Nurse – RN (CA Board of Registered Nursing)Req Basic Life Support (BLS) Healthcare Provider from American Heart AssociationReq Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)The hourly rate range for this position is $46.00 – $76.07. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

Ophthalmic Service Specialist – Glendale Eye Institute Cl – Full Time 8 Hour Days (Non-Exempt) (Non-Union) – (Glendale, California, United States)

The Ophthalmic Service Specialist I provides technical ophthalmic and administrative assistance for the USC Roski Eye Institute multi-specialty group practice. Obtains medical histories from patients with standard and rare medical disorders. Patient-care duties include recording patient ocular history, obtaining visual acuity, autorefractometry, lensometry, tonometry, pupillary defect evaluation, confrontational field testing, administration of eyedrops for pupil dilation with topical anesthesia, and assisting with minor procedures. Assists with administrative duties including patient follow up calls, prescription refills, clinic preparation, file preparation, appointment scheduling, submission of billing, insurance verification, sending dictations and insurance verification. Daily interactions with supervisor and doctors, as well as periodic meetings with ambulatory services manager. Incumbents are expected to work with minimal supervision; periodic and regular progress checks are performed to evaluate and adjust workload accordingly.Essential Duties:Clinical Duties Accurately document, record, and update patient’s ocular and medical history, and all other medical information as requested by provider, in electronic and/or paper medical record. Perform all necessary tests for providers to adequately diagnose patients including recording patient’s ocular history, obtaining visual acuity, autorefractometry, refractometry under provider supervision, lensometry, tonometry, visual fields, ocular motility testing, and optical coherence tomography. Administration of eyedrops for pupil dilation and topical anesthesia, under provider supervision. Provide assistance to physicians during minor surgical procedures (intravitreal injections and laser treatments) by setting up instruments and medications, responding to physician needs during procedure and prepare instruments after procedure for reprocessing. Process patient requests for medication refills including contacting pharmacies to order prescription refills. Determine the need for physician review of prescription refills. Be willing to be trained and use newer technologies such as microperimetry or experimental equipment that poses minimal risk to patients (training will be provided). Assist and educate patients on how to take their medications. Handle daily schedule to assure that patients are seen at proper intervals. Maintain equipment and supplies for patient examination rooms. This includes dating topical medications and removing expired materials. Properly clean/disinfect instruments and equipment routinely. Prepare the necessary supplies for diagnostic testing, exams, and procedures. Provide basic maintenance of all clinic equipment. Ensure instruments and devices are clean, fully functional, and sterilized if necessary. Ensure rooms are stocked daily with medications and ophthalmic supplies, place orders as necessary and appropriate. Consult with physician concerning test results and alert physician to positive test results or test abnormalities. Report patient concerns, symptoms, reactions, and changes to licensed clinic personnel. Serve as liaison between the medical staff and patients to answer questions, coordinate patient care, and/or provide patient education. Monitor and track work requests. Perform all tasks in a safe manner in compliance with organizational safety policies and according to applicable regulations; maintain a neat workstation and environment. Provide excellent customer service. Maintain confidentiality of all records and information related to patients, physicians, employees, the University and in related interests. Obtain, document and update in appropriate system(s) all necessary patient information. Provide technical services where needed, including but not limited to Roski Eye Los Angeles, Arcadia, and Pasadena clinic locations.General Administrative Duties Triage patient issues to achieve timely resolution. Respond to requests by doctors and staff during clinic. Follow up calls to patients, checking on status after procedures, appointment verifications or reschedules. Assist with file preparation, inputting appropriate forms in charts, insurance verifications and approvals. Maintain clinic/patient flow, balancing diagnostic testing requirements, patient appointment times, and non-appointment activities. Coordinate service requests with appropriate vendors and USC IT teams. Assist ambulatory services manager with design and implementation of educational programs, which support professional growth and staff development. Assist with pharmaceutical inventory and logs; identify variances. Always maintain and protect patient confidentiality. Support and participate in department huddles and team meetings. Demonstrate KNOWN service standards.Perform other duties or projects, as assigned, or requested.Required Qualifications:Req Associate’s degree Associate Degree required or Combined experience/education, as substitute for minimum education.Associate