Dartmouth Health
Newport, NH
52810856
Overview Under the direction of the Associate Director of Ambulatory Nursing, this role serves to ensure safe and effective patient transitions across the patient care continuum, to include the hospital, rehabilitation facilities, skilled nursing facilities, and home. As a patient educator and advocate, this position helps improve communication with patients and caregivers, resulting in effective care transitions, improved self-management skills, and reduced readmission rates while ensuring patient-centered care. This role will support both New London Medical Group and Newport Health Center. Responsibilities
Transitional Care Responsibilities
Develop and implement individualized transitional care plans that address medical, social, psychosocial, and functional needs, ensuring continuity of care across all settings.
Provide patient and caregiver education regarding diagnosis, treatment options, medication reconciliation, chronic disease symptom management, and...