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Care Nurse Coordinator RN
2 months ago
We are seeking a skilled Care Nurse Coordinator RN to join our team at WellSpan Health. As a key member of our interdisciplinary team, you will play a vital role in facilitating quality clinical care within our Inpatient Child/Adolescent and Adult Psychiatric Units.
Key Responsibilities- Support bedside staff in day-to-day psychiatric and medical care coordination and workflow to achieve best outcomes.
- Work as an active member of the Treatment Team, collaborating with all members of the interdisciplinary team, including psychiatrists, medical providers, primary nurses, Social Work, and Therapists.
- Engage assigned patients using Motivational Interviewing strategies to encourage participation in their care and collaborate with the treatment team.
- Collaborate with the discharge readiness team to enhance education and planning.
- Assist patients with understanding medication management, outpatient follow-up treatment, discharge transportation needs, and identifying and resolving obstacles related to discharge.
- Coordinate medical and psychiatric care and participate in Treatment Team meetings to ensure best patient outcomes.
- Follow regulatory procedures to comply with treatment plan requirements and ensure appropriate documentation of treatment team participants.
- Foster a team environment that relies on the strengths of interdisciplinary team members, maintains patient focus, and engages in flexible problem-solving to create new and innovative strategies for addressing patient needs.
- Establish new relationships with providers, participate in meetings, and follow through with recommendations for consultation, enhanced unit resources, and education to increase patient care.
- Oversee care progression in discharge readiness by rounding with the care team, using clinical judgment to identify discharge readiness, risk of readmission, and proactively identifying barriers.
- Initiate problem-solving for delays and barriers.
- Coach and mentor clinical nursing staff in care coordination, situational awareness, and patient engagement to facilitate a positive patient experience.
- Engage in crucial conversations to ensure completion of effective and necessary interventions to enhance patient care and treatment progress.
- Participate in daily communication with primary nurses, communicating clinical concerns and assisting in developing an action plan for the patient or updating the Nursing Care Plan.
- Facilitate nurse/provider rounds to ensure patients are informed of and included in their plan of care and discharge plan.
- Ensure all necessary discharge paperwork, including return to work/school letters and prescriptions, are provided.
- Coordinate with families in collaborative treatment planning and patient progress as appropriate.
- Assist the patient care team with identifying and coordinating alternative treatment settings to provide appropriate care.
- Coordinate with Case Management as indicated.
- Participate in the review of policy and procedures on an ongoing basis, providing evidence-based revisions as necessary.
- Participate in Quality Improvement endeavors through monitoring patient outcomes.
- Assist with the collection and analysis of utilization patterns, including avoidable days and denied cases, and share this with assigned clinical leadership.
- Take action to address these measures with the team as needed.
- Review readmission metrics, communicate safety concerns and customer issues when appropriate, and increase team awareness of these events.
- Bring known or suspected problems of under-, over-, or inappropriate utilization of resources to the attention of the appropriate manager(s).
- Identify educational opportunities and use a proactive and solution-oriented approach to meet defined objectives.
- Assume the role of staff RN if needed.
WellSpan Health's vision is to reimagine healthcare through the delivery of comprehensive, equitable health and wellness solutions throughout our continuum of care.
We are an integrated delivery system focused on leading in value-based care, encompassing more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care, and a behavioral health organization serving central Pennsylvania and northern Maryland.
Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and one of the best in the nation.
We have a team of 23,000 strong, with experts providing a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions.
Our clinically integrated network of 3,000 aligned physicians and advanced practice providers is dedicated to providing the highest quality and safety, inspiring our patients and communities to be their healthiest.
