RN CASE MANAGER -

Patient Care Assignment

Patient care assignments may include neonate, pediatric, adolescent, adult, and geriatric age groups.

Responsibilities

• PATIENT SAFETY 1 - Follow patient safety-related policies, procedures and protocols
• MEDICATION - (UPC and CPC Only) Administer medication, including IV medication, via the Seven Rights; document and communicate clinical findings
• PATIENT CARE - (UPC and CPC Only) Write treatment plans; coordinate patient drug and procedure activities; administer medication and treatment; provide and coordinate nursing care of assigned patients; may facilitate group therapy and/or education sessions
• DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops
• VARIANCE - Review variance from standardized protocols of care with health care team members and implement resolution strategies
• REPORTS & RECORDS - Maintain computer-based tracking system and compile required reports and records
• PATIENT SAFETY 2 - Demonstrate proactive approach to patient safety by seeking opportunities to improve patient safety through questioning of current policies and processes
• QUALITY - Participate in continuous quality improvement activities by evaluating patient care systems that may include standards, protocols, and documentation
• COMMITTEES - Attend meetings and represent department or Hospitals within Hospitals related committees or the community, as assigned by supervisor
• EDUCATION - Ensure and/or provide instruction to the patient and family based on identified learning needs; assess patient/family knowledge, health status expectations, and locus of control
• INFORMATION - Assist with development of activities and methods to ensure information is articulated and disseminated to appropriate members of the health care team
• DATA - Perform assessment, data collection, obtain, review, and analyze information in collaboration with the patient, family, significant others, health care team members, employers, and others as appropriate
• ASSESSMENT - Assess the patient's clinical, psychosocial status and current treatment plans
• PATIENT SAFETY 3 - Identify and report/correct environmental conditions and/or situations that may put a patient at undue risk
• COMMUNICATION - Use interpersonal communication strategies with individuals as well as groups of patients, families, significant others, and staff to achieve expected outcomes and patient/family and health care team satisfaction
• IDENTIFICATION - Identify appropriate patients within designated specialty area requiring patient case management interventions by utilizing established procedures including census review, risk screens, and referral
• GOALS - Assist the patient, family, significant others to set patient-centered goals for individual patient, family, and significant others in collaboration with physicians, staff RNs and other health care team members
• PLAN OF CARE - Develop comprehensive multidisciplinary plan of care effectively utilizing tools and resources
• VARIANCES - Intervene when variances occur in patient individualized treatment plan
• RESOURCES - Coordinate and evaluate the use of resources and services in a quality-conscious, cost effective manner and collaborate with appropriate providers to ensure effective, quality outcomes
• DISCHARGE PLANNING - Conduct timely discharge planning by anticipating patient needs in collaboration with physicians, staff RN's, and other health care team members
• INTERVENTIONS - Monitor and evaluate short-term and long-term patient responses to interventions in collaboration with quality assurance and utilization review, maintaining interdependent follow-up as necessary
• TREATMENT CONFERENCE - Facilitate and/or participate in conferences providing ongoing evaluation of interdisciplinary dynamics, goals attainment and treatment management
• CONTINUITY OF CARE - Collaborate with the health care team to ensure continuity of patient care throughout all health care settings; promote effective communication among health care team members including the patient, family, and significant others
• CARE PLAN - Incorporate recommendations and/or services of interdisciplinary team members in the care plan
• COLLABORATION - Develop collaborative relationships with other departments/services and community health care agencies facilitating and supporting quality care in area of clinical expertise; act as a resource on complex patient care activities
• DOCUMENTATION - Provide routine verbal and written documentation for the initial assessment and progress of the patient to other members of the health care team in a timely manner
• ORIENTATION - Participate in orientation, continuing education of staff RN's and other health care team members as appropriate
• NEEDS - Assess the patient/family/significant others needs in relation to the medical diagnosis and treatment and resources; provide treatment options, financial resources, psychosocial needs, and discharge planning in collaboration with appropriate resources
• ORDERS AND REFERRALS - Obtain necessary orders from physicians to initiate home health referrals, home infusion medications and supplies, oxygen and equipment; coordinate referrals for oxygen and equipment
• PATIENT SAFETY 4 - Report potential or actual patient safety concerns, medical errors and/or near misses in a timely manner
• PATIENT SAFETY 5 - Encourage patients to actively participate in their own care by asking questions and reporting treatment or situations that they don't understand or may "not seem right"
• PATIENT CENTERED MED - Adhere to and promote the core expectations of the Patient Centered Medical Home or Patient Centered Specialty Practice as applicable

Qualifications

• Education: Program Graduate
• Nationally Accredited Nursing Graduate
• Bilingual English/Spanish
• Bilingual English/Keres, Tewa, Tiwa, Towa, Zuni, or Navajo
• 2 years directly related experience