The Patient Key Worker role will primarily focus on providing a smooth discharge plan for each patient. The primary function of this role is to ensure patients and relatives are aware of the plan both in terms of interventions and expectations on discharge, and to highlight to all concerned any problems that may become apparent that could affect a delay in discharge. The post holder will facilitate the discharge pathway from admission, liaise with the wider multidisciplinary team to ensure timely interventions are addressed along said pathway, and provide daily updates to the ward sister and complex discharge team. The post holder will also act as a conduit between the ward-based team and the discharge teams, providing an extension of the discharge team within the ward environment, and will liaise and work alongside the ward teams and complex discharge team to assist and support the patients’ journey through the organisation, ensuring good communication with patients and families.
Key Responsibilities
* Provide smooth discharge planning for each patient, ensuring patients and relatives are aware of the plan in terms of interventions and expectations on discharge.
* Highlight any problems that could delay discharge and communicate them to the multidisciplinary team.
* Facilitate the discharge pathway from admission, liaising with the MDT to ensure timely interventions.
* Provide daily updates to the ward sister and Complex Discharge Team.
* Act as conduit between ward-based team and discharge teams, extending the discharge team into the ward environment.
* Work alongside ward teams and Complex Discharge Team to support patient journeys, ensuring good communication with patients and families.
* Support assessment, planning, implementation and evaluation of discharge pathways in conjunction with the Complex Discharge Team.
* Assist MDT in facilitating safe and timely transfer out of hospital for all ward patients.
* Initiate early conversations with patient/carer, ensuring they are aware of the expected discharge date and are updated if this changes.
* Identify and raise any barriers to patient returning home or to a care home on the expected discharge date.
* Liaise with care agencies/care homes to clarify patient needs and capabilities prior to admission.
* Support patients and families expectations about discharge destinations within the capability of partner agencies.
* Attend MDT meetings; update notes and systems as appropriate.
* Document verbal instructions and discussions related to the discharge pathway.
* Seek advice from the Complex Discharge Team if a complex need is identified.
* Communicate effectively at all times with the team, other health care professionals, and patient family, carers and visitors.
* Prioritise workload daily and adapt as needed.
Right to Work in the UK
This role is not available for Skilled Worker visa sponsorship. Applicants must already have the legal right to work in the UK at the time of application. Unfortunately, we are unable to support visa applications for this post in line with UKVI regulations.
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