Returning Candidate?

1.0 FTE Care Coordinator - Hamilton General Hospital

Competition Number: U.24/25.259
Branch: Hamilton
Site: HAMILTON - Hamilton General Hospital
Position Group: ONA
Type: Temporary
Closing Date: 11/26/2024
Length of Term: 12 months
Hours of Work: Monday to Friday 8:30am-4:30pm
Wage: ONA: $45.35 - $52.79 per hour

Position Summary

Reporting to the Manager of Patient Care, Care Coordinators are responsible for assessing, planning, coordinating, implementing and reviewing patient's care needs and services provided by Ontario Health atHome following Ministry of Health legislation and Ontario Health atHome policies and procedures. Care Coordinators are also responsible for providing information and/or referring patients to alternative community resources.

There are two functional areas within Care Coordination: Community and Access. Within the Community Care Coordination are specialty teams to address some of the unique service needs in our service area. Access refers to the Intake Care Coordination functions performed through our hospitals, community intake and after hours Care Coordinators.

Primary location will be Hamilton General hospital; however, may be required to support on-site at other Hamilton.

Core Duties - Responsibilities

Identification and Engagement:

To respond to inquiries and requests for service in accordance with the patient's care needs, identified risk factors, and urgency for services;
To provide the patient with information about legislation, Ontario Health atHome, client rights and responsibilities, and services available.
To problem-solve inquires and issues with the patient's needs and service provider’s need.
To obtain consent for the gathering and sharing of patient information.

Patient Assessment:

To determine eligibility and assess for Ontario Health atHome Services;
To determine capability and assess for placement into long term care facilities;
To counsel patient and family regarding the placement process; to understand the crisis component of urgent placement needs;
To plan for discharge;
To respect the patient's privacy, autonomy, ethnic, spiritual, linguistic, familial and cultural differences.

Client Safety

Promotes client safety in alignment with the Vision, Mission, Values and Strategic Directions of Ontario Health atHome.
Works within the basic principles of client safety by doing the right thing for the right client, using the right method at the right time.
Adheres to Ontario Health atHome client safety policies and procedures.

Accessing Resources and Linking:

To assist patients to access alternative community resources by providing appropriate information and referral.

Service Planning:

To develop a service plan that reflects the patient's assessed needs.

Goal Setting:

To establish goals in collaboration with the patient to ensure goals reflect the patient's desired outcomes, within the resource parameters of Ontario Health atHome.

Service Implementation and Coordination:

To implement a coordinated service plan that reflects the patient's needs and goals for service.

Monitoring and Reassessment:

To monitor progress towards established goal;
To reassess referral to appropriate team;
To reassess for ongoing eligibility and continuing needs for service; to discharge services when appropriate;
To link patient to other community services.

Resource Management:

To authorize the appropriate Ontario Health atHome services to ensure the effective and efficient utilization of resources.

Fiscal Accountability:

To order, allocate, and authorize services and manage expenditures within the Service Planning and Ordering Guidelines (units of service);
To negotiate visits frequency with patient and service providers and problem solve discrepancies regarding billing with service providers.

Evaluation:

To evaluate patient satisfaction with services, and to identify opportunities to improve the delivery of Ontario Health atHome Services;
To identify trends that will impact Ontario Health atHome resources;
To complete service feedback forms.

Documentation:

To maintain professional Ontario Health atHome documentation in accordance with professional documentation standards including the completion of appropriate forms;
To maintain accurate electronic client files.

Community Relations:

To interpret the Ontario Health atHome services to patients, families, community groups, and other health/social services providers through presentations and panel participation;
To develop partnerships with others in the community.

Other Related Tasks:

Collaborates with team members regarding work flow coverage
Precepts and mentors staff. Acts as a resource to other staff to assist in orientation, implementing change, and problem solving.
Assists with projects and new initiatives as they relate to position.
Participates on committees.
Promotes Best Practices and helps define best practices.
Promotes and supports research initiatives.
Participates in relevant educational opportunities.
Other duties as assigned.

Qualifications

EDUCATION:

A University Degree. An equivalent of education and experience may be considered. Registered Nurses with a Diploma in Nursing shall receive equal consideration.
Practitioner in one of the following health disciplines: nursing, physiotherapy, occupational therapy, medical social work, dietetics, or speech-language pathology
Maintain membership in a Regulated Health Professional College

EXPERIENCE:

Minimum two years recent experience in community health or a related field
Knowledge of community resources
Experience in acute care setting an asset for Access and Acute Teams
Experience related to paediatrics is an asset for the Paediatric/School Team
Experience related to palliative care and palliative care courses is an asset for the Palliative Team