Access & Flow Leader, MH&SUS

Fraser Health is the second largest health system in Canada with over 45,000 staff, medical staff and volunteers, and is the largest of five regional health authorities in British Columbia, providing hospital and community-based health services to nearly 2 million people in Metro Vancouver and the Fraser Valley.

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The Access & Flow Leader is responsible for overseeing and coordinating the delivery of access & flow services across Mental Health & Substance Use Services (MH&SUS), primarily on weekends and/or as assigned. Provides leadership and direction to designated staff at Fraser Health (FH) MH&SUS assigned sites including Patient/Client Care Coordinators and/or Charge Nurses, and leadership to external health care agencies, regarding timely patient placement to and from FH MH&SUS sites. Assesses the efficiency and effectiveness of patient placement within applicable site(s) and surrounding regional/provincial health care facilities; makes critical decisions and solves complex problems which impact patient care and safety in accordance with established policies & standards of quality and patient care. Collaborates with other service providers and acts as a resource regarding access and flow issues. Facilitates alignment/realignment of staffing resources; provides timely and autonomous decisions regarding bed utilization and appropriate patient placement (access); ensures patient safety protocols are followed and staffing issues are addressed in accordance with collective agreements /administrative policies. Implements appropriate policies and procedures and provides guidance to health care teams regarding admission requirements and criteria; notifies the Manager/AOC of any actual or potential problems for resolution; maintains communications with staff, families and physicians on issues relating to patient placement, bed utilization and related information. Develops and maintains effective working relationships with site medical and clinical healthcare providers, management and administrative personnel; addresses and facilitates resolution of customer service/client relations issues. This multi-site position performs duties at MH&SUS assigned sites and requires travel to and/or work at various site Emergency departments within Fraser Health.

1. Directs Patient Care Coordinators (PCCs) and/or Charge Nurses and coordinates appropriate patient placement and/or discharge needs.
2. Facilitates timely patient placement at designated FH acute sites; coordinates patient placement activities by assessing current and projected capacity, prioritizing and expediting critical issues requiring immediate action; evaluates potential staff implications to ensure optimal flow of patients between various units on any given shift. Reports back to MH&SUS / Site Administrator On-Call (AOC) managers for preparation for regional access and flow meetings.
3. Accountable for the optimal use of patient care resources; ensures that appropriate resources are available, including staffing and equipment, to provide safe care, by activities such as assesses workload/staffing needs, allocates staff and authorizes the use of overtime, and consideration of contingency staffing plans. Liaises and collaborates with Staffing Services to ensure optimal staffing levels are maintained and the use of overtime is effectively monitored. Identifies opportunities for improved utilization of resources. Advises AOC / Manager as appropriate.
4. Consults with Patient Transfer Network (PTN) and community resources as required to identify appropriate care for patients by developing and maintaining an understanding of available services at external health care facilities and agencies, determining appropriate contacts, and transfers and discusses bed availability and resources on a patient-to patient basis.
5. Screens higher level of care referrals for appropriate service level match, including those from other health authorities for Psychiatric Intensive Care Unit (PICU) beds; liaises and communicates with clinical/medical/operational leadership regarding referral screening and outcome if required, and provides direction to applicable staff regarding patient transfer to the appropriate site/unit.
6. Assesses critical situations and makes decisions on course of action, including bed utilization, authorization of bed openings, and higher level of care referrals. Liaises with and notifies MH&SUS Administrator on Call (AOC) of actual or potential problems which may have safety, legal or media implications.
7. Coordinates acute site transfer planning, both external and internal; identifies and reports potential discharges, associated issues and communicates to AOC/Manager.
8. Acts as a clinical resource for nursing staff and provides clinical guidance in patient placement and flow, bed utilization, and interpretation of administrative policies such as when there is difficulty in accessing resources for patient care; assists Bed Booking staff in allocating beds, interfacing with nursing units and services and notifying the Manager or AOC of actual or potential problems and follow up.
9. Supervises and coordinates clinical staff by making clinical and operational decisions after hours in liaison with AOC when necessary.
10. Consults and advises to FH leadership, acute and community staff on the interpretation and application of patient access and flow policies and procedures, and eligibility for non-acute bed resources. Assesses critical patient access and flow situations and makes recommendations on course of action related to best practices in efficient and effective bed utilization and patient placement.
11. Makes recommendations regarding resources management.
12. Develops new or proposes changes to existing patient access and flow policies, procedures, protocols, standards and criteria in conjunction with the interdisciplinary team, to optimize timely bed access and appropriate patient placement. Implements and evaluates same.
13. Works with clerical support and interdisciplinary staff on maintaining current and accurate databases for bed availability to achieve optimal utilization and ensure patient information is efficiently managed, including through activities such as analyzing statistics and trends (e.g. ALC, ALOS/ELOS, 10-hour rule, Acute Dashboard) at a regional level; identifies and participates in strategies to best manage the designated patient populations.
14. Ensures unsafe situations are reported; investigates and initiates corrective action. Investigates and completes accident and incident reports; communicates outcomes to the Manager and/or Director. Participates in Emergency Preparedness activities. Promotes and monitors safe work practices and enforcement of health & safety requirements.
15. Participates in staff education program and assists in the development and provision of an orientation package for students, new staff and other health professionals.
16. Identifies and promotes continuous quality improvement opportunities and activities including utilizing nursing research to implement current best practices in patient care. Promotes research-based practice by identifying potential areas of research, ensuring staff awareness and involvement in research activities, and facilitating the development of ongoing research.
17. Represents FH on external and internal committees and project groups at local levels to promote FH MH&SUS interests, provide an organizational perspective regarding patient placement, bed utilization, current issues and trends, and communicate opportunities for improvement and development.
18. Performs other related duties as assigned.

