Discharge Coordinator

The post holder aims to facilitate effective, efficient and timely discharge of patients from hospital and 'hub' beds. Particular emphasis is placed upon complex multi-disciplinary assessments and case conferences including patients with complex health and social care, palliative care or rehabilitation needs. The role will involve close working with all members of the multi-disciplinary team (nursing, medical, therapy, social work and care home staff) and patients/relatives/carers, ensuring safe discharge of patients to the most appropriate place. The successful candidate will play a vital role in managing patient pathways.,

• To work as a member of the multidisciplinary team to support the discharge process and identify patients to fill 'Hub' beds.
• Assist in the process of assessing and making appropriate and timely discharge plans for patients ensuring that all relevant information and assessments are continued upon transfer from acute beds to 'Hub' beds.
• Effectively communicate information to patients, relatives, carers and all members of the multidisciplinary team.
• Encourage the patient's family and friends to be actively involved in the discharge process.
• To liaise with other providers in ensuring that discharge plans for patients in acute and 'Hub' beds are proactively managed and supported through on going discharge planning process.
• In the case of 'Hub' beds, to work alongside an 'out of hospital MDT' in ensuring that patients independence is maximised and that plans for discharge are continued.
• To be a point of contact alongside a registered nurse for designated wards and 'Hub' beds in providing advice and support, liaising with clinical teams as required.
• To record and input patient data and information onto multiple IT systems.
• Work under the direction of the Senior Nurse Teams to ensure discharges are prioritised on a day to day basis.
• Plan and provide programmes of therapeutic activity for patients, within the framework laid down by the OT and Physiotherapist.
• Implement and evaluate basic O.T. interventions for patients in activities relating to their treatment programme., 1. To participate in multidisciplinary team meetings and actively contribute to the planning
of patients discharges. 2. Aim to develop and maintain effective interpersonal relationships with all members of the multidisciplinary team to ensure a good team spirit and collaborative and holistic working practices for the benefit of patient care. 3. Provide and receive routine information to staff including communicating factual information to patients. 4. Persuade patients to co-operate in their rehabilitation programme using encouragement, reassurance, tact and sensitivity; overcoming barriers with patients whose understanding is impaired. 5. Able to maintain records and documentation required by work settings in accordance with local policies. 6. To be able to work flexibly under-pressure at a fast pace. 7. Assist with ensuring flow through and 100% occupancy of 'Hub' beds Clinical responsibilities 1. Implement treatment plans. 2. Assess patients' mobility and issue appropriate equipment under guidance of Registered Clinicians, including providing advice to patients/carers on safe use and care of prescribed equipment. 3. Accurately document and report to a registered nurse and multidisciplinary team, information regarding the care given to patients, communicating changes as they occur. 4. Arrange case conferences where necessary, liaising with multiple agencies involved in a patients care, both in the community and in hospital. 5. Evaluate discharge plans regularly and work with the MDT to adapt, alter and implement plans as patients conditions change. 6. Monitor comfort of patient and feedback any concerns to the Senior Nurse Team and other agencies. 7. To ensure appropriate liaison and follow-up at all levels prior to patient's discharge including family members. 8. To use initiative when responding to changing patient signs. 2 9. Practical and teaching knowledge to NVQ3 level equivalent plus knowledge skills development. 10. To understand a range of procedures with a base level of theoretical knowledge by practical experience. And to have an understanding of patient and family dynamics, as well as patient's condition and its impact on function. 11. To work flexibly and be able to adjust to constant changing demands of the ward or 'Hub'. 12. Work with the Duty Matron/Sister, ops and Discharge Nurse Team to facilitate the effective flow of patients out of the unit to ensure 4hr access targets met in ED. 13. Work alongside the ward nursing staff to co-ordinate discharge plans to encourage patients to be transferred, discharged or moved to the Discharge Lounge before 10:00. 14. Identify 'internal' discharge delays and work with the Nursing staff to 'unblock' these delays to enable the timely discharge of patients. 15. Encourage Nursing Staff to send Section 2s and 5s in a timely manner 16. Facilitate wards and care homes with arranging transport and liaising with pharmacy and medical teams for TTO's. Planning and Organisational Skills 1. To manage own day to day work tasks in conjunction with Senior Nursing Team. 2. To assist Senior Nursing Team with ward based training. 3. To provide 7 day a week cover where identified. 4. Work flexibly under pressure at a fast pace to meet deadlines. Service and Personal Development 1. Work with ward to implement policies within team/site. 2. To assist the MDT to actively participate in the fieldwork education of Therapy and Nursing students. 3. To educate others informally about Discharge Planning. 4. To participate actively in sharing and receiving in-service training and development to ensure continuous professional development, as appropriate to grade and experience. 5. To be aware of and promote cross-site links. 3 6. Participate in formal and informal review/appraisal of own performance with designated line manager. 7. General support for less experienced staff, including demonstrating duties to new starters and informally educating others about the function of the Discharge Liaison Hub. 8. Follow policies (Trust and Departmental) in own role. 9. To help collect data for surveys, audits and clinical research activities, underpinned by appropriate methodology and documentation 10. Identify training needs and facilitate learning of self and others., The postholder will have access to vulnerable people in the course of their normal duties and as such this post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service to check for any previous criminal convictions.

