Discharge to Assess Hub Coordinator

Are you an organised individual with experience of working within a healthcare setting? Are you passionate about your profession? Are you interested in being involved in supporting independence for people in Somerset? Are you seeking a new challenge?

We are looking for dynamic and organised individuals to join the Somerset Discharge to Assess team. You will join a countywide team to provide an efficient and effective discharge process for patients/family entering the home D2A pathway.

You will coordinate and run the D2A HUB, you will create all the bookings for all patients entering the service and be responsible for matching the right patient to the right staff type. You record activity on electronic and paper systems to monitor individual patient level information and provide data analysis and reports in various formats as required.

You will be the Key link between our acute and community teams. You will triage all referrals sent to D2A to ensure the most appropriate discharge pathway is provided in the most patient centered way. Great Communication skills are essential.
- Good IT skills and trained in Microsoft packages to include Outlook, Word, and Excel?
- A good working knowledge of acute discharges and Community Services?
- Keen to take on a developing role with a developing service?
- Hoping to support the leadership of an engaged, friendly, and supportive team?
- Able to commit to an 8am to 8pm seven-day shift pattern.

We are a highly motivated and committed county wide discharge service that is well established and respected and seen as an integral part of Somerset’s discharge response. We pride ourselves in the collaborative work that we are doing and the exciting opportunities this is creating.

We work with individuals to see how they manage their day-to-day living and self-care tasks. We identify any support/equipment that they may need. We will discuss with them an ongoing plan to help them recover. This may include helping them to find support in their local community and talking to other professionals to make sure they are as independent as possible in their own home.

We arecommittedto ensure staff are valued and satisfied within their roles and we truly value all our people and their extraordinary commitment to our patients and our Organisation - together, we are dedicated to working as one team to make a difference in people's lives.

Good patient experience is at the centre of what we do and we are committed in involving our patient’s feedback to help us shape our service.
- To triage the discharge screening tool received as a referral into the D2A service. This includes the need to read the referral form, identify the clinical level of function prior to admission and compare to the current level of function and understand the D2A input requested. To ensure that this is an appropriate referral for the service.
- The coordinator may advice on alternative discharge services if they feel that the referral is not suitable for the D2A service. For example could be supported by a village agent or Red Cross service. This will be a discussion with qualified or unqualified members of staff from the acute or community services and could include but not limited to Nurses, Physiotherapists, Occupational therapists, discharge facilitators, discharge nurses, social workers.
- During triage the referral form is checked to ensure it is fully completed and has enough depth of information for the keyworkers and providers to understand the needs of the patient and the aim for the intervention. If information is missing the coordinator will liaise with the referrer to gain further information.
- Key responsibility for holding the capacity for the Key Workers and maintaining a booking system that allows efficient use of Key Worker time.
- Key responsibility for holding Provider capacity and maintaining a booking system that ensures a smooth flow of patients onto D2A.
- Key responsibility for liaison and negotiation with key internal and external partners across the community, including Health and Social Care professionals, the Reablement partnership, and voluntary services such as micro providers and village agents.
- Liaison with the multi-disciplinary team to ensure identified support services that are listed on the referral form will be in place at the coordinated start of the D2A service. This requires negotiation with the MDT, D2A keyworker and D2A provider.
- Coordinate and work with the MDT for booking transport for patient discharge.
- Integral part of the Lone Working Policy and other internal processes, to include responsibility for escalating at the correct times in each process.
- Key responsibility for compiling D2A SITREP, to include collecting data from different sources and sending out correct D2A OPEL Status to external parties.
- Share knowledge, expertise and skill to ward staff and community colleagues in order to facilitate safe, person centred, effective and efficient discharge