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San Antonio Behavioral Healthcare Hospital
San Antonio, TX, US
Source: San Antonio Behavioral Healthcare Hospital careers · View original posting
From San Antonio Behavioral Healthcare Hospital's posting. “We” and “our” refer to the employer.
The Discharge Care Coordinator ensures that there are appropriate appointments for follow-up care, safety plans, transportation, living arrangements, and prescriptions for any medications that may be needed following discharge. Helps patients smoothly transition from inpatient services to outpatient services.
Responsible for working with the treatment team in determining a psycho-social-emotional needs assessment, completing trauma informed care discharge plans, assisting patients and their families with accessing community resources, providing rehabilitative services, and initiating crisis intervention when needed.
· Conduct thorough assessments of patients' mental health status, treatment history, and support systems to identify their specific needs and challenges
· Collaborate with multidisciplinary teams, including psychiatrists, psychologists, social workers, and nurses, to gather relevant information and insights
· Create individualized discharge plans in collaboration with patients, caregivers, and healthcare providers, incorporating input from treatment teams and considering patients' preferences and resources
· Identify and address potential barriers to successful discharge, such as housing instability, lack of social support, and financial constraints
· Coordinate with community resources, including outpatient mental health clinics, housing assistance programs, vocational rehabilitation services, and peer support groups, to establish post-discharge support networks for patients
· Maintain accurate and up-to-date documentation of patient assessments, discharge plans, progress notes, and referrals
· Monitor patients' progress and adherence to discharge plans through regular follow-up contacts, phone calls, and appointments, adjusting plans as needed based on changes in patients' circumstances or treatment goals
· Foster effective communication and collaboration with internal and external stakeholders, including healthcare providers, social service agencies, community organizations, and insurance companies, to ensure continuity of care and seamless transitions for patients
· Participate in interdisciplinary treatment team meetings to discuss patient progress, treatment recommendations, and discharge planning strategies
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