Shift : Days 5x8 830a-500p or 4x10 700a-500p with weekends
- Manages all aspects of discharge planning for assigned patients.
- Implements discharge planning timely and provides resources in an efficient manner.
- Meets with patient / family to assess needs and develop an individualized discharge plan in collaboration with physicians.
- Identifies and documents barriers for timely disposition.
- Ensures / maintains discharge plan consensus with patient / family, physicians, care teams and payers.
- Responds to referrals for patient’s post-acute needs from physicians and the care team.
- Participates in Interdisciplinary Rounds with the patient’s care team to confirm estimated date of discharge and make recommendations for best level of care transition at discharge.
- Initiates / facilitates post-acute referrals through departmental processes for timely transition to the next level of care.
- Refer appropriate cases for social work intervention based on departmental protocol.
- Allows for any cultural or religious beliefs in providing service and continuity of care. Documentation
- Initial clinical / psychosocial assessment completed and documented in medical record.
- Ensure all records are up-to-date and documentation is clear and concise.
- Ensure timely and accurate documentation in progress notes of interactions with patient / family, physicians, care team, and community partners as it pertains to the patient’s discharge plan.
- Accounts for and indicates all services arranged / delivered in electronic medical record.
- Track avoidable days and report trends that lead to undesired outcomes. Professional Development and Initiative
- Completes all initial and ongoing professional competency assessment, required mandatory education, population specific education.
- Supports department-based goals which contribute to the success of the organization.
- Serves as a preceptor and / or mentor for student interns (if appropriate)
Required Minimum Education
Associate's Degree in Nursing from an accredited school of nursing with a Georgia RN License Required
Shift
Days
Additional note : Shift : Days 5x8 830a-500p or 4x10 700a-500p with weekends
6 days ago