Advocate Aurora Health
West Allis, WI
Major Responsibilities: Develops and maintains a therapeutic relationship throughout the healthcare continuum. Regularly communicates/consults with APC and MD Advanced Care at Home (ACAH) team regarding patient needs. Assesses patient’s ongoing clinical status in person to determine healthcare needs or facilitates referrals to the needed community resources. Demonstrates the use of nursing process as a problem-solving model. Recognizes changes in clinical situations. Evaluates and implements changes to the plan of care. Plans, implements, coordinates, monitors and evaluate all options and services with the goal of optimizing the patient’s health status, quality of life, and ability to remain in their home. Facilities the patient and family’s right to receive quality, cost effective care. Mobilizes appropriate resources in response to situations that have the potential to negatively impact patient and family outcomes. Participates in quality/process improvement initiatives....