COPD Navigator

The COPD Navigator utilizes a focused approach in following and directing inpatients with COPD to the after discharge clinic. In the process of following and directing those inpatients, the COPD navigator will educate the patient and family/caregiver regarding the disease process and the necessity of close, continual monitoring to reduce the need for inpatient admission and readmission. The COPD Navigator will possess the attributes of a leader, self-starter, and team player enabling them to serve as a bridge between the professional staff and the patient and family/caregiver. The COPD Navigator will possess exceptional communication skills, both written and oral that will allow them to build collaborative relationships to enable the patient and family/caregiver to better navigate the health care system. The COPD Navigator will work closely with the COPD Leadership and Management Team.

Responsibilities

1. Following all COPD patients during their admissions addressing the following: a. Through coordination of care and promotion of self-management, decreases re-hospitalization. b. Educates and assures understanding by patient and family/caregivers of symptoms, a general management plan, potential red flag symptoms, and an emergency plan for each unique symptom. c. Collaborates with health care team to determine extent of functional deficits and areas for potential improvement. 2. For COPD patients nearing discharge, confirming the following is completed: a. Patients have received education on their disease process and questions answered on plans of care. b. All Discharge appointments are made. c. All DME equipment needs are met and completed. d. If patient qualifies, referral to pulmonary rehabilitation program completed at discharge. e. Patients are identified who have not previously completed PFTs to facilitate scheduling at time of followup appointment if patient at baseline respiratory status. f. Patient who are candidates are identified for preventative screening tests for shared decision making discussion at time of followup appointment. 3. After discharge, care coordination will assist with the following: a. A phone call will be made with appropriate documentation within 72 hours of discharge to follow up on any needs. b. Assist all pulmonary offices with identification of patients for PFTs, Pulmonary Rehabilitation, and preventative screening at time of followup appointment. 4. Other responsibilities include: a. Navigator will be educated and aware of smoking cessation techniques, pulmonary rehabilitation programs, palliative services, and medication assistance programs available in the community for patients that qualify. This includes local resources as well as resources in the surrounding communities, the 340B program, and drug manufacturer programs. b. Responsible for gathering, recording, and synthesizing our quality data in conjunction with Six Sigma.

Knowledge, Skills & Abilities

Patient Group Knowledge (Only applies to positions with direct patient contact): The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department’s identified patient ages. Specifically the employee must be able to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients. Competency Statement Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist. Common Duties and Responsibilities (Essential duties common to all positions) • Maintain and document all applicable required education. • Demonstrate positive customer service and co-worker relations. • Comply with the company's attendance policy. • Participate in the continuous, quality improvement activities of the department and institution. • Perform work in a cost effective manner. • Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations. • Perform work in alignment with the overall mission and strategic plan of the organization. • Follow organizational and departmental policies and procedures, as applicable.

Education

• Post High School Diploma or Certificate Program (Required) Experience: 6 months of experience
  

Credentials

• Basic Cardiac Life Support (Required)
  

Work Schedule: Days

Status: Full Time Regular

Location: Memorial-MSOB

Location of Job: US:WV:Charleston