Acute Rehab / PATH Referral Coordinator

Detailed Overview

In accordance with the British Columbia College of Nurses and Midwives (BCCNM) standards of practice and the Mission, Vision and Values of Fraser Health, and working collaboratively and in partnership with the interprofessional care team in the provision of person-centered care, coordinates and implements a centralized referral and access system related to patient referrals to inpatient rehabilitation and alternate care (PATH) across Fraser Health. Receives, prepares and assesses the efficiency and effectiveness of patient placement within the appropriate site / unit, coordinates timely patient placement and bed utilization, collaborates with referring and receiving sites, and visits sites in order to assess patients, review referral and identify and reduce barriers to patient flow. Develops and determines the effectiveness of related policies and procedures, maintains and collects access data, participates in quality improvement activities, and provides education and referral information to referring sites. Responsibilities Coordinates, develops and implements a centralized referral and access system for patient referrals to inpatient rehabilitation units and alternate care (PATH) units across Fraser Health. Receives, reviews and assesses referrals for inpatient rehabilitation and / or alternate level of care. Prepares referral for screening in accordance with established protocols, ensures comprehensive information is included, prioritizes placement of patients using established guidelines and policies, and facilitates timely admission to appropriate bed resources. Works in close collaboration with sites, Patient Care Coordinators, and multidisciplinary care teams across Fraser Health to ensure efficient flow of referrals and promotes maximum bed utilization within receiving units. Performs site visits as required in order to review referrals and patient needs directly; may participate in care rounds to support care leaders, assess needs, and identify and reduce barriers to patient flow related to rehabilitation and alternate level of care. Develops and determines effectiveness of referral policies and procedures and provides consultation and guidance to referral sources on the interpretation and application of policies related to eligibility and access. Provides education and specific information related to inpatient rehab and alternate level of care referrals. Collects data and maintains a current account of bed utilization for inpatient rehabilitation and PATH units across relevant sites. Analyzes statistics and trends; identifies and participates in developing strategies that will optimize patient access and flow. Assists in the implementation of quality improvement activities, outcome follow up, and evaluation. Participates on relevant planning groups and committees to ensure a Fraser Health wide perspective on referral activities and to ensure strong linkages and relationships among key clinical partners. Participates in and coordinates projects / initiatives related to access and flow. Performs other related duties as assigned. Qualifications Education, Training and Experience Current practicing registration as a Registered Nurse with the British Columbia College of Nurses and Midwives (BCCNM). Three years recent, related clinical experience in an acute rehabilitation setting, including one year of experience in a supervisory and / or leadership role responsible for patient care coordination, access and planning, or an equivalent combination of education, training and experience. Valid B.C. Driver's License and access to personal vehicle for business-related purposes. Skills and Abilities Comprehensive knowledge of nursing theory and practice within a person-centered model of care. Comprehensive knowledge of the BCCNM Standards of Practice. Broad knowledge of evidence-based nursing practice related to acute rehabilitation and alternate levels of care. Ability to apply knowledge of the theory and practice of patient access and flow. Ability to make decisions regarding patient referral and placement. Ability to work independently and as a member of a team. Ability to communicate effectively, both verbally and in writing. Ability to deal respectfully with other health care professionals in supporting efficient patient referral and in providing related education / information. Ability to plan, implement, organize, prioritize work and problem solve. Ability to operate related equipment including applicable software. Physical ability to perform the duties of the position.