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Ann Arbor

    clinical care coordinator - Ann Arbor, MI , USA, United States - University Of Michigan

    University Of Michigan
    University Of Michigan Ann Arbor, MI , USA, United States

    2 weeks ago

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    Description
    Mission Statement


    Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally.

    Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

    Responsibilities** Provide coordinated care to heart transplant patients and families receiving care in the Michigan Congenital Heart Center (MCHC).

    • Participate in all aspects of care coordination as a member of a collaborative and multi-disciplinary team.
    • Communicate with referring clinicians and other healthcare team members.
    • Provide professional nursing support in the management of pre and post heart transplant patients and associated chronic disease management. Provide skilled observations, triage, education and health assessments of patients including history, appropriate interventions and referrals.
    • Provide patient-and-family-centered-care in the outpatient setting and tele-health management.
    • Tele-health management includes triaging calls and in-basket messages from patients, families, clinicians, and other healthcare team members.
    • Provide accurate and efficient documentation of nursing care
    • Work in an integrated fashion with physicians, physician assistants, nurse practitioners, nutritionists, discharge coordinators, and other consulting services to provide high quality patient care
    • Teaching and counseling for MCHC heart transplant patients via phone screening and in person clinic visits.
    • Maintain patient flow in clinic, and support assistive staff as needed.
    • Collaborate with clinicians, other health team members, and associated resource persons to provide continuity of care.
    • Maintain knowledge of all applicable regulatory laws and requirements, including HIPPA, CMS Conditions of Participation, The Joint Commission, and UNOS to ensure regulatory compliance in nursing practice.
    • Assist in the development and implementation of standards and protocols in collaboration with the clinical management team.
    • Participate in meetings involving the care of MCHC heart transplant patients as well as meetings to support program development.
    • Participate in performance improvement activities
    • Partner with outreach referring cardiologists
    • Participates in data collection for the Heart Failure Transplant program and other QA,/QI endeavors related to MCHC population.
    • Other duties as assigned


    The MCHC Heart Transplant CCC provides comprehensive coordination of care to congenital heart transplant patients and works collaboratively with colleagues across the MM health system and relevant outreach locations.

    The RN will coordinate pre and post transplant nursing care to patients with complex cardiac conditions
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