Welcome To Beth Israel Lahey Health at Home. Our team provides high-quality home care and hospice services by partnering with physicians, hospitals and skilled nursing facilities to provide specialized care to patients in the comfort of their own home. Our team of nurses, therapists (physical, occupational, and speech), medical social workers, and home health aides work together to devise and implement a compassionate care plan that is expressly tailored for each patient.
About the Job
Position Summary: The Triage Registered Nurse will coordinate the afterhours healthcare needs of the home health patients by utilizing a disease management process, critical thinking skills, sound judgment, the OASIS assessment, physician orders, plan of care and established protocols. Will also educate the patient/caregiver in the management of their illness and promote the home health support systems to decrease re-hospitalization and utilization of hospital emergency services.
Beth Israel Lahey Health is dedicated to improving health and wellness and making a difference in the lives of our patients, their families and all members of the communities we serve. Formed in March 2019, Beth Israel Lahey Health is a patient-centered, integrated care delivery system providing a continuum of services spanning academic, tertiary and community hospitals, dedicated orthopedic and psychiatric hospitals, primary and specialty care, community acute care, ambulatory care, behavioral services and home health.
Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.
Essential Duties & Responsibilities including but not limited to:
- Triage after hour calls with the goal of problem resolution, patient satisfaction, patient safety, positive patient outcomes and reduction of preventable ER/hospital admissions.
- Maintain physician communication with the goal of problem resolution to prevent avoidable ER/hospital admissions.
- Accepts accountability for patient satisfaction scores and quality of care outcome measure results.
- Counsels the patient and family in meeting nursing and related needs.
- Respects and supports patient and family’s cultural beliefs and values, individual needs, health goals and treatment preferences.
- Provides health care instructions to the patient as appropriate per triage assessment and plan of care.
- Helps manage episode of care or coordination of care with the primary disciplines in accordance with evolving nursing needs and continued eligibility for services.
- Delegates PRN visits to field clinicians as appropriate based on triage outcome.
- Supports field clinician questions and will contact administrator on call when needed.
- Communicates with the physician regarding the patient’s needs and reports any changes in the patient’s condition; obtains/receives physician’s orders as required.
- Document accurately and appropriately all communication from physicians, clinicians, caregivers and patients, etc., as a Case Communication in the patient’s chart in real time.
- Attends meetings per Clinical Director and as needed.
- Communicates with other disciplines on the care team if triage does not result in a PRN visit.
- Practices confidentiality principles set by the agency and federal HIPAA guidelines.
- Clinical case communication notes explain the need for PRN skilled nursing services in light of the patient’s overall medical condition and experiences; Assessment/triage process if a PRN visit is not required and the plan for the next visit based on the rationale of prior results.
- Document new physician orders in the order section of the patient’s chart when applicable.
- Completes documentation in accordance with agency timeliness policies.
- Maintains and updates clinical knowledge and skills based on current nursing practice.
- Adheres to departmental requirements for required training.
- Identifies specific learning needs and goals and collaborates with nursing leadership in developing a plan to meet them.
- Participates in the holiday rotation (triage and/or visiting patients) as defined by Lahey Health at Home.
- Participates in in-service programs and supervises, teaches and precepts other nursing personnel per Clinical Director.
- Maintain strict adherence to the Continuing Care Confidentiality policy.
- Incorporate Continuing Care Standards of Behavior and Guiding Principles into daily activities.
- Comply with all Continuing Care Policies.
- Comply with behavioral expectations of the Continuing Care Division.
- Maintain courteous and effective interactions with colleagues and patients.
- Demonstrate an understanding of the job description, performance expectations, and competency assessment.
- Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.
- Participate in departmental and/or interdepartmental quality improvement activities.
- Participate in and successfully completes Mandatory Education.
- Perform all other duties as needed or directed to meet the needs of the department.
- Registered Nurse from a Graduate of National League for Nursing accredited school of nursing.
- BSN strongly preferred.
Licensure, Certification & Registration:
- Registered nurse with current licensure to practice professional nursing in the state of Massachusetts.
- Has an active American Health Association BLS. If no American Heart Association BLS the employee must complete an annual BILHAH BLS Competency. No other forms of BLS will be accepted.
- Minimum of 2 years nursing experience, at least one of which is in the area of public health or home care nursing with OASIS experience is preferred.
Skills, Knowledge & Abilities:
- Demonstrates excellent observation and problem solving/critical thinking skills.
- Well-developed verbal and written communication skills; essential computer skills to work with EMR.
- Must be a licensed driver with an automobile that is insured in accordance with state or organization requirements and is in good working order.
- Self-directed and able to work with minimal supervision
- Shows strong ability to organize and prioritize workload independently; nursing skills per competency checklist.