Registered Nurse (RN), Clinical Program Coordinator, Heart Institute - FT/Days (8hr)
MemorialCare Health System
Location: Long Beach, California
Internal Number: LON008367
Purpose Statement/Position Summary
The Structural Heart (SH) Clinical Program Coordinator serves as a liaison between the patient/family and healthcare team for assessment, coordination of diagnostic work-ups, treatments and services, referrals for outside/contracted services, follow-up of study results, and documentation of the progress of the patient condition across the continuum of care. This position will focus on the coordination of a patient’s care for the patient population of structural heart disease, in collaboration with the entire healthcare team. This position will also function as a member of the multidisciplinary CORE team in the outpatient clinic setting to provide/ensure nursing assessments, contribute to the plan of care, coordinate team conferences and provide patient/family education. The SH coordinator also supports SH and cardiology research functions, data integrity, performance impovement and outreach activities.
Essential Job Outcomes & Functions
Coordinates, prioritizes, and organizes individual patient care in collaboration with the attending physician for patients within structural heart disease, across the continuum of care from inpatient to outpatient and home settings.
Attends multidisciplinary inpatient bedside rounds and family/multidisciplinary team conferences for all inpatients with a primary cardiac diagnosis and collaborates with multidisciplinary professionals to integrate the team’s interventions into a comprehensive plan of care and mobilize clinical resources to enhance patient outcomes, meeting the requirements of the goals of care and best practice recommendations.
Acts as a liaison with other hospitals, business groups, departments, out-patient services, carelines and service lines demonstrating communication and leadership and ensures timely tracking and coordination all follow-up studies, scans, and visits that result in the achievement of intended outcomes. Develops collaborative relationships with other departments, physicians, the public, healthcare facilities, and other applicable organizations in the community to utilize and support the cardiac program services. Works closely with all member of the cardiac program services. Supports professional and patient education efforts.
Collaborates with the multidisciplinary outpatient healthcare team to coordinate linkages to and provide referrals to other programs, to ensure ongoing two-way communication with patients and their families (family conferences, team conferences, phone communication, electronic methods), and to coordinate patient care and services in an effort to meet the needs of patients and families within the Heart Center. Collaborates with the healthcare team to assess and document education needs for the patient and the family, (including barriers to learning) and coordinates education plan as appropriate. Acts as a resource for the intra-professional team regarding this patient population.
Provides direct patient care in the outpatient setting untilizing the nursing process and in accordance with established guidelines: This includes assessment, establishing nursing diagnoses, development and documention of a plan of care, team conferences, implementation of the plan of care, coordination of care, advocating for the patient and family and evaluating the patient's response making modifications as appropriate. This position will anticipate potential discharge needs on admission and throughout the patient stay and ensure completion of discharge care plan including education, equipment, and supplies prior to discharge or in preparation to a different level of care. In the outpatient setting, this position will provide assessment and care coordination for cardiac patients related to their care continuum and other complex needs, as well as patients who will be undergoing cardiac interventions (cardiac catheterization and surgery), and other patients with structural heart disease or complex needs, above and beyond what is provided by the care team.
Attends and participates in the coordination of outpatient team conferences. Coordinates conferences. As appropriate attends monthly cardiac M&M and other meetings. Other meetings/conference attendance as appropriate. Participates in program-related activities and projects including regulatory preparation and reporting, quality improvement activities, LEAN projects, program development, and education.