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1. General Summary
   

Serves as the on-site nursing supervisor for the Medical Center 24 hours/7days per week. Collaborates, coordinates, and communicates with administrators, physicians, nurse leaders, staff, patients, support services, and external agencies to facilitate the delivery of quality patient care. In collaboration with unit and department-based leaders, the Nurse Coordinator assumes administrative responsibility for the Department of Nursing for assigned shifts, off sifts and holidays. Serves as a liaison between Maryland Access Center (MAC) and nurse manager and assists unit personnel in problem solving, interpretation of institutional policies and procedures, and coordination of patient care services.

1. Principal Responsibilities and Tasks
   

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Maintains and communicates accurate information regarding availability and type of patient beds and services within the hospital to support patient placement. Plans and coordinates patient and bed assignments with the MAC for the Emergency Department, Procedural Areas, and all access points in collaboration with requisite disciplines and providers within the organization.

A. Promotes the mission, vision, and values of the organization. Interprets and enforces hospital and nursing policies, practices and procedures with staff, patients, the public and other members of the healthcare team in a consistent and equitable manner.

B. Assess patient care requirements on each unit/area.

C. Incorporates unit rounds into daily activities

1. As the primary resource for nursing personnel, responds appropriately to clinical issues; guides and directs staff according to nursing standards and practice.

1. 1. 1. Assess the acuity of care required by patients and communicates changes in patient condition or unusual events to the oncoming Shift Coordinator.
      2. Coordinates staff utilization by assisting the charge nurse when necessary in identifying resources to meet the unit's needs.
      3. Develop and implement staffing strategy for shift based on patient acuity, patient census and available staff; based upon information obtained regarding staffing needs from charge nurses on units.
      4. Collaborates with all appropriate Coordinators (i.e. Trauma Coordinator, Neuro Care Coordinator) and Supplemental Staffing to assign available staff to inpatient units.

3. Assists MAC with patient flow issues and works with clinical leadership to ensure safe staffing on patient care units. Coordinate local patient flow and bed access. Monitors and evaluates patient flow and patient placement considering financial and regulatory issues.

1. 1. 1. Responds to crises and emergency situations (RRT, Code Blue) and assists as necessary.
      2. Assists in placement and transport of acutely ill patients to ensure patient safety and coverage.
      3. Report significant hospital events to the hospital administrator-on-call.

4. Identifies and provides for specialized care needs of post arrest patients until planned transfer to the appropriate critical care unit is complete. Oversees the interim management of patients requiring specialized care but who are not in intensive care units.

5. Utilizes knowledge of legal principles that affect the provision of nursing care and educates nursing staff of those principles related to consent, blood administration, patient elopement, discharge against medical advice and other such issues.

6. Collaborates with hospital and physician leadership to define, reduce and eliminate barriers within the system which may impede patient flow.

A. Negotiates with physicians related to patient placement

B. Works within the critical care model

C. Negotiates off service patient placement with physicians, staff and managers

1. Works collaboratively with Maryland Access Center physician leaders and requisite physician leaders to resolve bed management issues
2. Communicates a rationale for placement decisions

7.

1. Establishes articulate communication with essential team members across neurology, surgery, and medicine departments
2. Establishes strong interpersonal relationships across complex systems
3. Operates from a team-centered orientation during bed flow meetings and decision making
4. Exercises strong understanding of complex systems and organizational thinking as it pertains to throughput
5. Demonstrates excellent multi-tasking skills managing multiple patients' bed needs
6. Collaborates with UMAC Coordinators and cross-campus coordinators when risk-stratifying patients during routine and priority bed identification and placement
7. Develops and uses strong analytical and problem-solving abilities
8. Demonstrates leadership skills that are goal and outcomes focused
9. Communicates and assists physicians, nurses, *support services and **consulting services in a wide spectrum of needs
10. Resolve conflict and reach agreement by facilitating open communication between departments OR, PACU, ICU, CCRU, and procedural areas.
11. Reviews all arrivals and communicates with UMAC nurse coordinators on bed placement
12. Reports delays and gaps in care to attending, nursing leadership and nurse coordinators
13. Attends service-line specific bed huddles to obtain Admission, discharge, discharge (ADT) needs
14. Obtains pertinent updates from all divisions to coordinate 'loose ends' to expedite pending transfers or discharges.
15. Works across multiple services to connect patient to service/department/resources
16. Confirms home or SAR transportation times and family notifications during IDR's with charge nurse. Boarding locations for in-hospital patient pick-ups by family must be communicated
17. Provides continuous communication throughout shift to all units, providers, UMAC, and staff to streamline patient throughput. Improves the patent experience using direct communication amongst the patient care team and ensures efficient and organized admissions, transfers, and discharges
18. Reduces pressure on staff by coordinating communications amongst several providers to coordinate priorities, patient movement and decision making
19. Checks dashboards and milestones to track hospital census and critical situation developments
20. Communicates with nursing coordinator for possible patient transfers to the medical center, and in/out repatriations to system hospitals
21. Ensures that units staff have organized hospital transport for transfers to floors, procedural areas, or other locations\
22. Contacts consultant services for requests that are delayed
23. Confirms discharge teaching, prescriptions, and other discharge requirements prior to discharge order
24. Performs unit sweeps of discharged patients for room readiness and EVS services and arranges for STAT cleans
25. Requests/Obtains stretchers/wheelchairs to avoid patient transport delays when none are available

