Care Coordinators

Measurement Criteria:    1. Evaluate patients to determine care, discharge planning and other care needs.

1. Communicate with attending physician and social worker to develop a comprehensive discharge
2. Participates in the development and implementation of Case Management policies and protocols as related to patient care/services.
3. Promote effective and efficient utilization of clinical

 Outcome (Results):  Goal achievement within ninety percent (90%) of established target. Essential Function?  Yes        No       Percentage:      20%

Responsibility: Methodology

Complete clinical reviews to be submitted to healthcare insurance provider.

Measurement Criteria:   1. Assist in the evaluation of appropriateness of plan of care and revise on an

ongoing basis with communication to all other disciplines.

• Review diagnostic results to ensure that continuation of stay meets medical necessity.

1. Complete daily clinical reviews and submit to healthcare insurance provider to review for medical

• Compare assessment data to baseline assessment to monitor patients' progress.

1. Recognize changes in patient's condition and reports to healthcare insurance provider.

• Communicates with attending physician regarding patients' status with insurance coverage, g., denied days due to delay, lower level of care needed.

Outcome {Res ults):  Timely completion of clinical reviews is achieved. Essential Function?  Yes             No       Percentage: 85%

Responsibility:           Effectively assist in managing discharge planning.

 Methodology

Measurement Criteria:    I. Assess patients to obtain appropriate discharge placement.

1. Integrate clinical needs in plan of care to ensure appropriate discharge plans are in
2. Coordinate discharge plans with interdisciplinary team to ensure a safe and effective
3. Participate in the development of patient goals and discharge plans; make revisions based on changes in patient

Outcomes (Results):          Discharge planning goal met.

 Essential Function?  Yes                                     No          Percentage: 20 %

 Responsibilin•:             Monitor continuing services to ensure appropriate continuation of care.

 Methodology

Measurement Criteria: 1. Monitor patient's condition to ensure continuation of services meets medical necessity.

• Remain flexible and responsive when changes occur in patients'
• Demonstrate appropriate judgment skills to make independent clinical decisions in routine patient

1. Perform appropriate documentation to maintain the standards set by the hospital or fiscal

• Promote level of clinical expertise to ensure high quality of

1. Adhere to the scope of practice for Registered Professional Nurse per State regulatory

Outcome (Results):   Medical Necessity Guidelines are met.

 Essential Function?  Yes                                     No           Percentage: 80%

Responsibility:

Methodology Measurement Criteria:

Outcome <>es ults):

Effectively work to ensure patient experience and other customer service (internal and external) goals are met.

1. Works with hospital leaders and staff to establish departmental patient experience
2. Mobilizes department staff to become actively involved with improving patient
3. Works with staff to meet established patient experience

Patient experience goals are achieved within ninety percent (90%) of goal target.

Essential Function?  Yes                                     No        Percentage: 10%