Degree required or Combined experience/education, as substitute for minimum education.Req 1 year Minimum one year experience serving as an ophthalmic technician in a high-volume setting.Req Knowledge of ophthalmic medical terminology, anatomy, and physiology of the visual systems helpful.Req Skill in acquiring accurate medical history, measuring, and recording visual acuity, and tonometry.Req Ability to work with Microsoft Word & Excel software.Req Ability to type with speed and accuracy.Req Ability to write concisely and clearly, edit, and proofread to ensure grammatically correct and factual correspondence.Req Excellent interpersonal skills.Req Ability to work independently with minimal supervision.Req Ability to prioritize activities with varying time sensitivities.Req Ability to analyze clinical and administrative information and determine appropriate course(s) of action to resolve conflicts and discrepancies.Req Pleasant, caring, and compassionate personality.Req Ability to interact effectively with patients, staff, and physicians.Req Knowledge of the operations and maintenance of patient-related testing equipment.Req Responsible and detailed-oriented.Req Ability to learn state of the art diagnostic equipment.Req Ability to organize and prioritize duties to maximize clinic efficiency.Req Ability to work as a team member in an ophthalmic setting.Req Knowledge of various ophthalmic clinical protocols.Req Demonstrate professional and effective work skills to handle all responsibilities within a fast-paced, high pressure setting.Req Strong organizational and follow-up skills.Req Flexibility and adaptability given the dynamic nature of medicine and departmental needs.Req The ability to interact calmly and effectively with patients with difficult personalities..Preferred Qualifications:Pref Experience working in a university-based medical facility/academic teaching environment.Required Licenses/Certifications: Req Certified Ophthalmic Assistant (COA) Certified Ophthalmic Assistant (COA) or obtained within 12 months of hire and maintained by renewal before expiration date.Req Basic Life Support (BLS) Healthcare Provider from American Heart AssociationReq Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)The hourly rate range for this position is $25.00 – $39.69. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

Supervisor, Clinic (Contact Center) – LV Family Medicine Clinic – Full Time 8 Hour Days (Exempt) (Non-Union) – (Las Vegas, Nevada, United States)

Performs complex and varied administrative and clinical assignments. Serves as a personal contact for physicians, staff, and outside departments in order to address problems, issues or concerns that require attention. Assists in management of clinical unit operations. Reports to the Clinic Manager of the Department. This position supervises clinical staff, including Support Coordinators, Medical Assistants, and LVN’s.Performs complex and varied administrative and clinical assignments. The Clinical Contact Center (CCC) Supervisor provides leadership, coaching, development, and support to their CCC team as they field calls from clients/patients. The CCC Supervisor will be responsible for identifying training and performance needs, monitoring phone and work queue performance, developing action plans for improving and sustaining team performance as well as participating in and completing special projects as assigned. They will work closely with clinic partners and serve as an escalation point for providers and clinical staff. They will be responsible for ensuring that Health Center and Contact Center policies are followed as well as helping to identify and execute changes in policy and procedure. The CCC Supervisor is expected to set the example of living the Keck Medicine of USC values. This position will report to the Clinic Manager of the Las Vegas Health Center. This position supervises clinical staff, including Medical Assistants and Non Nursing Care Coordinators and Schedulers. The Clinic Contact Center Supervisor performs complex and varied administrative and clinical assignments. This position supervises clinical staff, including Medical Assistants and Non Nursing Care Coordinators and Schedulers. • Hiring, training, and preparing call center teammates to respond to client/patient questions and complaints and troubleshoot problems with services or products. • Ensuring teammates understand and comply with all call center objectives, performance standards, and policies. • Answering team member questions regarding best practices or difficult calls. • Identifying operational issues and suggesting possible improvements. • Monitoring and evaluating team member performance, providing learning or coaching opportunities, and taking corrective action, if necessary. • Preparing reports and analyzing data to assist management as they determine call center goals. • Proficiency with technology, especially computers, software applications, and phone systems. • Exceptional verbal and written communication skills. • Strong understanding of company products, policies, and services. • Ability to coach, train, and motivate employees and evaluate their performance. • Excellent problem solving, leadership, and customer service skills. • Analytical, efficient, and thorough. • Ability to remain calm and courteous under pressure and navigate tense situations, especially during busy hours. • Working with other supervisors