Summary of Duties
The primary goal of the Weekend Discharge Team is to facilitate weekend discharges from all 10 of the SHSC Acute Care units (General Internal Medicine, Oncology, Cardiology, Muscular Skeletal and Trauma), to facilitate referrals and to divert admissions from the Emergency Department.
The Weekend Discharge Team consists of an Occupational Therapist, Physiotherapist and Social Worker. The team will use a person centred model of care that enables each professional to optimize their scope of practice, improving effectiveness and efficiency of care, and the patient experience.
The team in collaboration with the weekend unit based staff, ED staff, CCAC patient flow and Medical teams will monitor for weekend discharges, assess patients and complete referrals / applications to facilitate weekend discharges.
The candidate will be able to work in a fast paced environment determining priorities according to the patient’s goals and estimated discharge date.
The successful candidate will practice in accordance with the appropriate legislation and organizational policies for decision making, care planning and coordination of care.
Collaborate with colleagues regarding weekday handover list outlining pending issues for focused weekend follow-up
Complete assessments and applications for weekend discharge planning
Assess and confirm medical stability to determine if patient is requiring Alternative Level of Care
Update eALC tool as appropriate by Social Work
Prioritize RM&R referrals for home, rehabilitation and palliative care for weekend and Monday discharges
Collaborate with Emergency Department and Acute Care Unit teams, CCAC, other community resources to facilitate weekend discharges
Problem solve to facilitate weekend discharges
Qualifications / Skills
Master’s Degree in Social Work required
Registered and a Member in good standing of the OCSWSSW
Minimum 2 years of experience working as an acute care hospital required
Emergency Department experience an asset
Conducting Psychosocial assessments with a priority on identifying complexities regarding discharge over the weekend or Monday
Knowledge and skills in applying relevant theoretical frameworks in particular systems theory, crisis intervention, brief solution focused perspectives and adjustment to illness / injury
Demonstrated understanding of caregiver stress or family dynamic factors that may impact discharge planning
Advanced negotiation and mediation skills to balance patient, family / caregiver, team, organizational and access to care needs and opportunities.
Knowledge of Social Work Competencies in Hospice and Palliative Care
Competency in adhering to the SW Standards of Practice at SHSC
Knowledge of practice, theoretical perspectives and community resources in End of Life Care
Understanding of the Health Care Consent Act and its interpretation to navigate, educate and facilitate identification of an SDM where appropriate
Strong Advocacy skills to support patient autonomy and self determination.
Knowledge of and timely management of the Wait Management system (eALC)
Well-developed communication, interpersonal, time management and organizational skills
Strong teambuilding skills and conflict resolution skills
Excellent assessment, interviewing and problem solving skills
Computer literacy required
Knowledge of the health care system, community resources and eligibility criteria for system partner facilities
Good working knowledge and execution of referral systems such as RM&R
Superior ability to manage multiple tasks and set priorities in a fast-paced environment
Qualified candidates are invited to submit their resume and cover letter (in one document) quoting 190533 to :
Sunnybrook Health Sciences Centre