Coordinator – Southlake@Home

at  Southlake Regional Health Centre

COMPANY BIO

Southlake is building healthy communities through outstanding care, innovative partnerships, and amazing people. We deliver a wide range of healthcare services to the communities of northern York Region and southern Simcoe County. Our advanced regional programs include Cancer Care and Cardiac Care and serve a broader population across the northern GTA and into Simcoe-Muskoka.
Our team of nearly 6,000 staff, physicians, volunteers, students and Patient and Family Advisors are committed to creating an environment where the best experiences happen. As a recognition of our commitment to quality and patient safety, we have received the highest distinction of Exemplary Standing from Accreditation Canada.

JOB SUMMARY

Reporting to the Clinical Manager, the Care Coordinator in collaboration with the patient, physician, caregiver and/or family and care-team members identify appropriate patients for bundled care pilot “Southlake@Home”. The care coordinator acts as the liaison between the home and community care providers and the Southlake hospital care team including physicians. In the event that a patient’s care needs change to an extent that Southlake@Home is not appropriate, the care coordinator identifies to the hospital care-team and physicians the patient will require a referral to CLHIN home and community care services.
The care coordinator will liaise with the community providers on a daily basis and participate in joint problem solving. Will provide case management to ensure the provider interventions are meeting the patient’s goals, to refer to CLHIN home care in matters related to Long term care applications where required and to facilitate the transitions to CLHIN home and community care program as required. Knowledge of Quality Improvement methodologies such as PDSA cycles is an asset. Prior knowledge and experience working on the implementation of new care/clinical pathways and or Best Practice Guidelines is an asset. Data collection may be required. Providing information on community resources and facilitating referrals to Community Support Services is a requirement of this role

QUALIFICATIONS

• Degree in a regulated health profession (BScN, BScPT, BScOT, MSW, MScSP); or Diploma in nursing along with relevant certificate programs or relevant LHIN experience.
• Degree in Nursing (BScN) preferred.
• Current registration with the appropriate regulating college.
• Two years’ experience in care coordination, or advocacy and discharge planning in a healthcare setting.
• Knowledge of community and government resources and relevant legislation.
• Excellent assessment, negotiation and problem solving skills.
• Excellent interpersonal, communication, organization and time management skills.
• Bilingualism (English/French) considered an asset.
• Excellent team player who is capable of working both independently and interdependently.
• Ability to build and maintain relationships with hospital staff and manage conflicting priorities.
• Must be able to practice in a culturally sensitive manner.
• Ability to work in a fast-paced, physically demanding hospital environment.
• Ability to wear protective masks as required.
• Accurate and efficient keyboarding skills and ability to use a mouse.
• Regular attendance at work is required
• Demonstrated excellence in communication, both written and verbal
• Demonstrated problem assessment skills
• Demonstrated commitment to customer service and teamwork
• Demonstrated individual leadership skills

Please refer the Job description for details