and management team members to support team members and maximize customer satisfaction.Essential Duties:Serves as Clinic Supervisor. Supervises at least two full-time staff or the equivalent, coordinates personnel actions, including, but not limited to performance evaluations, time-off requests, staff disciplinary actions, hiring, and terminating staff.Manages and oversees a team of Clinical Contact Center Staff, measures KPI’s like inbound calls, call waiting, and call abandonment. Improves quality of results by recommending changes.Serves as a personal contact for physicians, staff, and outside departments in order to address problems, issues or concerns that require attention.Generates Staff Assignments. Arranges for staff coverage as needed.Trains all clinical staff to ensure compliance with Ambulatory policies.Oversees Special Programs/Projects for the DepartmentActs as liaison between supervisor and his/her subordinates for communicating information, assignments, priorities and special requests. Monitors status of pending items and follows-up, as needed.Promotes security by alerting appropriate personnel for safety, fire and other unsafe situations. Reports any unusual occurrences to supervisor. Responds to emergency situations using standard emergency protocols and procedures.Participates in monitoring and evaluating the quality and appropriateness of patient care. Contributes objective data regarding performance of other clinical staff members, as requested.Maintains a safe environment in accordance with standards, policies and safety regulations. Ensures compliance with infection control policies.Coordinates staffing to ensure breaks and meal periods are covered. Provides coverage as needed.Schedules clinic appointmentsPerforms other duties as assigned.Required Qualifications:Req High school or equivalentReq Lead or Supervisory experience.Req Clinical & Office management combined with experience in general administration requiredReq Organization/time management skills.Req Demonstrates ability to utilize effective, appropriate and diplomatic oral and written communication skills.Req Must be comfortable with computers and medical terminology.Req Must have in depth knowledge of all insurance types, including government health programs.Preferred Qualifications:Pref Specialized/technical training Medical Assistant Diploma /Certificate from an accredited program requiredPref Call Center and Customer Service ExperienceRequired Licenses/Certifications: Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)Req Basic Life Support (BLS) Healthcare Provider from American Heart AssociationThe annual base salary range for this position is $52,000.00 – $82,560.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

Part-Time Lecturer of Population and Public Health Sciences – (Los Angeles, California, United States)

The University of Southern California (USC), founded in 1880, is the largest private employer in the City of Los Angeles. As an employee of USC, you will be a part of a world-class research university and a member of the “Trojan Family,” which is comprised of the faculty, students and staff that make the university what it is.Part Time Instructor in the Department of Population and Public Health Sciences, Master of Public Health (MPH-on campus and online), and bachelor’s in health Promotions (HP on campus, University of Southern California. The HP and MPH Programs (on campus and online) seeks faculty candidates at the instructor level, non-tenure track (part-time). The candidate should have a Ph.D. or Dr.P.H. in population and public health sciences, public health, or a closely related discipline from an accredited institution. Prior teaching experience at the graduate level is required, and experience in online teaching is preferred. Expertise in one or more of the following areas is highly desired: Health policy, healthcare management, community health services, social determinants of health and health disparities. In addition to a track record in teaching at the graduate level, the candidate should have publications in peer-reviewed journals and knowledge of statistical software.Potential candidates are encouraged to submit their applications (along with current CV, statement of teaching interests, and two or more letters of recommendation) to: Roberta McKean-Cowdin, PhD, University of Southern California, via e-mail to mckeanco@usc.edu. The University of Southern California strongly values diversity and is committed to equal opportunity in employment.  Women and men, and members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply.

Clinical Lab Scientist – Norris Cancer Hospital Clinical Laboratory – Per Diem 8 Hour Days (Non-Exempt) (Non-Union) – (Los Angeles, California, United States)

