Transition Services Coordinator; RN - Nursing

Minimum Nurse to Patient Ratios

Vancouver Coastal Health participates in the provincial implementation of minimum Nurse to Patient Ratios (mNPRs) to enhance nursing practice and quality of care. mNPRs set the minimum number of nurses providing care to patients on a given unit.

Come work as a Transition Services Coordinator with Vancouver Coastal Health (VCH) at UBC Hospital in Vancouver, BC. In this role you will lead and facilitate acute to community transitions, assess and evaluate clinical and functional needs, and coordinate community staff/resources to support care following discharge from an acute site.

• Lead and facilitate transitions from acute to community care, assessing and evaluating clinical and functional needs.
• Coordinate community staff/resources to ensure seamless discharge planning and continuity of care.
• Develop and implement policies, procedures and standards for the transition services program.
• Coach and encourage acute and community colleagues in current clinical pathways and practice.
• Plan and facilitate clinical discussions to support safe client discharges with care teams and other health professionals.
• Make community referrals based on client needs, urgency and best practices.
• Educate and provide consultation to clients/families.
• Coordinate transition to residential care using clinical decision support tools such as Inter-RAI MDS when appropriate.
• Document and maintain client records and clinical assessments.
• Participate on committees as directed.
• Assign service priorities to Home Health teams and adjust client/patient/resident assignments.
• Assist in administrative activities and optimize program resources.

• Current registered nurse or registered psychiatric nurse, registered with the British Columbia College of Nurses and Midwives (BCCNM).
• Five (5) years of recent, related experience including three (3) years in a community health setting, one (1) year in quality improvement, research or evaluation, and experience with a clinical decision‑support tool for severity assessment and discharge.
• Experience in a tertiary health care environment or equivalent combination of education, training and experience.

• Broad knowledge of nursing theory and practice within a client and family centred model of care.
• Broad knowledge of the BCCNM Standards for Nursing Practice and of evidence based nursing practice related to patient acuity and bed utilization practices in a tertiary teaching hospital.
• Broad knowledge of other health care disciplines, their role in client care and discharge planning.
• Broad knowledge of clinical studies methodology and data presentation.
• Strong critical thinking, independent and collaborative work abilities, coaching and facilitation skills.
• Excellent oral and written communication skills and ability to work effectively with co‑workers, physicians, health staff, clients, families and outside agencies.
• Ability to handle conflict, adjust to new or unexpected events, plan, organize and prioritize work.
• Physical ability to perform the duties of the position and proficiency with computer software (word processing, databases, spreadsheets, presentations, internet access) and with a computerized patient care information system.
• Ability to operate related equipment.

• Comprehensive health benefits package including MSP, extended health and dental and municipal pension plan.
• Employer‑paid training and leadership development opportunities.
• Wellness supports including counselling, critical incident and innovative wellness services for employees and their immediate families.
• Recognition programs to honour staff.
• Access to exclusive discount offers and deals for VCH staff.

Vancouver Coastal Health encourages applications from equity‑deserving communities, including Indigenous peoples, members of racialized groups, people with disabilities and people of all gender identities and expressions and sexual orientation.

Hours of work including days off and work area may be subject to change consistent with operational requirements and the provisions of the Collective Agreement and applicable statutes.

All health care workers in publicly‑funded facilities are required to report their receipt of certain vaccines or history of infections. This information will be obtained during onboarding.