Overview
Responsible for the coordination and daily operations of the Swing Bed Program. This includes ongoing program development, community and patient education, program promotion, and adherence to regulations.
Responsibilities
- Meets with patients/family/significant others to assess post-hospital needs and facilitates linkage to the swing bed program.
- Reviews medical documentation to ensure criteria for admission are appropriate.
- Ensures patients have a well-planned process from admission to discharge or transfer for medically complex patients, and collaborates with the interdisciplinary team to assess clinical readiness for transfer and discharge.
- Focuses on referral growth, census development, and promoting efficient and effective transitions of care to the skilled nursing facility.
- Maintains constant communication with discharge planners and social workers to facilitate patient transfer within the Swing Bed Program.
- Attends daily rounding.
Quality and Care Coordination
- Recognizes potential and actual patient concerns, investigates problems, intervenes when immediate attention is needed, and reports results to the appropriate person.
- Talks with and listens to patients, families, and health team members.
- Contributes to the program's Performance Improvement Plan.
- Reviews, interprets, and administers Swing Bed policies to staff, patients, physicians, and others.
Care Coordination and Transition
- Evaluates appropriateness of care coordination services for referred patients and coordinates transitions between in-patient or out-patient settings, including the patient\'s home.
- Communicates positively and effectively with all levels of participants in health care delivery in formal and informal settings and with individuals and groups of varying sizes.
- Clinical expertise appropriate for the designated patient population.
- Capable of managing a complex workload and establishing priorities.
- Provides clinical data to insurance companies to ensure admission is certified and continued stay is justified based on interventions and patient condition.
- Maintains spreadsheets and data reporting measures.
Professional Development
- Serves on committees and completes other job-related duties and projects as assigned.
- Provides education and serves as a clinical resource for the Swing Bed patient.
Management Support
- Develops professional relationships with physicians and multidisciplinary staff; assists with coordination of care and implementation of protocols as appropriate.
- Provides input into capital and operating budgets; participates in evaluating needs for equipment, instrumentation, and supplies based on trends in perioperative nursing.
Additional Responsibilities
- Maintains liaison with Manager of Patient Care Services, physicians, nursing personnel, and ancillary/support departments.
- Assists in resolving physician/patient/family concerns.
- Completes other job-related assignments and special projects as directed.
Organizational Responsibilities
- Attends and participates in department meetings and is accountable for information shared.
- Completes mandatory education, annual competencies, and department-specific education within established timeframes.
- Maintains licensure/certification and registration in good standing; ensures BCLS (CPR) and other certifications as required.
- Uses universal precautions and protective equipment to protect patients and self; adheres to regulatory requirements and department policies.
- Available to work overtime and additional shifts as required.
Beacon Way
- Leverage innovation everywhere.
- Cultivate human talent.
- Embrace performance improvement.
- Build greatness through accountability.
- Use information to improve and advance.
- Communicate clearly and continuously.
Education And Experience
- Bachelor of Science in Nursing required. Current Michigan RN license and a minimum of three years job-related experience. Healthcare-related experience preferred; prior referral, transitional care coordination, or community health services experience preferred.
Knowledge & Skills
- Outstanding interpersonal skills with emphasis on listening, assertion, persuasiveness, and collaboration.
- Ability to show empathy, be sensitive, and tactful; maintain a positive attitude.
- Ability to manage a complex workload, prioritize, and navigate transfer of care with patients and families.
- Strong knowledge of medical and clinical processes and reimbursement knowledge; ability to communicate with all levels of staff and groups.
- Commitment to ethical behavior, patient privacy, and professional conduct.
- Excellent planning and organizational skills for coordinating activities of diverse groups.
- Strong customer service orientation.
Working Conditions
- Complex workload and potential mental stress; patient care environment with physical demands.
- Schedule flexibility due to 24/7 operation; possible exposure to bloodborne pathogens and biohazards.
- Travel required to visit patients in-hospital and skilled nursing facilities.
Physical Demands
- Must be able to walk/stand for prolonged periods, push carts/wheelchairs, assist with patient lifting, provide CPR, and meet other essential physical requirements.