The Clinical Laboratory Scientist performs a variety of standardized and highly specialized Biochemical, Hematological, Microbiological and Blood Banking, etc. analysis in the Clinical Laboratory. The Clinical Laboratory Scientist is responsible for the accuracy, reliability and timeliness of patient test results used for the diagnosis, management and treatment of patients.Essential Duties:Performs a variety of manual, semi-automated and automated Biochemical, Hematological, Microbiological and/or Blood Bank analysis on varied patient specimens, maintaining a high degree of accuracy , reliability and productivity.Recognizes normal, abnormal, unusual and critical results and takes appropriate action as established by laboratory policy, including appropriate considerations for the age of the patient.Demonstrates proficiency in clerical and computer functions, for communicating results and for carrying out additional clinical and clerical duties to meet the needs of the Department.Assures results are available within defined TAT guidelines.Communicates and interacts effectively with co-workers, guests of the Institution and hospital clinical staff.Maintains professional growth and development.Participates in the Department’s Quality Assurance Program and continuing education sessions.Help monitor supply levels, communicating with the supervisor for supplies that are needed, assisting in monitoring inventory, as assignedAssists in training personnel.Functions independently in performing responsibilities, organizing and prioritizing work, assisting others when work is caught up.Adheres to Safety / Infection Control guidelines using personal protective equipment as requiredWillingness to take on new tasks and additional responsibilitiesDisplays flexibility to cover the lab in emergencies and difficult staffing situationsObtains specimens from designated patients as necessary.Performs other related duties as assigned or requested by the supervisor.Adheres to established Hospital and Departmental policies and procedures.Possesses both a theoretical and working knowledge of all procedures and instrumentation in assigned areas.Understands the clinical significance of each test performed.Identifies and correct problems that may adversely affect test performance or reporting of test results.Adheres to, performs and documents all calibration, maintenance and quality control as required according to the laboratory policies and procedures.Performs other duties as assigned.Required Qualifications:Req Bachelor’s degree Degree in Related fieldReq Specialized/technical training Training for California Clinical Laboratory Scientist or California Specialty (Limited) LicenseReq 1 year Prior work or training experience to include: specialized and complex analysis, computer experience, quality control, calibration, QC evaluation, inventory control, preventative maintenance, and quality improvement.Req 1 year Experience for CLS license.Req 2 years Experience for a Limited license.Req Organization/time management skills.Req Demonstrates excellent verbal and written communication skills.Req Well-developed planning, marketing, organizational development, and business skills.Req The ability to work with physicians, staff and professionals in multiple settings and locations and to promote diversity in the workplace.Req Sensitivity for and understanding of academic disciplines and issues.Req Knowledge of GMP (good manufacturing practice in accordance with FDA, AABB, and State requirements.Req Knowledge of basic computer skills including Microsoft Office applicationsPreferred Qualifications:Pref Clinical Laboratory Specialist in Microbiology (ASCP)Required Licenses/Certifications: Req Clinical Laboratory Scientist – CLS OR Limited license from the State of California.Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)The hourly rate range for this position is $46.00 – $76.07. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

RN Clinical – OPSC (HC3 OR) – Per Diem 12 Hour Rotating (Non-Exempt) (Union) – (Los Angeles, California, United States)

As an integral part of the interdisciplinary team, the Registered Nurse utilizes the nursing process to provide therapeutic care to patients. The Registered Nurse is accountable for the coordination of patient care and education to the patient and family in accordance with the standards, policies, and practices in a compassionate, supportive, and therapeutic environment.The perioperative registered nurse uses the nursing process, designs, coordinates, and delivers care to meet the identified needs of all patients during perioperative phase. Perioperative nurses possess and apply knowledge of procedure and patient’s intraoperative experience throughout the patient care continuum. Perioperative nurse assesses, diagnoses, plans, intervenes and evaluates the outcome of interventions based on criteria that criteria that support a standard of care. Perioperative nurse addresses the impact of the surgical experience on the patient’s physiological, psychological, sociocultural and spiritual responses. Perioperative nursing role and activities performed during the preoperative, intraoperative and postoperative phases of the patient’s surgical intervention. Perioperative nursing includes, but is not limited to: Peer education and patient/family teaching; support and reassurance; advocacy; control of environment; efficient provision of resources; maintenance of asepsis; monitoring physiological and psychological status; management aggregate patient needs; supervision of ancillary personnel; preoperative exploration, validation of current and future practices; integration and coordination of care across settings and among disciplines, collaboration and consultation.Essential Duties:Follows policies and procedures; demonstrates ability to access online manuals.Transfers learned scientific knowledge into practical application in applying the Nursing Process.ASSESSMENT Appropriately completes Nursing Assessment upon patient admission, at each shift and with change of condition. Completes patient acuity