Job Details
Job Location
Eglin AFB - Eglin AFB, FL
Description
Registered Nurse-Discharge Planning
Eglin AFB FL
Work Schedule: The Registered Nurse-Discharge Planner will be on duty for a minimum
of 40 hours per week. Scheduled shifts are normally Monday through Friday 9 hours per
day (to include a one hour, non-paid, lunch break). Scheduled shifts will be between the
hours of 0700 and 1700. Shifts will be 0700-1600 or 0800-1700; however, schedules
may vary to accommodate demand. Any schedule changes are to be approved by the
Functional Requirements Evaluator Designee and must be submitted to the COR in
writing for coordination with the company. The RN - Discharge Planner will not be
required to perform services on federal holidays. The Contractor shall, at all times,
maintain an adequate workforce for the uninterrupted performance of all tasks defined
within this PWS when the Government facility is not closed for the above reasons. When
hiring personnel, the Contractor shall keep in mind that the stability and continuity of the
workforce are essential.
Duties: The duties for the HCW are as follows:
Assess and proactively identify/evaluate patients for discharge planning/case
management in the three inpatient locations (Intensive Care Unit, Multi-Service
Unit, Labor & Delivery Unit) within 24 hours of identification or notification, or
by close of the first business day after a weekend or holiday. Will conduct
systematic, on-going, thorough assessment of patient’s physical, emotional,
psychological, social and medical status. Will collect information to determine
specific needs to include equipment, social service intervention or referrals through
direct patient contact and/or contact with family/caregiver, and other relevant
sources such as professional and non-professional caregivers while patient is in the
acute setting. Review the patient’s medical record against McKesson (InterQual)
discharge planning criteria to determine readiness for discharge. Will develop a
proactive process as well as assist, when requested, for patients undergoing same
day surgeries in Ambulatory Surgery Unit, anticipating actual and potential needs
for post-operative services.
lan and develop appropriate patient-specific discharge plan of care within 5
working days of discharge. Shall coordinate, collaborate, and obtain approval of
the plan among the patient, family/caregiver, primary provider and other members
of the healthcare team. Document review of the plan in the patient’s electronic
health record. Implement, coordinate, and execute the discharge plan with the
patient and family/caregiver, optimizing access to appropriate services. Shall
assist the Health Care Team with acute-to-acute patient transfers when requested.
Follows through with finalizing all aspects of the discharge plan including
facilitating hand-off communication between sending and receiving nurses and
confirming transportation/transfer arrangements. Shall ensure necessary referrals
are ordered by the appropriate discipline and that they are coordinated. Refer
patients not currently requiring acute or skilled nursing care for discharge with
appropriate services to lower level of care, or placement in appropriate facility.
Assist health care team and family/caregivers with coordination for patients
requiring End-of-Life Care to ensure physical, emotional, and spiritual needs are
being met. Facilitate family/care giver meetings with health care team and clinical
staff. Serve as an advocate for, and ensures education is provided to the patient
and family/caregiver as required and when requested.
Preparation for discharge may include speaking with the patient, family,
physicians, therapists, nurses, supervisors, intake coordinators, residential care
facility managers, insurance companies, and reviewers.
Ensure coordination of care delivery processes, to include alternate healthcare
settings and the home environment, for the purposes of enhancing the patient's
health and wellness, safety, productivity, and quality of life, and for providing the
most beneficial, cost-effective health care. Shall develop, utilize, and maintain a
variety of military and community resources to optimize access to services and
medical care. Shall ensure timely and appropriate provision of services.
Re-evaluate the patient and the plan every 72 hours until discharged per
McKesson (InterQual) guidelines, aligning the plan with TRICARE benefits and
policies documents in accordance with existing local facility/DHA/AF/DoD and
other agency guidelines. Shall maintain data collection in accordance with local
facility/DHA/AF/DoD and other specified agency guidelines. Such data includes
but is not limited to resource utilization and patient outcomes, and Length of Stay
(LOS) and Avoidable Bed Days, analyzing for variance, appropriate interventions
and cost containment.
Conduct timeliness in completion of the discharge plan, patient’s adherence and
response to the plan, identification of variances, patterns or trends from
established practice guidelines and/or standards, established outcome
measurements, results of interventions, treatment delivery and timeliness of care,
and utilization of resources. Monitors and evaluates the facility’s discharge
planning program per local facility/DHA/AF/DoD policies and guidelines.
Maintain a level of productivity and quality consistent with complexity of the
assignment; facility policies and guidelines; established principles, ethics and
standards of practice of professional nursing; the Case Management Society of
America (CMSA); American Accreditation Healthcare Commission/Utilization
Review Accreditation Commission (URAC); CAMH; (AAAHC); Health Services
Inspection (HSI); and other applicable DoD and Service specific guidance and
policies. Shall also comply with the Equal Employment Opportunity (EEO)
Program, infection control and safety policies and procedures and follow
applicable local facility/DHA/AF/DoD instructions, policies, and guidelines.
Demonstrate knowledge and experience in Patient Advocacy, Patient Privacy, and
Customer Relations. Respect and maintain the basic rights of patients,
demonstrating concern for personal dignity and human relationships. Only release
medical information obtained during the course of this contract to other MTF staff
involved in the care and treatment of that individual patient.
Serve and participate in committees, functions and other meetings as directed.
Attend meetings to include bed meetings; interdisciplinary rounds;
interdisciplinary meetings; and clinical/discharge planning sessions/meetings as
requested. Shall provide relevant and timely information to these groups and
assists with decision-making and process improvement. Shall participate in
customer service initiatives, quality projects, and medical readiness activities,
designed to enhance health services.
