Alison Sample

Launched new post-acute care coordination program to facilitate swift transitions from acute to post-acute settings. Oversee SNF and DSHS inquiry/assistance requests. Assisted in establishing pilot program with WA Healthcare Authority (HCA) to implement swift pandemic strategies. Primary lead post-acute care coordinator for all Washington LTACH’s. Designed and currently maintain new resource to better utilize SNF logistics. Mentor other transitions staff on difficult discharges. Coordinate transitions of care utilizing a blend of case management, discharge planning, social work, and nursing. Integrate members with providers and public agencies to ensure quality, cost effective care for MCO as well as reduced readmissions for the member. Review discharge plan and members' understanding of the plan resulting in reduced readmissions due to increased health literacy. Develop medication management care plans. Develop a plan of care consistent with medical, behavioral health, chemical dep and financial management resources. Consult with interdisciplinary care team as needed. Document assessments, service/care plans within the EMR system. Maintain constant, revolving, and active caseload. Skilled with both Medicaid and Medicare lines of business.

Performed various nursing interventions such as wound dressing, vital sign monitoring and specimen collection. Gathered patient health data through interviews and observation, documenting data in electronic records. Facilitated in creating care plans. Worked with MD and families to discuss plans for effective discharge after leaving rehab. Coordinated with other team members and outside medical staff to ensure patient has everything in place prior to discharge and post discharge. Carefully explained discharge plan of care including medications, treatments, and future goals. Advocated on patient's behalf for quality-of-life changes. Administered treatments and medications as prescribed while coordinating with MD to quickly change treatment plans based on emergency or patient needs. Assessed situations appropriately and swiftly to relay information to necessary team members.

Responsible for inserting foley catheters, replacing gastric tubes, IV ABO therapy, wound vac changes, administering medication and wound care. Managed unstable diabetes clients using nursing judgement and MD parameters. Made fast decisions using nursing judgement in emergency situations. Explained the necessity, preparation, nature, and anticipated effects of procedures to patients and families. Made comprehensive nursing decisions based upon the interpretation of facts and evaluations; modified care plans as needed. Managed test/lab results using critical thinking skills. Supervised and directed CNA's. Documented information in patients' electronic medical record, relaying information to clinicians and care providers to facilitate continuity of care. Responsible for admission and discharge of patients. Interacted utilizing calm, reasonable judgement with a demonstration of commitment to the patient during high-stress situations.

Recorded conditions and nursing requirements of residents. Supervised teams of caregivers when required. Assigned nursing staff according to patient needs and nurse capabilities. Administered medications and treatments as directed by healthcare providers and documented this information on patient charts. Documented treatment plans and procedures in accordance with regulations. Monitored stocks of medical supplies. Liaised with other nursing departments regarding patient treatments and therapies. Assisted with emergency response to sudden patient illness/trauma. Cared for post-surgical patients. Assisted residents with self-care techniques. Spend quality time with residents, providing compassionate support and understanding.