by 0200/1400 daily.DIAGNOSIS Interprets assessment information and formulates Nursing Diagnoses.PLAN Develops Plans of Care with individualized interventions. Documents expected/projected patient outcomes. Reviews/Revises/Updates Plans of Care daily based on evaluation and interpretation of patient outcomes.INTERVENTION Administers medication and IV therapy appropriately at prescribed intervals. Completes patient care procedures correctly per policy at prescribed intervals. Delegates tasks based on others’ scope of practice and competency. Acts as patient advocate. Manages restraint use per policy Attempts alternative non-restraint measures first. Assures complete MD order per policy. Ensures MD assessment per policy. Assures patient monitoring per policy. Ensures Restraint Audit Form is completed each shift.DOCUMENTATION Documentation is complete and correct on all flow sheets and chart forms: Admission Assessment Pain scale assessment and reassessment before and after intervention Daily flow sheet Restraint flow sheet Diabetes flow sheet Educational flow sheet Kardex Care Plan Risk Assessment & Reassessment upon Fall MAR Equipment & Supplies Intra and Inter Facility Transfer Forms Belonging Tracking Form Ensures orders are transcribed and signed off prior to the end of the shift. Completes 12h/24h chart checksEDUCATION Provides patient/family education as needed Room/unit orientation Plan of Care Identifies knowledge deficits related to diagnoses and care Uses and provides MICROMEDEX information to patients and families.TRANSFER & DISCHARGE Collaborates with Case Manager and/or physician regarding discharge planning. Ensures all transfer paperwork is completed. Ensures belongings are sent with patient.EQUIPMENT Utilizes patient care equipment appropriately and safely according to manufacture guidelines IV pump Feeding pump PCA pump Epidural pump Sequential compression device Wound VAC Heating pad/pumpCOMMUNCATION Communicates effectively with all members of the healthcare team including patient and family: Shift to shift report Physician Rounds Patient/family interactions MDP Rounds Hand-Off reports Facility E-mail Student/New employee/Contract employeeORGANIZATION Manages time effectively. Able to organize and prioritize responsibilities. Takes meal breaks without incurring overtime. Completes shift on time.OBSERVES REGULATORY AGENCY REQUIREMENTS: National Patient Safety Goals Patient identifiers Unapproved abbreviations Universal Protocol (Procedural Time Out) Hand-Off Medication Reconciliation Clinical Alarms Other Hazardous waste management Biohazard Medication Sharps HIPAA OSHA requirements (i.e. no food or drink in clinical areas) JCAHO – continuous survey readiness Critical Values § Write Down § Read Back § Follow up Telephone order § Appropriate § Documented § Signed, Timed and Dated § Stamped § Entered into unit log Maintains safe practice in the work environment § Correct body mechanics § Electrical safety § Infection Control Procedures § Hand WashingMANAGEMENT OF THE CARE OF MEDICAL SURGICAL PATIENTS (6N) Demonstrates the ability to manage patients with THA. (6N) Demonstrates the ability to manage patients with TKA. (6N) Demonstrates the ability to manage patients with spinal surgery (6S) Demonstrates the ability to maintain isolation precautions, respiratory and nutrition care specific to cystic fibrosis patients. (6S) Demonstrates the ability to manage medications and maintain protective isolation precautions for patients with abdominal organ transplants (6S) Institutes safety precautions and skin care for patients with hepatic encephalopathy.MANAGEMENT OF THE CARE OF PATIENTS IN THE INTENSIVE CARE UNIT/S Demonstrates the ability to manage complex critically ill patients. Neurosurgery, thoracic-forgut, gastric bypass, orthopedic. Liver/kidney/pancreas transplants, hepatobiliary. Open heart, heart and lung transplants. Demonstrates the ability to manage advanced therapeutic modalities. Hemodynamic monitoring. Continuous renal replacement therapy (CRRT, CVVHD). Ventriculostomy, intracranial pressure monitoring. Ventricular assist devices, balloon pumps.MANAGEMENT OF THE CARE OF PATIENTS IN THE STEPDOWN/TELEMETRY UNITS Demonstrates the ability to manage high acuity patients requiring specialized monitoring and care. Status post open heart, heart transplant, lung transplant. Status post liver/kidney transplants, orthopedics, hepatobiliary, general surgeries. Status post thoracic-forgut, gastric bypass, neurology, neurosurgery. Demonstrates the ability to manage advanced therapeutic modalities. Ventilator care. Arterial/CVP lines. Ventricular assist devices. Lumbar drains.MANAGEMENT OF THE CARE OF PATIENTS UNDERGOING DIALYSIS TREATMENT Initiates, performs and terminates all dialysis treatments according to policy and dialysis standards of care. Reviews all orders and labs prior to initiating treatments. Informs patient of treatment plan. Completes all documentation completely and according to policy on the dialysis treatment record. Performs all pre-treatment safety checks. Performs appropriate machine maintenance according to dialysis policies and procedures. Checks charts for dialysis orders prior to arriving on the unit with the dialysis equipment. Calls physicians for orders early in the shift when orders for dialysis have been placed, but no treatment orders are written. Completes med/surg dialysis treatments on 3S whenever there are more