Client Care Coordinator

Job Summary:

In accordance with the Mission, Vision and Values, and strategic directions of Provincial Health Services Authority patient safety is a priority and a responsibility shared by everyone at PHSA, and as such, the requirement to continuously improve quality and safety is inherent in all aspects of this position.
Reporting to the Health Services Manager, the Client Care Coordinator works collaboratively as part of an interdisciplinary team and within a trauma informed model of care and Indigenous Cultural lens, coordinates client care activities to effectively support the delivery of primary care services to the clients at the designated Correctional Centre. The Client Care Coordinator provides leadership in the effective and efficient delivery of primary care to clients, and in collaboration with the Medical Leads, is jointly responsible for providing clinical leadership and direction for the operations management, utilization and risk management, and quality improvement of patient care services. The Client Care Coordinator supervises CHS nurses and will also provide direct clinical primary care. Ensures a high standard of client care by acting as a clinical resource for staff and supporting staff training and development. Promotes education and research. Consults and collaborates with team members, the leadership team and other health care professionals/providers to achieve excellence in client centered care and enhancement in the quality of life consistent with established policies, standards of practice and philosophy of BC Mental Health and Substance Use Services.

Duties/Accountabilities:

1. Coordinates client care related activities and provides leadership in the planning and implementation of innovative and creative approaches for the delivery of services. Promotes quality of care by consulting and collaborating with interdisciplinary team members to help establish appropriate goals of care and individualized care plans considering the client’s physiological, psychiatric, psychological, spiritual and sociocultural needs.
2. Assists staff in operationalizing care standards, client care guidelines, protocols, clinical pathways and organizational policies. Works with clients and the team to minimize variances from the standardized elements of care as described in the clinical pathway. Facilitates the evaluation of services to ensure program and service needs are met. Ensures adherence to established policies, procedures, and protocols including those for quality assurance and the safety of staff and clients; making sure that an adequate number of appropriate qualified clinical staff are available, coordinating equipment and other resources; and collaborating with other areas/external resources to solve operational problems, facilitating continuity of nursing care. Advises the HSM (or on-call Administrator) of any urgent patient care issues or concerns.
3. Attends and participates in initial client care evaluations and admission meetings as a member of an interdisciplinary team by providing input on a variety of care issues, practice effectiveness and administrative decisions according to client care standards. Assesses the client’s overall needs, conducts risk assessments, formulates initial diagnostic impressions and determines priority of care requirements.
4. Reviews client progress and needs. Provides formal and informal consultation as needed to health care team members, other health care providers and students. Promotes interdisciplinary collaboration for treatment concerns, continuity of care, crisis management protocols and community resource coordination. Assists with therapeutic interventions and problem solving, provides clinical guidance and information on complex cases, discusses client care issues and develops linkages/partnerships to meet client need.
5. Establishes, maintains and enhances therapeutic relationships based on respect with client. Engages others in treatment planning and evaluation, provides follow-up planning, supports clients to manage self-care, encourages informed decision making and empowers client to improve quality of life. Teaches client about management/treatment of medical conditions.
6. Provides continuous communication with team members and works collaboratively with staff, management and outside agencies in the identification and resolution of client care issues, cultural and language barriers, ethical dilemmas, coordination and integration of care.
7. Facilitates transition planning by supporting nursing practice and interdisciplinary team in delivery of ongoing care and transition planning along usual care path. Liaises with community and hospital transition teams as applicable during transition planning to ensure successful transition to home, new units or other health care facility. Collaborates with interdisciplinary team and other health care providers in the identification and resolution of patient/client care issues, such as defining appropriate lengths of stay, by ensuring care standards are based on clinical practice guidelines, protocols and clinical pathways.
8. Carries out direct client care activities as required in accordance with the care plan by providing nursing services, information and support, and short-term, time-limited follow-up as required; administering medications and assessing their effectiveness, monitoring client for presence of side effects; maintaining complete and accurate records; and facilitating access to medical care and transitional services, and conducting/participating in pre-release planning.
9. Assists the HSM or designate with the coordination of staffing/scheduling activities by participating in the development of rotation schedules, ensuring daily schedules are prepared and troubleshooting staffing/scheduling related issues. In consultation with the HSM coordinates and approves requests for leaves of absence based on operational requirements and communicates changes to staff. Ensures sick/last minute vacancies are filled and liaises with HSM on longer term leaves, regarding status of ill/injured team members and return to work programs/approval. Maintains timekeeping records and communicates with payroll on issues such as changes in timekeeping procedures, employee enquiries and corrections to identified discrepancies.
10. Assists the HSM with administrative activities and promoting optimal use of client care resources by identifying systems for improving resource utilization, providing input into budget/staff allocation, assisting team members in workload decision-making, evaluating clients for care needs, evaluating client care products/equipment and identifying new equipment purchases required. Recommends changes to existing administrative processes as needed.
11. Maintains statistical records and reports on various activities by methods such as collecting data, recording, tabulating and summarizing information, utilizing basic spreadsheet software for budgetary requirements and workload monitoring, and providing input into proposals, budget policies and procedures as required.
12. Assists the HSM by participating in the selection of new staff and performance evaluation of staff by attending interviews, assessing clinical skills and providing recommendations regarding the evaluation of candidates to facilitate optimal hiring decisions. Provides written input into employee performance evaluations to promote quality work performance. Discusses and clarifies performance expectations with staff, determines orientation and training requirements, documents performance problems and provides input to the HSM regarding probationary period extensions and disciplinary action.

