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Patient Identification and Care Planning:
- Work with hospital care teams to identify patients meeting RCM criteria.
- Attend inpatient rounds and review charts to assess medical and social needs.
- Communicate program benefits to physicians and care teams, and facilitate patient enrollment.
Case Finding and Program Expansion:
- Teach and promote RCM to primary care providers and community partners.
- Support coordination of care and develop individualized care plans.
- Participate in hospital and community events to expand program reach.
Program Coordination:
- Track and document referrals from hospital and community providers.
- Enter data on enrolled patients and report challenges and successes.
- Prepare and validate program results data.
Program Development and Growth:
- Support readiness and operational activities for new RCM pathways.
- Co-chair working group meetings for pathway development and quality improvements.
- Prepare materials for internal, external, and patient-facing communications.
Halton Healthcare
Halton Healthcare provides quality, compassionate healthcare services to rapidly growing communities in Ontario. As a progressive and vibrant organization, they are committed to being an innovative center of excellence in community hospital care, with a culture focused on exemplary patient and staff experiences.