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RN Patient Care Coordinator - Littleton, CO, United States - Aledade
Description
RN Patient Care CoordinatorNorth Country Primary Care
Position:
RN Patient Care Coordinator
Our mission is to provide patients with the highest possible quality of healthcare within an atmosphere of genuine caring. This includes recognition of the importance of quality customer service to patients, visitors and staff. Displays sensitivity and empathy to the needs of patients, visitors and staff.
Recognizes time as a most valuable resource and responds promptly to patients, visitors and staff.
Prioritizes delivery of care and utilizes resources to maximize efficiency.
Registered Nurses are responsible for the delivery of safe, timely, appropriate patient care through the use of nursing process.
The Registered Nurse understands and adheres to all hospital and department specific policies and procedures as well as to the practice standards set forth in the New Hampshire Nurse Practice Act.
The Registered Nurse retains the responsibility for the direction and guidance of ancillary personnel activities within the units.The Registered Nurse provides individualized care, education and support which addresses the immediate and anticipated needs of the patient and family across the care continuum.
Review of individual job descriptions with employees is an on-going part of our annual performance evaluation program.The Registered Nurse coordinates team-based care to provide health services to individuals, through effective partnerships with patients, their caregivers/families, community resources, and their physician.
The Registered Nurse facilitates a "shared goal model" within and across settings to achieve coordinated high-quality care that is patient and family-centered.
Patient Care:
The nursing process is utilized to provide comprehensive, age appropriate nursing assessment including biophysical, psychological, social and educational needs.
Assessment of patients learning needs, abilities, preferences and readiness to learn with consideration to cultural and religious practices, emotional barriers and financial implications of care choices.
Patient assessment and interview is utilized to formulate an individual care plan within the limits of New Hampshire Nurse Practice Act and Littleton Regional Hospital policies and procedures.
Patient and family involvement in development of the plan of care and all care decisions will be a priority.Implementation of all clinical and technical aspects of individual patient care plan to include the use of proper techniques, infection control guidelines, established procedures/safety precautions to meet the individual needs/priorities of the patient.
Supports and augments the medical regimen by implementation of physician orders.Provides accurate and timely documentation of nursing interventions, patient response, and nursing evaluation and further actions if required.
Evaluate:
Reviews and evaluates patient care plan through continuous patient assessment.
The plan of care is coordinated in consultation with multidisciplinary team involvement and adjusted to provide seamless delivery of care across the patient care continuum.
Ongoing evaluation of patient care will include continued patient/family involvement and adjustment to meet the evolving biophysical, psychological, social and educational needs.
Supports and contributes to the Mission and Vision of Littleton Regional Hospital with a continuous focus on excellence in customer service and patient care delivery.
Establishes and maintains a professional relationship with patients, visitors, staff, physicians and the community.Adheres to hospital, departmental, and compliance policies, procedures, regulations, and laws (OSHA, DEA, CLIA, etc)
Performs other duties as needed within the scope of practice in support of departmental and institutional needs and requirements Provides telephone triage
Assists/chaperones the treatment of patients in accordance with policy, procedures and guidelines
Utilize tools and documents that support a guided care process, collaborate with patient/family toward an effective plan of care.
Assess patient and family's unmet health and social needs.
Provide effective communications to improve health literacy.
Develop a care plan based on mutual goals with the patient, family, and provider's emergency plan, medical summary, and ongoing action plan, as appropriate.
Monitor patient adherence to plan of care and progress toward goals in a timely fashion, and facilitate changes as needed.
Create ongoing processes for patients/families to determine and request the level of care coordination support they desire over time. Promote healthy behaviors in all populations and ensure navigation assistance with community resources.Facilitate patient access to appropriate medical and specialty providers as well as other care coordination team support specialists (e.g., Diabetes Educator).
Cultivate and support primary care and subspecialty co-management with timely communication, inquiry, follow-up, and integration of information into the care plan regarding transitions-in-care and referrals.
Serve as the contact resource, advocate and informational resource for patient, family, care team, payers, and community resources. effective medication reconciliation and shared medical records).Facilitate and attend meetings between patient, families, care team, payers, and community resources, as needed.
Attend and actively participate in all Care Coordination related training and meeting activities (Health Coach Certification, quarterly Regional Workshops, monthly cohort calls with other NRACO Care Coordinators and Coaches).
Core values consistent with a patient/family-centered approach to care.Demonstrates continual learning skills, effects changes in approach to care based on established, evidence-based practice. Provides mentoring/coaching of other population health and care coordination team members.
Cultivates effective partnerships, effectively collaborates with all practice providers (Physician, Nurse Practitioner, Physician Assistant and other licensed allied health team-members).
Demonstrates understanding in use of IT resources and patient databases.Demonstrates effective delegation skills to streamline operational workflows and optimize inter-office resources.
Must be a graduate of an accredited school of nursing
Bachelor of Science preferred
3-5 years experience in clinical or community health settings preferred.
Previous Care Coordination, Case Management or Home Health experience preferred.
Proficient in communication technologies (email, cell phone, etc.).
Must have ability to communicate compassionately with patients, families, visitors and office staff
Previous experience with health IT systems and data reports preferred.
Must have ability to understand medical records, provider's orders
Previous experience with mobilizing community resources, navigating patients through the healthcare continuum, and working with disparate populations preferred.
Ability to speak a relevant second language preferred.
Must be flexible and able to work as member of the team.
All staff will be required to float, when needed, within the parameters of orientation and hospital policy