We are looking for pro-active, highly motivated individual to work independently and as part of a team. The applicant should be enthusiastic, organised with excellent communication and IT skills.,
• Knowledgeable about health care issues
• Worked as a band 2 or 3 CSW in a clinical setting for at least 12 months
Desirable criteria
• GCSE (or equivalent) passes in Maths and English
• Practical knowledge of the discharge process, A positive enthusiastic character
• Evidence of ability to deliver a high standard of care
• Being self aware and able to accept constructive criticism
• Organisational skills
• Ability to prioritise own workload and take responsibility for patients in your care
• Able to take initiative and work independently with minimal supervision
• Able to work as part of a team
• Good verbal and written communication skills
• Belief in patient centred philosophy
• Ability to cope under pressure
• Aware of own limitations
• Understands concept of confidentiality and standards of conduct and care.
• Able to use a computer
Desirable criteria
• Flexible working pattern including weekend working, Smart professional appearance
• Pleasant personality
• Good self presentation
  
  Oxford University Hospitals NHS Foundation Trust is one of the largest NHS teaching trusts in the country. It provides a wide range of general and specialist clinical services and is a base for medical education, training and research.
The Trust comprises of four hospitals - the John Radcliffe Hospital, Churchill Hospital and Nuffield Orthopaedic Centre in Headington and the Horton General Hospital in Banbury. Our values, standards and behaviours define the quality of clinical care we offer and the professional relationships we make with our patients, colleagues and the wider community. We call this Delivering Compassionate Excellence and its focus is on our values of compassion, respect, learning, delivery, improvement and excellence., Oxford University Hospitals NHS Foundation Trust is one of the largest NHS teaching trusts in the country. It provides a wide range of general and specialist clinical services and is a base for medical education, training and research. The Trust comprises four hospitals - the John Radcliffe Hospital, Churchill Hospital and Nuffield Orthopaedic Centre in Headington and the Horton General Hospital in Banbury. Our values, standards and behaviours define the quality of clinical care we offer and the professional relationships we make with our patients, colleagues and the wider community. We call this Delivering Compassionate Excellence, and its focus is on our values of compassion, respect, learning, delivery, improvement and excellence. These values put patients at the heart of what we do and underpin the quality healthcare we would like for ourselves or a member of our family. Watch how we set out to deliver compassionate excellence via the OUH YouTube channel. In 2023 NHS England launched its first sexual safety charter, and our Trust proudly signed it. We pledge zero tolerance for inappropriate sexual behaviour and commit to the ten core principles Oxford University Hospitals promotes a safe, respectful hiring environment. If you want to make a difference with us, come and join our team. Together, we will uphold the highest standards of care and professionalism., Sexual Safety Charter: In 2023 NHS England launched its first sexual safety charter, and our Trust proudly signed it. We pledge zero tolerance for inappropriate sexual behaviour and commit to the ten core principles Oxford University Hospitals promotes a safe, respectful hiring environment. If you want to make a difference with us, come and join our team. Together, we will uphold the highest standards of care and professionalism.