RN Navigator Heart Failure, Jewish Hospital, CHF Clinic

JHHS - Jewish Hospital - UMC

200 Abraham Flexner Way Louisville, KY 40202

Salary Shift (United States of America)

UofL Health is a fully integrated regional academic health system with five hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehab Institute and Brown Cancer Center.
With more than 12,000 team members—physicians, surgeons, nurses, pharmacists and other highly skilled health care professionals—UofL Health is focused on one mission: delivering patient-centered care to each and every patient each and every day.

The UofL Health - Advanced Heart Failure Therapies Program offers comprehensive care and treatment options for patients with advanced heart failure (HF), including heart transplantation and ventricular assist device (VAD). Our highly trained physicians and nurses have advanced training, specializing in advanced heart failure, complex medical needs of heart transplant, and VAD patients.

The RN Navigator is responsible for coordination of care across the spectrum of advanced heart failure with strong emphasis on patient education and engagement in care, including self-management. This employee will implement and monitor patient care plans, monitor, record and communicate patient condition, and utilize a multidisciplinary approach to patient care. This employee will note and carry out physician and nursing orders, provide efficient and effective telephone triage for the heart failure patient population and serves as the primary contact and resource for patient/family throughout the continuum of care.

They will contribute expertise as a member of a multi-disciplinary team to facilitate the provision of care of those patients with advanced heart disease and serve as a liaison between physician and other disciplines (VAD and Transplant Team) to expedite interventions which optimize clinical outcomes[

Essential Functions:

Completes comprehensive patient health evaluations in collaboration and consultation with the Cardiologists, Specialists and Multidisciplinary Team
Uses all components of the nursing process, to provide comprehensive nursing care, support and education to patients and their families regarding screening and diagnostic tests, and treatment of advanced heart failure
Responsible for the coordination of care from initial referral through the care continuum including referral for advanced therapies such as mechanical circulatory support and heart transplant
Staffs outpatient heart failure clinic, schedules follow-up visits, and triage’s patient calls.
Provides ongoing education and reinforcement to patients and caregivers regarding medication regimen, dietary compliance, follow up, etc

Other Functions:

Coordinates the long term follow-up care of each heart failure patient
Schedules follow-up laboratory tests, X-rays, cardiac catheterizations, etc. according to the established protocols
Reviews all test results and reports any abnormal findings to the appropriate physician
Triages phone calls from heart failure patients regarding medical problems, questions/concerns, medications, etc. and provides the appropriate follow up
Communicates with other team members regarding problems/concerns to ensure continuity of care and patient safety is maintained
Liaises with other members of the multidisciplinary team to ensure psychosocial and financial needs of the patient are being addressed
Maintains accurate and current documentation of demographics, To Dos, laboratory, diagnostic tests, medications, clinic visits, telephone follow up, other miscellaneous communication, etc. in the EMR

Assures the evaluation of the CHF candidate is complete
Initiates evaluation…