Care Coordinator

1 week ago


Selby, United Kingdom Beech Tree Surgery Full time

**Data gathering & organization**: Developing an understanding of our coding of dementia and cognitive impairment using clinical templates Identifying missed dementia due to coding errors Developing and maintaining a register of patients with dementia Creating a RAG (red, amber, green) dashboard of risk/need, with red being the patients we most need to consider for advanced care planning and green being low level concern Monitoring systems that inform GPs about secondary care episodes, outpatient/in patient and Emergency Department attendances, as well as OOH activity. Develop & reviewing care plansto include: Being involved in the introduction of & changes to care plans Ensuring care plans & advanced care plans are up to date & shared with the relevant people Ensuring that all patients are discussed & outcomes are recorded & reviewed. Working with staff teams to ensure any planned or recommended treatment occurs in a reliable & timely manner acting as a single point of contact Informing the Lead Clinician of any delays in assessment or delivery of care needs. Identify where plans or recommendations are not achieved & undertake process mapping to identify any bottlenecks.

**Develop communications & effective reporting to include**: Negotiating with all involved in care issues to establish & promote good working relationships & improve the coordination of the patient journey. Establishing effective communication networks with clinicians & other team members & ensuring the continuation of good communication. In particular, developing close working relationships with the existing Care Coordinators & Wellbeing Link Workers Recognising peoples needs for alternative methods of communication & respond accordingly. Preparing reports on behalf of Clinical Leads for peer review activities.

Updating & maintaining a Directory of Services in real time. Providing a local point of contact for bereaved relatives, sign posting towards appropriate support at any stage following the loss of a relative or close friend to dementia. Liaise with local Dementia support groups and where required attend Dementia Action meetings to build network of support agencies.


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