Registered Nurse Patient Access Center

This position is 40 hours/week, rotating.

Days of the week will be variable and based operational needs of the department.

The MGB Capacity Center Access Nurse will have a unique opportunity to join a multidisciplinary, cross-institutional team of individuals who will play a central role in managing capacity and access on behalf of the eleven hospital MGB system. The Capacity Center's aim is to enable safe, efficient, and timely patient care by serving as the unified hub for system capacity management. The Capacity Center strives to help patients inside and outside of MGB gain access to high quality care within our system as efficiently as possible. To achieve this aim, the Access Nurse will work in close collaboration with teammates within the Capacity Center, colleagues at each member hospital, and other key stakeholders across the system.

A central pillar of the Capacity Center is to coordinate and optimize all incoming hospital transfers and referrals for the system, which currently includes over 50,000 requests annually. The Access Nurse will play a lead role in this critical activity by adopting a 'system mindset' with strong situational awareness of system-wide capacity, knowledge of service capabilities at all MGB hospitals and other assets, and a dedicated approach that matches patient need to site of care in the most timely and efficient manner possible. By centralizing these activities under the Access Nurse, the key aims are: (1) to leverage the Access Nurse expert clinical knowledge and triage capability to match patients inside and outside of MGB with the services and site of care that they need within the system, utilizing all MGB assets to achieve the most timely access to care possible; (2) to reduce transfer delays for patients with emergent care needs that cannot be fulfilled at the referring facility so as to achieve the best possible clinical outcome; (3) to leverage real-time system-wide capacity information in the MGB Capacity Center to help balance the flow of transfers across the system so that no one asset is unsafely overloaded; (4) to activate and coordinate standardized transfer pathways (e.g., direct admission, Round Trip, direct-to-procedure, etc.) that ensure the most efficient use of capacity at MGB assets; and (5) to coordinate tightly and collaborate openly with the multidisciplinary and institutionally diverse team of the MGB Capacity Center as well as the physicians, nurses, and capacity leaders for each MGB asset.

The Capacity Command Access Nurse will be a valued member of the Capacity Center team and their input, feedback, and recommendations will be regularly sought by leadership to further strengthen our system-based capacity management and achieve our collective goals to improve patient care.

• Provides leadership to managers and professionals

• Is accountable for the performance and results of multiple related teams

• Develops plans for own teams and contributes to the development of departmental strategy, plans and priorities

• Decisions are guided by resource availability and organizational objectives.

The Capacity Command Access Nurse provides leadership in strategy, planning, design, implementation and evaluation of the Access Center. They work in partnership with leaders for implementation of structures and processes to achieve key objectives in the Capacity Center. They will be the proxy as needed for the Director, assisting with team cohesion, development, supervisorial duties, including, providing 24-hour coverage 7 days a week, as well as other responsibilities as needed.

Principal Duties and Responsibilities:

Organizational Relationships

• Reports directly to the Capacity Command Center Access Director.

• Acts in a supporting role to the MGB Access Director, contributing to development and continuous engagement of team members, in alignment with MGB Leadership competencies.

• Creates and fosters Inter-professional collaborations with physicians, hospital leadership, team members, and referring providers and others, to maintain, grow and develop service line goals and optimal patient care delivery.

Scope and Responsibilities (include, but not limited to):

Operational

• Elicits patient information from referring MD and outside facility nurse to allow appropriate patient triage and placement. Directs patient transfer using triage tools and algorithms, working in collaboration with patient access services and others to transfer the patient in a clinically appropriate timeframe.

• Acts as the manager and primary resource person for the Access Nurse, referring physicians and MGB physicians, and is responsible for decision-making about level of care, priority, disposition, and arrival of intermediate and intensive care level of patients.

• Notifies inpatient clinicians and inputs appropriate clinical document in accordance with institutional standards

• Serves as a representative of organization and consults with appropriate administrators, patient care unit leadership, procedural unit leadership and access services during extreme census. Updates physicians and transferring facilities on bed availability. Troubleshoots potential issues (referring, physician, patient) and collaborates with appropriate stakeholders

Administration, Business, Management

• Analyzes daily report and or monthly audits of staff work, and acts as backup for payroll entry and may approve earned time requests. Responsible for posting the schedule and making sure Access Center has appropriate 24-hour coverage.

• Responsible for scheduling and approving requests from clinical staff under the direction of the Director. Approves payroll.

• Participates and monitors hybrid program for Access Center staff.

• With Director, interviews and hires department nursing personnel and administrative staff considering hospital, departmental needs, clinical expertise, team temperament, and diversity

• With Director, ensures that all employees are oriented to the Hospital, Department, and assigned Clinical Service and that appropriate documentation of competency is completed.

• With Director, ensures timely completion of competency, maintenance of licensure, evaluation, and performance appraisal. Supports Director with:

• Establishing and maintaining budget, operating standards/expectations and performance for team.

• Applying knowledge of key business drivers and/or system drivers and the factors that maximize department performance; anticipates business and regulatory issues to identify opportunities for improvements and growth.

• Seeking and acting upon feedback and initiates appropriate actions.

• Promoting, developing and evaluating processes and systems for capacity management care; advocates for resources and system improvements when necessary.

• Ensuring accountability for compliance and regulatory standards.

• Making recommendations for improving practices within the capacity command center.

Quality, Safety & Performance Improvement

• Leads and participates in development and review of patient care policies and nursing standards related to care transitions.

