Patient Care Navigator (SKMC)

Role Overview

Patient Care Navigator at SEHA, located at SKMC. The role involves organizing and coordinating patient care activities to ensure optimal patient outcomes by collaborating with healthcare providers, patients, and families to facilitate communication, address concerns, and resolve issues.

Company Overview

SEHA is a healthcare network with multiple facilities and directorates across the region. The role operates within SEHA's healthcare system and coordinates with internal and external organizations.

Role Purpose

Act as a liaison between patients, their families, and the healthcare team to contribute to a seamless and positive patient experience. Demonstrate professional leadership in supervising the patient care team, uphold clinical standards and quality of patient care within specialty, and adhere to and promote the Professional Nurses Code of Conduct while actively promoting health and delivering health education. Support and promote SEHA's mission, vision, and values.

Key Responsibilities

Managerial & Technical Leadership

• Provide professional leadership, act as a role model, and mentor fellow nursing staff.
• Demonstrate critical thinking and provide leadership in conflict management and problem-solving.
• Promote and support a collaborative practice model.
• Monitor staff performance and provide regular constructive feedback, coaching, guidance, and support to team members.
• Act as a preceptor to less experienced staff and participate in organizational change initiatives.
• Monitor and coordinate effective and efficient utilization of human resources, consumables, and equipment.
• Monitor clinical care to ensure clinical standards are met, identify variances, and initiate corrective measures as required.
• Participate in staff performance evaluations and achievement of annual performance goals.
• Participate in unit budget preparation and monitor resource usage.
• Adopt an interdisciplinary team approach based on mutual respect and direct communication between health professionals.
• Liaise with the Nurse Manager or Nurse Supervisor to ensure appropriate staffing and skill mix.
• Provide guidance and advice to nursing staff on clinical and administrative matters.
• Educate healthcare professionals and employees on patient experience and varied ways to humanize a patient's experience based on feedback from individual patients and their families.
• Adhere to and promote the Professional Nurses Code of Conduct.
• Respond to and investigate complaints and concerns and communicate identified issues to appropriate staff and department.
• Work with individuals or departments to address issues related to care delivery.

Quality & Safety

• Anticipate patient and family needs, understand their expectations, and respond appropriately.
• Treat others with compassion, fairness, courtesy, and respect while honoring their uniqueness.
• Willingly work with others to identify and achieve common goals.
• Enthusiastically approach the role and display pride in the organization.
• Take personal responsibility for doing the right thing.
• Demonstrate exceptional communication skills along with excellent customer service skills.
• Perform a variety of duties, often changing from one task to another of a different nature, without loss of efficiency or composure.
• Perform under stressful conditions when confronted with multiple requests, demonstrating prioritizing skills.
• Ensure provision of a clean and safe working environment that minimizes risks to patients, visitors, other staff, and self.
• Identify faulty and defective equipment and furniture, remove from service, and take corrective action.
• Comply with International and HAAD Patient Safety Goals.
• Promote and audit compliance with the organization's Infection Control policies and procedures.
• Identify, investigate, report, and implement corrective action for incidents or complaints as appropriate.
• Delegate responsibilities to the nursing team in response to an emergency situation.

Patient Care & Assessment

• Assess patient needs, identify barriers, and develop individualized care plans.
• Serve as a primary contact and advocate for patients, build trust, and provide emotional support.
• Navigate the healthcare system, locate resources, and coordinate services to ensure timely access to care.
• Make follow-up calls to discharged patients, monitor patient progress, and address concerns.
• Monitor patient outcomes and identify opportunities for improvement.
• Provide education on treatment side effects, self-management strategies, and refer patients to support groups and integrative therapies.
• Collaborate with physicians, nurses, social workers, and other healthcare providers to ensure coordinated care.
• Coordinate referrals to specialists, community services, and other healthcare providers.
• Promote and utilize evidence-based practices to enhance patient care.
• Administer medications according to organizational policies and procedures.
• Respond to emergencies according to organizational protocols.
• Facilitate a collaborative approach with other health professionals to ensure appropriate continuous, coordinated, and integrated patient care.
• Facilitate a climate of mutual understanding and appreciation of cultural differences.

