MERCY HEALTH
Mercy Care Centre / Case CoordinatorTransitional Aged Care Program
POSITION DESCRIPTION
Core Mercy Values: / Compassion, Hospitality, Respect, Innovation, Stewardship, TeamworkPosition title: / Transition Aged Care Program (TACP) Case Coordinator / Employee name:
Entity/Group:
Business Unit/Department: / Transition Aged Care Program / Date:
Position reports to: / Community Health Programs Manager / Positions reporting to this one: / Care Service Worker
Allied Health Assistant
PT, OT
Position Purpose: / · To provide case management for patients determined to be suitable for TACP to enhance functional independence
· To ensure effective operation and appropriate use of the community program in conjunction with the Community Health Programs Manager
Qualifications: / · Certificate IV in Allied Health Assistance
or
· Enrolled Nurse/ Endorsed Enrolled Nurse
· Demonstrated knowledge and experience in Case Coordination and rehabilitation
· Current Drivers License
Resource management: / Total staff management (FTE):
Annual Operating Expenditure:
Annual Capital Expenditure:
Personal Competencies required /
Job Competencies Required
¨ Consistently shows respect and compassion to all. / ¨ Knowledge and understanding of the Mission, Vision and Values of Mercy Health and Aged Care.¨ Excellent interpersonal and communication skills. / ¨ Demonstrated ability to effectively liaise with the multidisciplinary team and provide optimal client care.
¨ Practices with a high level of integrity and professionalism. / ¨ Demonstrated capacity for initiative and ability to work effectively with limited direction.
¨ Demonstrates effective leadership by being approachable, fair and adaptable in an ever-changing environment. / ¨ Sound working knowledge of current evidence based practices and a commitment to continuing professional development and research.
¨ Able to approach conflict openly and with a problem solving approach. / ¨ Understanding of and commitment to customer focused service.
¨ Willingness to participate and contribute to a learning environment. / ¨ Has an understanding and knowledge of WHS and Infection Control Policies
¨ Demonstrated higher level of skills in clinical decision making, problem identification analysis and interpretation of clinical data.
¨ Excellent time management skills. / ¨ Computer literacy
Key Result Areas / Standard Measures / Key Activities /
MERCY VALUES
Promote and uphold the Values and Mission of Mercy Health / ¨ Ensures the values of the Young Mercy Care Centre are incorporated into daily work practices. / ¨ Be compassionate and provide support to others.
¨ Consistently shows respect and values each person’s dignity.
¨ Seeks opportunities to be innovative for improvement.
¨ Is accountable for a high standard of client care.
¨ Communicates openly and honestly as an effective team member.
CLINICAL CARE
Provide appropriate quality clinical care service delivery. / ¨ Ensures quality clinical care is provided within the policies and procedures of Mercy Care Centre (MCC)¨ Patient records are maintained to reflect an accurate objective record of patient assessment, treatment, care plan development and patient care.
¨ Discharge planning begins on admission to program / ¨ Promotes best practice initiatives in clinical care activities, rehabilitation and self management.
¨ Demonstrates competence in comprehensive assessment and delivery of high quality care using evidence-based practice.
¨ Chair weekly Case Management Meetings
¨ Ensures accuracy of client records.
¨ Identify clients who have chronic disease or complex needs and develop strategies to improve health outcomes in conjunction with the Allied Health Professionals
¨ Advocate for clients needs by providing information, assisting them to follow recommended treatment regimes, promoting local health services, identifying gaps in services and identifying long term solutions to meet their changing health needs
¨ Demonstrates appropriate level of treatment, planning and consultation with key stakeholders (family, Mercy Care Centre staff, GP, community agencies)
¨ Demonstrates appropriate prioritisation of caseload.
¨ Demonstrates an understanding of services provided by the Acute, Sub-acute and Community healthcare settings.
¨ Provide expertise in own area of professional training to clients and the TACP team
CUSTOMER FOCUS
Ensure all services and practices are delivered with strong focus on individual client needs.
/ ¨ Care is planned with consideration to individual needs.¨ Proactive in managing potential customer complaints.
¨ Case Coordinator identifies own professional boundaries / ¨ Ensures clients, family and significant others are included in the development and implementation of care plans and goal setting.
¨ Acts as a client advocate with internal and external service providers.
¨ Seeks to address conflict in a professional, problem-solving manner while maintaining confidentiality.
COMMUNICATION
Ensure effective lines of communication are maintained to ensure optimal service and patient care
/ ¨ Effective and appropriate patterns of communication are maintained.¨ Collaborates with all members of the TACP team and internal/external stakeholders.