13. Participates in the orientation of new staff by providing support to preceptors and preceptees, monitoring and evaluating the progress of the new staff member through consultation with preceptor and clinical educators and communicating staff performance information to the HSM.
14. Supports or leads in staff education and training and development activities in collaboration with HSM, Clinical Educator or other designated personnel, by conducting needs assessments of individuals, coordinating or demonstrating the introduction of new knowledge/skills/procedures, role modeling, supporting autonomous practice, promoting a learning environment and arranging in-service sessions and orientations as required. Maintains records and identifies and schedules staff attendances at yearly updates.
15. Participates in students' clinical experience and/or works with Clinical Educator or designate by assigning staff to students in order to meet students' learning needs. Collaborates with the preceptor to assign patients/clients to allow for student’s maximum learning. Gathers feedback from students and staff regarding their experience to identify opportunities and formulate recommendations to the HSM for quality improvement.
16. Integrates quality improvement and risk management principles and activities into nursing practice for assigned areas through evaluating effect of changes in care practice, generating recommendations for alternate approaches, following up on incident reports, conducting safety audits, taking corrective actions and recommending changes to selected policies, procedures or protocols. Maintains awareness of all necessary legislation, regulations, requirements, client needs, industry trends, technology and protocols to ensure current policies, standards, and protocols are relevant, safe, effective, current and cost effective.
17. Identifies opportunities and resources (e.g. rounds, communities of practice, journal clubs) to promote staff awareness and support knowledge sharing. Facilitates evidence informed nursing practice and nursing and interdisciplinary research by identifying issues and practices which require research, by reviewing relevant literature/resources and participating in research activities. Oversees the collection of statistical and performance data and ensures reporting requirements/submissions are met; shares relevant research findings with the team by collaborating with the team to change practices in response to research findings. Promotes and supports Knowledge Translation activities and evaluates results.
18. Participates on committees and teams that promote improvements to client care and the efficient and safe delivery of services by attending meetings to promote optimal support for clients. Participates in educational programs to ensure resources and activities are current, accurate and appropriate.
19. Sets measurable personal performance goals in collaboration with the HSM for professional development such as, updating own knowledge within area of practice by reviewing current literature and research, identifying new theories, trends and opportunities and developing a plan in collaboration with the HSM for professional development. Reviews progress to ensure that goals are achieved within established time frames.
20. Maintains and updates relevant knowledge and understanding of correctional nursing practice, principles of relational security in secure settings, nursing standards of professional practice and Code of Ethics, and the applicable sections of the Freedom of Information and Protection and Privacy Act, CHS health information records as per CHS policy.
21. Carries out responsibilities in accordance with health and safety requirements. Promotes awareness of Work Safe BC and Occupational Health and Safety standards by reviewing standards with staff to determine adherence.
22. Immediately reports unsafe situations by notifying supervisor or other appropriate personnel and using online patient safety learning system (PSLS). Assists the HSM in leading review of safety events as a handler such as, interviewing patients/clients/families to investigate clinical components of incident reports; refers performance related issues to the HSM. Shares learning from safety events with team members and incorporates recommendations within clinical practice to enhance client safety.
23. Adheres to and continually works to improve security protocols in collaboration with BC Corrections leadership to maintain the safety and security of clients, staff, families and the general public at all times; and takes immediate action to mitigate risks, as well as reporting all real and potential risk issues to the Health Services Manager and site Warden/security personnel as appropriate in the circumstances.
24. Performs other related duties as required.

Qualifications:

Qualifications
Education, Training and Experience
• Graduation from an approved School of Nursing with current practicing registration as a Registered Nurse or Registered Psychiatric Nurse with the British Columbia College of Nurses & Midwives (BCCNM).
• Completion of post basic specialty nursing certificate/program if applicable, and three (3) years' recent, related experience in the designated clinical area, including working with the applicable population group when indicated, and one (1) year's related administrative/supervisory experience or an equivalent combination of education, training and experience.
• Valid BC Driver's License and access to personal vehicle for local area travel may be required.
Skills and Abilities
• Knowledge of primary care practices, mental health illnesses, substance use and concurrent disorders and treatment.
• Knowledge of evidence informed nursing theory and practice, including pharmacology (indications and side-effects) and therapeutic and counseling skills.
• Knowledge of Trauma-Informed Practice and its application to the defined population of clients
• Demonstrated ability to provide effective leadership, supervision, work direction and consultation.
• Demonstrated ability to conduct comprehensive clinical assessments, utilizing relevant tools and rating scales, and formulate a treatment plan, participate in transition planning and provide crisis intervention.
• Demonstrated ability to communicate (orally and in writing) and collaborate effectively with clients, coworkers, physicians, other health care staff, and staff of external agencies.
• Knowledge of primary, secondary and tertiary care programs.
• Knowledge of health care disciplines and their role in client care and service provision.
• Knowledge of legislation and government policies and procedures that relate to client.
• Demonstrated ability to develop and deliver educational materials for staff, clients and correctional staff based on education theories, principles and best practices.
• Demonstrated ability to promote a supportive, creative learning environment and lead continuous quality improvement.
• Demonstrated skill in CPR techniques.
• Demonstrated critical thinking and problem solving skills.
• Demonstrated ability to effectively plan, organize and prioritize work.
• Demonstrated ability to work collaboratively as a member of an interdisciplinary team.
• Demonstrated ability to set priorities, adjust to unexpected events, mediate and deal with conflict.
• Demonstrated ability to effectively lead change and support staff through transitions.
• Knowledge of basic research, e.g. research ethics, research question, hypothesis and qualitative and quantitative data analyses methods
• Demonstrated computer literacy to operate a computerized client care information system as well as applicable word processing, spreadsheet and database software applications.
• Ability to operate related equipment.
• Demonstrated physical ability to perform the duties of the position.