Job Duties Specific to This Position:
- Supervises the clinical care planning process to ensure the coordination and delivery of quality patient care.
- Oversees the collaboration process to meet the critical needs of each client/resident.
- Reviews all admission orders for accuracy.
- Utilizes best practice guidelines.
- Manages the delivery of patient care, maximizing quality and efficiency.
- Effectively communicates between shift changes or triggers in resident/patient condition.
- Provides assessment for resident/patient upon admission and periodically as regulations or changes in condition requires.
- Obtains and implements physician orders. Ensures documentation is current and accurate.
- Provides education and instruction to resident/patients, families and care givers as required.
- Analyzes problems, plans resolution strategies, implement plans and evaluates outcomes.
Interdisciplinary Team Process:
- Collaborates with the Interdisciplinary Care Plan Team to:
- Participate in family conferences to discuss the resident care plan if indicated or required.
- Keep the family informed of any resident changes.
- Facilitate discharge planning.
- Communicate any significant clinical changes in the resident that would alter the care plan.
- Identify the need for health teaching, teach nursing care issues to the resident and/or family members and verify/document understanding in a timely manner.
- Ensures the IDCP team is aware the patient is under the Bundle Program.
- After review of the patient, medical record and length of stay for the Bundle DRG ensures the appropriate discharge date is set and within length of stay goal and the IDCP team is aware.
- Provides clinical assessment and oversight to identify clinical changes in an effort to avoid re-admission to the hospital.
- Ensures all paperwork is completed timely for the Bundle Program.
- Completes discharge training/education for patients/families under the Bundle Program.
- Works closely with the IDCP team to assure all equipment needs for safe discharge are in place.
- Maintains and updates binders on rehabilitative units up to date so all staff are aware of the Bundle Program for the patient and goals for discharge.
- Provides weekly updates to nurse navigators and case managers as requested.
- Maintains tracking log sheet for all resident's covered under the BPCI program.
- Completes and facilitates the completion of required documentation, i.e., admission assessments, risk assessments, discharge teaching, discharge paperwork and BPCI documentation.
- Initiates the development and implementation of patient care standards, policies and procedures to be in compliance with regulatory requirements.
- Develops, reviews and revises policies, procedures and other applicable operational documentation to ensure regulatory agency standards are met.
- Ensures policies and procedures are adhered to by nursing staff. Monitors and maintains compliance with third party agency regulations.
- Ensures effective communication with the client/resident, family, and interdisciplinary team.
- Interprets policies/procedures/regulations for the staff.
- Fosters problem-solving abilities with staff.
- Supports facility management and staff by facilitating change in a positive manner.
- Ensures a safe and secure environment for clients/residents, staff, and visitors.
- Shares current knowledge and up-to-date clinical expertise with staff through formal and informal education.
- Takes responsibility for own education and stays clinically current.
- Participates and conducts Quality Assurance audits as requested.
Job Expectations for All Employees:
- Promotes and role-models the mission, values, vision and strategic goals of Loretto in all interactions with staff, peers, residents, family members, vendors and visitors. Treats people with dignity, professionalism and kindness.
- Demonstrates excellent internal and external customer service skills such as friendly greeting, making eye contact, listening attentively, responding in a timely manner, showing respect and empathy and acting as a role model for staff and peers.
- Demonstrates excellent work attendance, reliability and work ethics.
- Attends and actively participates in required meetings and training sessions.
- Complies with established policies, procedures, and codes of conduct at all times.
- Adheres to all health and safety requirements, regulations, policies and procedures.
- Practices and teaches safety awareness. Identifies and reports or corrects any possible safety or environmental issues.
- Understands all HIPAA and other compliance & regulatory requirements associated with their role, including completion of required internal or external training/certifications.
Performs a variety of related duties as