8. Ensures smooth functioning of the bed management process to reduce wait times and avoid unnecessary movement of patients.

A. Makes timely bed assignment

B. Triages/prioritizes admissions from multiple sites, i.e., community referral, Express Care, ED, etc., and internal transfers

C. Manages complex decisions related to patient placement.

D. Matches the clinical needs of patients with staff competencies and unit resources to optimize patient placement decisions

E. Pre-assigns scheduled patients to beds

F. Ensures patients are placed in a clinically appropriate level of care

9. Maintains continuous knowledge of patient census, Alert Status, OR, STC Capacity Alert, or ExpressCare demands.

A. Ensures continuous analysis of patient throughput. Identifies barriers or process issues.

B. Tracks bed turnaround time and analyzes variances.

C. Prepares and communicates data on program outcomes to key constituencies communicating with managers in real time.

D. Leads performance improvement efforts related to patient placement and access.

10. Makes authoritative decisions regarding the following:

1. 1. 1. Places scheduled and emergency patients into an appropriate inpatient bed consistent with hospital guidelines. May maximize the use of inpatient beds to place patients.
      2. In collaboration with appropriate providers, determines appropriate level of care based on the patient's clinical status and matches this with the competencies of a given inpatient unit.
      3. Determines if there is a need to place patients in access points (i.e. PACU, ED, CCRU, landing zone) and ensures patients are safety transferred to assigned bed/unit.
      4. Transfers or defers patients to system partner facilities with the agreement of the attending physician.
      5. Negotiates times for transfer to UMMS from outlying hospitals and may deny admission when all access possibilities have failed.
      6. Intervenes with patient/families discharge delays by coordinating transportation in conjunction with on-site and/or on-call Case Manager/ Social Worker.
      7. Facilitates and evaluates patients to determine infection control cohorting based on infection control policies and procedures.

11. Administrative Responsibilities

1. 1. 1. Provides on-site presence and proxy for Patient Care Services leadership on off-shifts, weekends, holidays. Appropriately escalates when required.
      2. Anticipates and responds to patient problems or complaints that unit staff cannot resolve. Provides assistance in a courteous and quick manner with patients and family.
      3. Informs the unit Manager and other appropriate administrators regarding situations that require further attention.
      4. Collaborates with the Administrator-on-call to initiate and coordinate internal and/or external disaster plan or other emergency actions. Takes immediate action as required and in accordance with hospital policy, procedures, emergency codes, and disaster plans to ensure the safety of patients and staff until the Administrator-on-call can be reached.
      5. Institutes immediate corrective action, as appropriate and required, according to UMMC Human Resource policies and procedures, with prior consultation with the employee's immediate supervisor whenever possible. Provides written communication to the employee's immediate supervisor following corrective action or concerns.
      6. Evaluate staff during off-shift to determine Fitness for Duty per Human Resource policies and procedures.
      7. Acts as a liaison with patients/ families and staff to facilitate discussions involving ethical issues.
      8. Assures staff completion of required incident reports (UMMSafe) related to patient and employee adverse events.
      9. Facilitates media sensitive information through discussion with the Administrator-on-call and media relations

12. Performs related duties as required.

1. Professional Development

1. Maintains competencies required for the position and remain current with all mandatory training.
2. Formulates realistic professional goals for growth and development and works with Manager to develop a plan for achievement.
3. Maintains accountability for own educational needs and attends appropriate educational programs.
4. Contributes input to committees as requested.