Education and Experience

Bachelor's Degree in Nursing from an approved School of Nursing, and current practicing registration as a Registered Nurse/Registered Psychiatric Nurse with the British Columbia College of Nurses and Midwives (BCCNM).

Five (5) years' recent, relevant, acute care experience with mental health and substance use services, including a minimum of two (2) years' experience in a supervisory and/or administrative capacity or an equivalent combination of education, training and experience.

Valid BC Driver's License and access to a personal vehicle for business-related purposes.

Skills and Abilities

• Comprehensive knowledge of nursing theory and evidence-based practice.
• Demonstrated knowledge of principles for bed management.
• Comprehensive knowledge of the BCCNM Standards of Practice.
• Comprehensive knowledge of health care disciplines and their role within health care.
• Demonstrated ability to plan, organize and prioritize work in a continuously changing environment.
• Broad knowledge of clinical pathways, expected length of stays, resource utilization, and patient assessment.
• Working knowledge of pertinent legislation, policies, standards and collective agreements.
• Demonstrated ability to supervise, lead and provide work direction.
• Demonstrated ability to teach and facilitate learning of staff and/or patients/families.
• Demonstrated ability to role model.
• Demonstrated ability to communicate effectively, both verbally and in writing.
• Demonstrated ability to apply critical thinking skills, problem solve and deal with conflict situations.
• Ability to work independently in an organized and self-directed manner and also as a member of an inter-professional team.
• Demonstrated ability to deal effectively with patients, families, the public, medical staff and members of interdisciplinary teams.
• Ability to operate related equipment including proven ability to utilize applicable software.
• Physical ability to perform the duties of the position.

Fraser Health is the heart of health care for over two million people in Metro Vancouver and the Fraser Valley in British Columbia, Canada, on the traditional, ancestral and unceded lands of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish region.

People - those we care for and those who care for them - are at the heart of everything we do. Our hospital and community-based services are delivered by a team of 48,000+ staff, medical staff and volunteers.

We are committed to planetary health and value diversity in the work force. We strive to maintain an environment of respect, caring and trust. Fraser Health’s hiring practices aspire to ensure all individuals are treated in an inclusive, equitable and culturally safe manner.

Together, we are the heart of health care.

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