Transition Services Coordinator

3 weeks ago


Vancouver, British Columbia, Canada Vancouver Coastal Health Full time

Job Summary

Vancouver Coastal Health is seeking a Registered Nurse to join the Transition Services team at Vancouver General Hospital. As a Transition Services Coordinator, you will lead and facilitate acute to community transitions by assessing and evaluating clinical and functional need and coordinating community staff/resources in carrying out the care following discharge from an acute site.

Key Responsibilities

  • Lead and facilitate acute to community transitions by assessing and evaluating clinical and functional need and coordinating community staff/resources in carrying out the care following discharge from an acute site.
  • Be responsible and accountable for the development and effectiveness of policies, procedures and standards for the transition services program in community care.
  • Coach and encourage acute and community colleagues to embrace new and evolving clinical pathways and practice.
  • Plan and facilitate clinical discussions to support safe client discharges with care teams and other health care professionals; advise on the availability and eligibility for community services.
  • Make community referrals based on client needs, urgency and best practices to determine the appropriate treatment; educate and provide consultation to the client/family.
  • Coordinate transition of clients to long term care, utilizing clinical decision support tools as appropriate.
  • Document and maintain client records and clinical assessments.
  • Participate on committees as directed.
  • Coordinate care given by others in an area or unit by way of assigning service priority to various Home Health teams and making/adjusting client/patient/resident 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.
  • Five years' recent, related experience which includes three years in a community health setting, one year experience in quality improvement, research and evaluation activities, and a clinical decision-support tool for severity assessment and discharge, experience in a tertiary health care environment, or an equivalent combination of education, training and experience.

Knowledge, Skills & Abilities

  • Broad knowledge of nursing theory and practice within a client and family centred 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 health care 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 health care 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 more than 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.

Benefits

  • 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 counselling, critical incident and innovative wellness services are available to employees and their immediate families.
  • Award-winning recognition programs to honour staff, medical staff and volunteers.


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