Participate in clinic quality assurance programs to meet standards for the Joint
Commission, in QA/RM activities to the extent required by AFI 44-119, Chapters
3, 6 and 8 and the individual MTF QA/RM plan or regulation.
Completes medical record documentation and coding and use designated tracking
logs and data reporting as required by local facility/DHA/AF/DoD instructions,
policies and guidance and complete all required electronic health record system
training, facility-specific orientation and training programs, and any
DHA/AF/DoD mandated training.
Prepares all documentation to meet or exceed established MTF standards, to
include, but not limited to: timeliness, accuracy, content, and signature, use MTF
and Air Force-approved abbreviations for documentation in the patient health
records and follow the MTF’s Do Not Use Abbreviation List, (AFI 44-172 / AFI
48-123, Medical Examinations and Standards) with no more than 2 deficiencies
per month, complete medical records documentation within 72 hours of the
encounter with the patient, use the proper coding of procedures and treatment at
90% or higher, as military and civil service health care providers engaged in
comparable work.
Not dispose of any records without prior written approval of the Functional Area
Records Manager (FARM) evidenced by the FARM's signature on the SF 135. If
requested by the government, the contractor shall provide the original record or a
reproducible copy of any such record within five working days of receipt of the
request. All records, files, documentation, working papers, and software provided
by the government or generated in the performance of this contract become and
remain government property. All such records, files, documentation, and working
papers, which this contract requires the contractor to maintain, shall be
maintained in accordance with AFI 33-322, Records Management Program; AFI
33-364, Records Disposition-Procedures and Responsibilities; AF Electronic
Records Management (ERM) Solution, AFRIMS, Records Disposition Schedule
located at https://www.my.af.mil/gcss-af61a/afrims/afrims/ and all other pertinent
directives, as supplemented.
Comply with standards of care and practice in accordance with all established
policies, procedures, and guidelines used in the medical treatment facility. The
Department Functional Requirements Evaluator Designee (FRED) shall monitor
the contractor employee productivity, monthly performance reviews, customer
and staff comments, government information systems and records, customer
service information, and time sheets.
Must be knowledgeable of clinical and administrative theories, principles,
practices, and procedures underlying nursing practice; effectively apply core
discharge planning and case management functions: a) Assessment: Assesses
every inpatient and same day surgery patient for discharge planning needs; b)
Referral: Considers all needs for referrals to include TRICARE authorizations,
durable medical equipment, special needs equipment/services, ongoing specialty
medical care, case management, institutional referrals such as transfers for
rehabilitative or nursing home care; c) Formulation: Collaborates with the provider
and other members of the healthcare team as needed to determine the best
discharge plan for the patient; d) Implementation: Reviews the discharge plan with
the patient and the patient’s family/caregiver prior to discharge and documents the
review in the patient’s medical record; e) Monitoring: Documents and updates the
discharge plan as needed in accordance with local facility DHA/AF/DoD policies
and guidelines. Conducts periodic evaluations of the quality and effectiveness of
the discharge planning process; be able to sit, stand bend or walk as required to
accomplish primary duties of typing, shorthand, filing etc. for a period of a 9 hour
duty day. Read, understand, speak, and write English fluently with excellent
communications and customer service skills.
Comprehension of the medical privacy and confidentiality (Health Insurance
Portability and Accountability Act [HIPAA]) and accreditation standards of
Accreditation Association for Ambulatory Health Care (AAAHC) and The Joint
Commission (TJC). Working knowledge of computer applications/software to
include Microsoft Office programs, MS Outlook (e-mail), and internet familiarity
is required. The ability to input, extract and format data from established
databases. Have experience with McKesson (InterQual) and/or Milliman Care
Guidelines and a working knowledge of DRGs, ICD-9, CPT-4, HCPCS coding
and concepts Length of Stay (LOS) and Avoidable Bed Days. Possess ability to
use basic computer skills to enter patient data and extract patients’ information,
from a variety of sources to include MHS GENESIS System, Joint Legacy
Viewer (JLV) and integrated clinical database (ICDB) and be proficient and
independent in data entry within 2 months of start date.
Possess organization, problem-solving and communication skills to articulate
medical requirements to patients, families/care givers, medical and non-medical
staff in a professional and courteous way. As well as demonstrate ability to apply
critical thinking skills and expertise in resolving complicated healthcare, social,
interpersonal and financial patient situations. Skillful and tactful in
communicating with people who may be physically or mentally ill, uncooperative,
fearful, emotionally distraught, and occasionally dangerous.
Qualifications
Qualifications:
Degree/Education: Hold an Associate Degree in Nursing from a nationally accredited program with a minimum of 3 years’ experience. Maintain an active, valid, current, and unrestricted license (with no limitations, stipulations or pending adverse actions) to practice nursing as a registered nurse
in any US state/jurisdiction.
Certifications in addition to Basic Life Support (5.2.3): Maintain an active, valid, current, and unrestricted license (with no limitations, stipulations or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction. The contractor/employee shall hold current Healthcare
Provider (HCP) Basic Life Support (BLS) certification using American Heart Association or the American Red Cross guidelines. Computer-based training does not constitute fulfilling the training requirements.
Experience: ADN/BSN shall have at least 3 years of active nursing practice, 24 months of which shall be clinical case management/discharge planning for adults, children, families, seniors or groups. Shall have worked in nursing the past 12 months.
Licensure/Registration: Current, full, active, and unrestricted license to practice as a Registered Nurse as required in the TO from a United States (US) jurisdiction, state or territory.