Transition Services Coordinator

1 month ago

Vancouver, British Columbia, Canada Vancouver Coastal Health Full time

About the Role

Vancouver Coastal Health is seeking a skilled Registered Nurse to join our Transition Services team in Vancouver. As a Transition Services Coordinator, you will play a critical role in ensuring seamless transitions between acute and community care settings.

Key Responsibilities

  • Lead and facilitate transitions by assessing and evaluating clinical and functional needs, and coordinating community staff and resources to ensure effective care.
  • Develop and implement policies, procedures, and standards for the transition services program in community care.
  • Coach and encourage acute and community colleagues to adopt new clinical pathways and practices.
  • Plan and facilitate clinical discussions to support safe client discharges, and advise on community services and referrals.
  • Make community referrals based on client needs, urgency, and best practices, and educate and consult with clients and families.
  • Coordinate transitions to long-term care, utilizing clinical decision support tools as appropriate.
  • Document and maintain client records and clinical assessments.
  • Participate in committees as directed.
  • Coordinate care given by others in an area or unit by assigning service priority to Home Health teams and making client assignments.
  • Assist in administrative activities and optimal use of program resources.

Qualifications

Education & Experience

  • Current practicing registration as a Registered Nurse with the British Columbia College of Nurses and Midwives (BCCNM).
  • Five (5) years' recent, related experience, including three (3) years in a community health setting, one (1) year experience in quality improvement, research, and evaluation activities, and a clinical decision-support tool for severity assessment and discharge.

Knowledge, Skills & Abilities

  • Broad knowledge of nursing theory and practice within a client and family-centered model of care.
  • Broad knowledge of the BCCNM Standards for Nursing Practice.
  • Broad knowledge of evidence-based nursing practice related to patient acuity and bed utilization practices within a tertiary level teaching hospital.
  • Broad knowledge of other healthcare disciplines and their role in client care and discharge planning.
  • Broad knowledge of clinical studies methodology and data presentation.
  • Demonstrated ability to apply critical thinking within clinical and evaluation activities.
  • Demonstrated ability to work independently.
  • Demonstrated ability to work collaboratively as a member of an interdisciplinary team.
  • Demonstrated ability to demonstrate, facilitate, and coach.
  • Demonstrated ability to communicate orally and in writing.
  • Demonstrated ability to communicate with, and deal effectively with, co-workers, physicians, other healthcare staff, clients, and their families, and staff of outside agencies.
  • Demonstrated ability to effectively deal with conflict situations.
  • Demonstrated ability to adjust to new or unexpected events.
  • Demonstrated ability to plan, organize, and prioritize work.
  • Demonstrated physical ability to perform the duties of the position.
  • Demonstrated computerized software skills in word processing, databases, spreadsheets, presentations, and internet access, and ability to operate a computerized patient care information system.
  • Ability to operate related equipment.

Why Join Vancouver Coastal Health?

Vancouver Coastal Health is a world-class innovator in medical care, research, and teaching, delivering service to over one million BC residents. We invite you to join us in creating healthy lives in healthy communities by showcasing our passion for care, connection to the communities we serve, and our culture of teamwork that makes VCH a great place to work.

  • Comprehensive health benefits package, including MSP, extended health, and dental, and municipal pension plan.
  • Grow your career with employer-paid training and leadership development opportunities.
  • Wellness supports, including counseling, critical incident, and innovative wellness services, are available to employees and their immediate families.
  • Award-winning recognition programs to honor staff, medical staff, and volunteers.
  • Access to exclusive discount offers and deals for VCH staff.

Equity, diversity, and inclusion are essential to our goals of creating a great place to work and delivering exceptional care. We acknowledge and accommodate unique differences and ensure special measures are in place so that all prospective and current employees are given an opportunity to succeed.

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