Documentation & Communication

• Maintain accurate and complete documentation and facilitate effective communication within the healthcare team.
• Maintain confidentiality and security of patient, family, and organization information in accordance with the confidentiality policy.
• Facilitate effective communication between the patient, family, and the interdisciplinary healthcare team as required.
• Liaise with other healthcare providers as necessary to ensure appropriate and timely interventions for patients and for discharge planning.
• Provide a comprehensive clinical handover or report as required to ensure patient safety.
• Attend Patient Care rounds and communicate and update the attending healthcare provider on changes in the patient's condition.
• Communicate with the patient care team ongoing changes in patient's plan of care and unit activity.
• Ensure nurses communicate and report changes in the patient's condition to the relevant healthcare provider and that new orders are carried out.
• Ensure documentation reflects a continuous, systematic, and accurate nursing process.
• Ensure clear and accurate documentation of all patient care events and compliance with organization policies and procedures.
• Monitor and audit compliance with organization documentation standards.
• Establish and maintain professional boundaries with patients and members of the healthcare team.
• Interact with patients, families, customers, and utilize feedback to improve and reinforce satisfaction.
• Assess patient or family questions and concerns and develop a plan to address needs.
• Communicate information to appropriate person(s) in appropriate time frames to meet patient or family questions, concerns, and expectations.
• Initiate patient or family concern reports as appropriate when issues arise.
• Consult, collaborate, and cooperate with colleagues, peers, supervisors, and other healthcare providers in a professional manner to improve quality, effectiveness, and efficiency of patient care.

Education

• Plan, teach, supervise, and counsel regarding physical care measures to promote improvement or recovery, symptom or complication management, expected disease progression, social or emotional care, and community resources.
• Facilitate patient and family education based on identified learning needs and document appropriately.
• Assess patient and family education needs, plan for and provide education, and evaluate outcomes.
• Provide a suitable environment that supports patient and family learning.
• Act as a resource nurse to ensure patient and family are provided with accurate information and resources to meet their healthcare needs.
• Engage in health promotion activities in the organization and community.
• Identify own training and development needs and undertake appropriate training or education as required.
• Identify learning needs of junior staff on the unit in conjunction with the Clinical Resource Nurse and Manager and assist with implementation of educational activities.
• Educate less experienced staff in adverse drug reactions and the process to be followed for medication errors.
• Ensure healthcare professionals have comprehensive knowledge of processes and procedures of care coordination specialty.

Outpatient Pathway

• Ensure that any diagnostics and investigations required as part of the patient pathway have been requested and that results are available for consultations, including those carried out at other SEHA or private facilities.
• Coordinate appointments and procedures at other hospitals and organizations where the pathway requires input from these.
• Ensure that SEHA-agreed standard of service is delivered to patients requiring elective admission to specialty.
• Use EMR systems and specialty databases to ensure relevant and accurate information is recorded.
• Provide cross cover within specialty.
• Attend meetings for service development initiatives as required.
• Organize formal patient-related meetings, including preparation of agendas, transcription of minutes, and collation and distribution to staff.
• Contribute to specialty improvements and efficient processes.
• Demonstrate high levels of customer care and be an ambassador for customer care within SEHA.
• Serve as the friendly, sensitive, and accessible focus for patient and carer communication, ensuring all patients have the opportunity to agree their appointment and admission dates.
• Act as the communication hub for clinical team, other sub-specialties, patients and their relatives, and internal and external organizations as permitted.
• Promptly answer telephone enquiries, take and relay messages in a polite and helpful manner, and take action as appropriate.
• Deal with complex queries.
• Ensure interpreting service is available when required for patient consultations.
• Be responsible for timely written and verbal communications with patients, clinicians, nursing staff, and management.
• Ensure that all information distributed to patients is accurate and up-to-date.
• Attend clinics where appropriate to coordinate the patient pathway.

Program Development & Quality Improvement

• Participate in the execution of