than 2 med/surg patients scheduled.MANAGEMENT OF THE CARE OF THE PSYCHIATRIC PATIENT Engages patients in therapeutic interactions Maintains therapeutic milieu Assesses and monitors for patient safety including: Contraband assessment upon admission, change of shift and prn. Initiates and participates in treatment planning. Monitors locked doors into and out of the unit. Logs in Visitors and assesses for contraband. Follows patients’ legal status q shift and communicates with Department of Mental Health and other agencies as required Administers psychotropic medications only after proper consent and documentation Initiates and participates in treatment planning. Submit Fire Arms Reporting FormBEHAVIORAL RESTRAINTS Demonstrates de-escalation techniques as an effort to prevent the need for behavioral restraint/seclusion. Applies behavioral restraint/seclusion when appropriate. Continuously monitors patients for safety (or delegates as appropriate). Ensures physician assessment of patient within 1 hour of application of restraint/seclusion and then at least every 8 hours. Obtains physician orders per policy. Notifies Manager of all behavioral restraint incidences. Contacts significant other as allowed by patient. Completes debriefing, with patient if appropriate, after the incident.QUALITY MEASURES § Accurately identifies patient that fit Core Measure criteria § Completes Core Measure Documentation § Identifies and participates in data collection and process improvements related to Nurse Sensitive Quality IndicatorsPROFESSIONAL DEVELOPMENT Participates in professional hospital/nursing activities Relief Charge Nurse Nursing committees/councils Hospital Teams Unit Based Projects Research Published peer review articleBONUS POINTS § Preceptor (5) § Professional Certification (5) § More than 8 Non-mandatory CEH (3) § USCUH Nurse Week Recognition (5) § Monthly Hospital or Unit Spirit Award Winner (1) § Public nursing recognition (3)Performs other related duties as assigned.Required Qualifications:Req Bachelor’s degree Nursing Degree in Nursing (BSN) *Grandfathered from BSN if hired prior to 12/2019Req 1 year operating room nurse in an acute care setting immediately prior to application.Req Must have excellent communication skills, including the ability to speak, read and write English proficiently.Req Knowledge of medical procedures and conditions and ability to understand, follow and successfully perform duties, including whole blood collection, and apheresis procedures, in accordance with administrative and clinical policies, regulations and procedures.Req Committed to excellence in patient care and customer service.Req Demonstrates ability to work independently with minimal direction and supervision.Preferred Qualifications:Pref Surgical Units: ICU and Telemetry experience.Pref Advanced Cardiovascular Life Support (ACLS) Healthcare Provider from American Heart AssociationRequired Licenses/Certifications: Req Registered Nurse – RN (CA Board of Registered Nursing)Req Basic Life Support (BLS) Healthcare Provider from American Heart AssociationReq Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)The hourly rate range for this position is $64.56 – $73.95. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

RN Clinical – Rehab – Part Time 12 Hour Days (Non-Exempt) (Union) – (Los Angeles, California, United States)

As an integral part of the interdisciplinary team, the Registered Nurse utilizes the nursing process to provide therapeutic care to patients. The Registered Nurse is accountable for the coordination of patient care and education to the patient and family in accordance with the standards, policies, and practices in a compassionate, supportive, and therapeutic environment.Essential Duties:Follows policies and procedures; demonstrates ability to access online manuals.Transfers learned scientific knowledge into practical application in applying the Nursing Process.ASSESSMENT Appropriately completes Nursing Assessment upon patient admission, at each shift and with change of condition. Completes patient acuity by 0200/1400 daily.DIAGNOSIS Interprets assessment information and formulates Nursing Diagnoses.PLAN Develops Plans of Care with individualized interventions. Documents expected/projected patient outcomes. Reviews/Revises/Updates Plans of Care daily based on evaluation and interpretation of patient outcomes.INTERVENTION Administers medication and IV therapy appropriately at prescribed intervals. Completes patient care procedures correctly per policy at prescribed intervals. Delegates tasks based on others’ scope of practice and competency. Acts as patient advocate. Manages restraint use per policy Attempts alternative non-restraint measures first. Assures complete MD order per policy. Ensures MD assessment per policy. Assures patient monitoring per policy. Ensures Restraint Audit Form is completed each shift.DOCUMENTATION Documentation is complete and correct on all flow sheets and chart forms: Admission Assessment Pain scale assessment and reassessment before and after intervention Daily flow sheet Restraint flow sheet Diabetes flow sheet Educational flow sheet Kardex Care Plan Risk Assessment & Reassessment upon Fall MAR Equipment & Supplies Intra and Inter Facility Transfer Forms Belonging Tracking Form Ensures orders are transcribed and signed off prior to the end of the shift. Completes 12h/24h chart checksEDUCATION Provides patient/family education