¨ Documentation meets all ethical and legal requirements.
¨ Confidentiality of verbal, written and electronic patient information is maintained. / ¨ Provides appropriate information to and liaises with the multidisciplinary team and support services to ensure optimal client care.
¨ Acts as a role model in preserving confidentiality of client information.
¨ Ensures accurate and timely documentation in medical record.
¨ Demonstrates ability to communicate with clients, families and colleagues.
¨ Is responsible for being proficient in the use of electronic technology required for client care.
¨ Develop formal and informal networks within the client care area and related health and community services to assist coordination of client care.
¨ Restricts discussion of client information to ‘private’ areas.
¨ Recognises and communicates matters requiring attention with the Community Health Programs Manager
LEADERSHIP AND MANAGEMENT
Along with the Community Health Programs Manager, ensures effective day to day management of the Transition Aged Care Program to ensure excellence of patient care within a harmonious environment.
/ ¨ Assists and supports the Community Health Programs Manager to meet the KPI’s of the program
¨ Effectively assesses and case manages the TACP clients
¨ Effective communication between members of the multidisciplinary team to ensure that patients are assessed and referred to TACP in a timely manner.
¨ TACP program is utilized effectively and efficiently.
¨ KPI’s are established and reported on as required.
¨ All documentation is completed as required
¨ Patients and families are informed of TACP and are involved in decision making process / ¨ Promote and market TACP Service within Young Mercy Care Centre, District Hospital and the local community.
¨ Attend appropriate community network meetings to foster strong links between the Mercy Care Centre and local community services.
¨ Displays a willingness to take on higher duties delegated by the Community Health Programs Manager.
¨ Works with the Manager to collect, analyse and report on key data for the TACP program.
¨ Acts as a key liaison person between Young District Hospital, the Mercy Care Centre bed based facility and MCC TACP team and as the central point of contact for all involved in the care of the client and assume specific functions in order to achieve TACP outcomes
¨ Effectively engages with patients and their families and provides all necessary TACP information to enable informed decision making
¨ Coordinates the assessment, development, implementation and monitoring of a comprehensive plan of care through the multidisciplinary team process and in conjunction with the patient and their family.
¨ Attendance at patient reviews in the bed based facility and community as required.
¨ Complies with DoH guidelines and reporting requirements.
¨ Ensures timely reporting of funding and patient reports occurs to meet budget requirements
SAFE ENVIRONMENT
Promotes a working environment supporting WHS and Infection Control practices. / ¨ Comply with risk management policies and procedures.¨ Care is provided within infection control guidelines and standards.
¨ Active involvement in health and safety issues. / ¨ Maintains knowledge of all emergency procedures and participates in disaster planning exercises.
¨ Completion of competencies for emergency procedures as per policy.
¨ Identifies and reports any potential or actual breaches of OH & S and initiates action to rectify breaches.
¨ Completion of accurate incident reports using IIMS
¨ Responds appropriately to specific client and community needs regarding potential infection control issues.
¨ Safe home visit risk assessment tool is completed prior to visit to client’s home
QUALITY
Maintains a high standard of care by promoting quality improvement programs
/ ¨ Demonstrates an understanding of the EQuIP accreditation process.¨ Fosters an environment of continuing improvement as part of everyday practice.
¨ Supports involvement in the EQuIP accreditation activities
¨ Demonstrates an understanding of the TACP Guidelines and TACP Quality Standards / ¨ In conjunction with the Community Health Programs Manager and TACP team, participates in review and development of TACP service in accordance with the Mercy Care Centre needs and the DoH requirements.
¨ Participates in quality improvement activities.
¨ Participates in the ongoing development of practice standards, policies, procedures and protocols.
¨ Takes responsibility for incorporating recommendations into daily practice
PROFESSIONAL DEVELOPMENT
Promotes professional development of self and colleagues./ ¨ Achievement of satisfactory performance appraisals.
¨ Provides contemporary evidenced based clinical care.
¨ Readily shares knowledge and skills and offers support to colleagues.
¨ Demonstrates a commitment to promoting education activities within hospital and community / ¨ Participates in an annual performance evaluation process.
¨ Regular attendance and participation in in-service education.
¨ Maintains an up to date knowledge of clinical, legal, ethical and professional implications of practice.
¨ Demonstrates responsibility for professional development.
Employee’s Signature: / Date:
Print Name:
Line Manager Signature: / Date:
Print Name:
Reviewed October 2012