• Analyzes trends in collaboration with emergency room and inpatient departments, in patient acuity and census and its impact on staffing patterns to assure the needed adjustments in resource allocation.

• Provides ongoing training across the department, seeking opportunities for improvement and/or changes in the process which may impact effectiveness and efficiency.

Collaboration, Communications, Escalation & Compliance

• Develops relationships with external constituents, community providers and referring physicians and clinicians, to insure understanding of program, development of shared goals for patient/family transition to the back to community. Assist in the development of workflows and with case management on repatriation of patients.

• Establishes and sustains successful external relationships with ancillary departments and referring physicians to assure smooth and efficient functioning of the schedule and excellent customer service to our referral base.

• Responsible for troubleshooting concerns, issues and/or difficult situations and taking necessary corrective action or referring to appropriate individuals.

Leadership, Team Building, Development

In partnership with Director,

• Develops education and training for support staff and works with for initial phases of Center launch, including best practices for integration of individual groups to into the larger inter-professional team.

• With Director, acclimates new employees to the department, providing the necessary orientation and training to enable the employee to function effectively.

• With Director, provides effective leadership and facilitates interactions among staff to promote teamwork and create an overall harmonious work environment.

• Contributes to environment that is engaging, providing ongoing recognition of staff performance, including commendation of good performance, etc.

• Provides guidance team in identifying developmental needs and strategies that foster effective problem solving, collaboration, consultation, sound judgment, and leadership.

Self-Development

• Proactively seeks out feedback and communicates leadership development goals with direct reports and supervisors. Role models growth mindset and maintains transparent environment of continuous self-improvement as aligned with senior leader expectations.

• Pursues a continuing program of self-development to remain cognizant of current trends and new methods within the health care environment.

• In collaboration with Director, formulates individual career goals and plans for achievement.

Environment

• Promotes MGB culture through living the MGB values; maintains respectful communication, teamwork, and maintenance of a professional environment, with a curious mindset.

• Responsible for contributing to a calm, organized, inclusive, appreciative, learning-oriented atmosphere.

Advocacy/Resources

• Responsible for accessing system resources to maintain an effective work environment.

• Responsible for informing executive leadership in a timely way when systems, tools, equipment, information access or other resources are inadequate

Qualifications:

• Education: Graduate of an approved school of nursing, BSN required. Master's degree preferred.

• Current license to practice as a registered nurse in the State of Massachusetts, is required. CCRN certification preferred.

• Experience: 10 years adult critical care and or emergency department experience required.

• 5-year Nurse leader experience required such as: flow coordinator, access nurse, bed control.

• Continually updates clinical knowledge and skills through formal and informal education and review of the current literature.

• Must work well independently and have sound decision making skills.

• Decisions are made independently from the direct guidance and supervision of a physician.

Skills/Abilities/Competencies:

Leadership: Demonstrates Mass General Brigham's Leadership Competencies for both Performance Focused Leadership and People-Focused Leadership:

• Performance Focused:

• Customer/Patient Focus: Building strong customer/patient relationships and delivering customer/patient centric solutions.

• Manages Complexity: Make sense of complex, high quality, and sometimes contradictory information to effectively solve problems.

• Cultivates Innovation: Create new and better ways for the organization to be successful.

• Ensures Accountability: Holding self and others accountable to meet commitments.

• Learning Agility: Actively learn through experimentation when tackling new problems, using both successes and failures as a learning folder

• People Focused:

• Drives Equity and Inclusion: Recognizes the value that different perspectives and cultures bring to an organization.

• Collaborates: Build partnerships and work collaboratively with others to meet shared objectives.

• Communicates Effectively: Develop and deliver multi-mode communications that convey a clear understanding of the unique needs of different audiences including senior system and hospital administrators, physician leadership, technician staff, and other personnel across different institutions.

• Instills Trust: Gain the confidence and trust of others through honesty, integrity, and authenticity.

Other:

• Attention to detail.

• Willingness to suggest and assist with improvements to policies, procedures, and process for referrals.

• Interest in hospital-wide and other asset-based capacity challenges and understanding of downstream effects of patient inflow on the whole system.

• Self-motivated, strong team leader, coach and role model.

• Possesses interpersonal skills to interact effectively with intra-inter and outside hospital physicians and personnel.

• Possesses ability to manage critical issues relating to patient care and changing organizational climate.

Supervisory Responsibilities:

• Capacity Command Center Access Nurse will be proxy for Capacity Command Access Director as needed providing 24-hour coverage 7 days a week.

• Must be able to manage and lead the work independently. Manages and supervises the Access workflows and processes.

Fiscal Responsibility:

• Direct impact on driving growth and development for MGB of complex cases, what is accepted or not and financial impact of patient transfer into the system.

Working Conditions:

• General Business/Healthcare Office and clinical treatment areas.

• The MGB Access Nurse will work in the MGB Capacity Center in the Assembly Row Building. This role is on-site initially with consideration in the future for off-site options.

• This role is office-based; nurses will not provide clinical care to patients.

• The Capacity Center Access Nurse (as an entity) is a 24/7 function.

• While performing the duties of this job, the employee is frequently required to sit; talk; or hear; use hands to finger; handle; or feel; reach with hands and arms. The employee is occasionally required to stand; walk; and stoop; kneel; or crouch. The employee must frequently lift and/or move up to 5 pounds and occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision and depth perception.

• The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Normal office working conditions. The noise level in the work environment is quiet to moderate.