as needed Room/unit orientation Plan of Care Identifies knowledge deficits related to diagnoses and care Uses and provides MICROMEDEX information to patients and families.TRANSFER & DISCHARGE Collaborates with Case Manager and/or physician regarding discharge planning. Ensures all transfer paperwork is completed. Ensures belongings are sent with patient.EQUIPMENT Utilizes patient care equipment appropriately and safely according to manufacture guidelines IV pump Feeding pump PCA pump Epidural pump Sequential compression device Wound VAC Heating pad/pumpCOMMUNCATION Communicates effectively with all members of the healthcare team including patient and family: Shift to shift report Physician Rounds Patient/family interactions MDP Rounds Hand-Off reports Facility E-mail Student/New employee/Contract employeeORGANIZATION Manages time effectively. Able to organize and prioritize responsibilities. Takes meal breaks without incurring overtime. Completes shift on time.OBSERVES REGULATORY AGENCY REQUIREMENTS: National Patient Safety Goals Patient identifiers Unapproved abbreviations Universal Protocol (Procedural Time Out) Hand-Off Medication Reconciliation Clinical Alarms Other Hazardous waste management Biohazard Medication Sharps HIPAA OSHA requirements (i.e. no food or drink in clinical areas) JCAHO – continuous survey readiness Critical Values § Write Down § Read Back § Follow up Telephone order § Appropriate § Documented § Signed, Timed and Dated § Stamped § Entered into unit log Maintains safe practice in the work environment § Correct body mechanics § Electrical safety § Infection Control Procedures § Hand WashingMANAGEMENT OF THE CARE OF MEDICAL SURGICAL PATIENTS (6N) Demonstrates the ability to manage patients with THA. (6N) Demonstrates the ability to manage patients with TKA. (6N) Demonstrates the ability to manage patients with spinal surgery (6S) Demonstrates the ability to maintain isolation precautions, respiratory and nutrition care specific to cystic fibrosis patients. (6S) Demonstrates the ability to manage medications and maintain protective isolation precautions for patients with abdominal organ transplants (6S) Institutes safety precautions and skin care for patients with hepatic encephalopathy.MANAGEMENT OF THE CARE OF PATIENTS IN THE INTENSIVE CARE UNIT/S Demonstrates the ability to manage complex critically ill patients. Neurosurgery, thoracic-forgut, gastric bypass, orthopedic. Liver/kidney/pancreas transplants, hepatobiliary. Open heart, heart and lung transplants. Demonstrates the ability to manage advanced therapeutic modalities. Hemodynamic monitoring. Continuous renal replacement therapy (CRRT, CVVHD). Ventriculostomy, intracranial pressure monitoring. Ventricular assist devices, balloon pumps.MANAGEMENT OF THE CARE OF PATIENTS IN THE STEPDOWN/TELEMETRY UNITS Demonstrates the ability to manage high acuity patients requiring specialized monitoring and care. Status post open heart, heart transplant, lung transplant. Status post liver/kidney transplants, orthopedics, hepatobiliary, general surgeries. Status post thoracic-forgut, gastric bypass, neurology, neurosurgery. Demonstrates the ability to manage advanced therapeutic modalities. Ventilator care. Arterial/CVP lines. Ventricular assist devices. Lumbar drains.MANAGEMENT OF THE CARE OF PATIENTS UNDERGOING DIALYSIS TREATMENT Initiates, performs and terminates all dialysis treatments according to policy and dialysis standards of care. Reviews all orders and labs prior to initiating treatments. Informs patient of treatment plan. Completes all documentation completely and according to policy on the dialysis treatment record. Performs all pre-treatment safety checks. Performs appropriate machine maintenance according to dialysis policies and procedures. Checks charts for dialysis orders prior to arriving on the unit with the dialysis equipment. Calls physicians for orders early in the shift when orders for dialysis have been placed, but no treatment orders are written. Completes med/surg dialysis treatments on 3S whenever there are more than 2 med/surg patients scheduled.MANAGEMENT OF THE CARE OF THE PSYCHIATRIC PATIENT Engages patients in therapeutic interactions Maintains therapeutic milieu Assesses and monitors for patient safety including: Contraband assessment upon admission, change of shift and prn. Initiates and participates in treatment planning. Monitors locked doors into and out of the unit. Logs in Visitors and assesses for contraband. Follows patients’ legal status q shift and communicates with Department of Mental Health and other agencies as required Administers psychotropic medications only after proper consent and documentation Initiates and participates in treatment planning. Submit Fire Arms Reporting FormBEHAVIORAL RESTRAINTS Demonstrates de-escalation techniques as an effort to prevent the need for behavioral restraint/seclusion. Applies behavioral restraint/seclusion when appropriate. Continuously monitors patients for safety (or delegates as appropriate). Ensures physician assessment of patient within 1 hour of application of restraint/seclusion and then at least every 8 hours. Obtains physician orders per policy. Notifies Manager of all behavioral restraint incidences. Contacts significant other as allowed by patient. Completes debriefing, with patient if appropriate, after the incident.QUALITY MEASURES § Accurately identifies patient that fit Core Measure criteria § Completes Core Measure Documentation § Identifies and participates in data collection and process improvements related to Nurse Sensitive Quality IndicatorsPROFESSIONAL DEVELOPMENT Participates in professional hospital/nursing activities Relief Charge Nurse Nursing committees/councils Hospital Teams Unit Based Projects Research Published peer review articleBONUS POINTS § Preceptor (5) § Professional Certification (5) § More than 8 Non-mandatory CEH (3) § USCUH Nurse Week Recognition (5) § Monthly Hospital or Unit Spirit Award Winner (1) § Public nursing recognition (3)Performs other related duties as assigned.Required Qualifications:Req Bachelor’s degree Nursing Degree in Nursing (BSN) *Grandfathered from BSN if hired prior to 12/2019Req 1 year Acute inpatient hospital experience in the United States as a licensed RN.Req Must have excellent communication skills, including the ability to speak, read and write English proficiently.Req Knowledge of medical procedures and conditions and ability to understand, follow and successfully perform duties, including whole blood collection, and apheresis procedures, in accordance with administrative and clinical policies, regulations and procedures.Req Committed to excellence in patient care and customer service.Req Demonstrates ability to work independently with minimal direction and supervision.Preferred Qualifications:Pref Specialty CertificationRequired Licenses/Certifications: Req Registered Nurse – RN (CA Board of Registered Nursing)Req Basic Life Support (BLS) Healthcare Provider from American Heart AssociationReq Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)The hourly rate range for this position is $52.24 – $85.69. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

Surgical Tech II – Surgery – Full Time 10 Hour Evenings (Non-Exempt) (Union) – (Los Angeles, California, United States)

Under general guidance of the Registered Nurse, the Surgical Tech II applies, demonstrates, and possesses proficient/advance knowledge, competencies, and skills of surgical and aseptic techniques and practices; assists the surgical team and performs a variety of tasks in an operating room; prepares, sterilizes, and cleans up surgical equipment and instruments; and is responsible for the care and safety of patients who come under his/her care. The Surgical Tech II is generally assigned a triad of surgical/operative procedures and exercises critical thinking and independent judgement.Essential Duties:Performs similar responsibilities as the Surgical Tech I but distinguishes from the Tech I in that the Surgical Tech II is an intermediate to advance level position and is generally assigned a triad of difficult surgical/operative procedures (such as Head, Neck, Neuro, Spine and/or Ortho surgeries) which requires proficient/advance knowledge, skills, and ability to adapt to the operative procedure.Adheres to all safety standards and policies (such as surgical, specimen collection, sterile processing, Title 22, JCAHO) as they relate while performing all responsibilities.Applies principles of aseptic technique and initiates prompt corrective action when breaks in aseptic technique occur.Remains attentive throughout the operative procedure, anticipating the needs of the surgical team, and responds appropriately during emergency intraoperative crises.Maintains ongoing communication with the circulating nurse and other members of the surgical team regarding changes in patient status or the progress of surgery.Arranges and inventories sterile set-up for operation.Facilitates the smooth flow of the surgical intervention (i.e., prepares for the procedure with updated preference cards, knowledge of instruments and equipment).Performs scrub role (such as anticipating surgical team’s needs, passing of instruments, cutting sutures, etc.) according to standards.Prepares, cleans, and maintains instruments, equipment, and all surgical related items in accordance to established guidelines.Transports patients, equipment, supplies, and specimens.Prepares operating room (OR) by setting up tables, instruments, and supplies in according to type of case/operative procedure.Performs the preceptor role in the training of students.Participates in decision-marking activities related to evaluating and acquiring surgical equipment, instruments, and supplies.Recommends, implements, and participates process improvement projects on an ongoing basis.May mentor and/or lead other surgical technicianMay assist in performing circulating skills and task.Performs all duties as assigned.Required Qualifications:High school or equivalentSpecialized/technical training Completion of a CAAHEP accredited Surgical Technician Program is required.1 year One-year experience as a Surgical Technician or as a Surgical Technician intern required. *Surgical Technician intern experience must be paid and completed at Keck Medicine of USC.Organization/time management skills.Demonstrates excellent verbal and written communication skills.Preferred Qualifications:Required Licenses/Certifications: Surgical Technologist – CST Valid Certified Surgical Tech (CST) or Surgery-Certified Credential (TS-C) from CAAHEP or ABHES certification.Basic Life Support (BLS) Healthcare Provider from American Heart AssociationFire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only) The hourly rate range for this position is $30.50 – $51.85. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.