PAULA CHURCH

• Complete initial assessments of patients and family to determine and address individual home care needs.
• Monitor and record patient condition, vital signs, recovery progress and medication side effects.
• Conduct regular re-evaluations to address changes in needs and conditions, introducing revisions to care plans as needed.
• Chart changes in patient conditions and discuss concerns with supervising healthcare provider.
• Utilize Devero EHR
• Modified patient treatment plans as indicated by patients' responses and conditions.
• Counsel caregivers and families on end-of-life planning and educate on patient care options.
• Help patients and families feel comfortable during challenging and stressful situations, promoting recovery and reducing compliance issues.
• Listened to patients and loved ones, offering emotional support and kindness to help with end-of-life transition.
• Guided patients' loved ones and caregivers in pain management, wound care and medication dosing.
• Created and applied tailored care plans that would meet each patient's individualized needs.
• Utilized effective interpersonal, writing and active listening skills to build and cultivate positive relationships with patients, caregivers and physicians.
• Delivered respectful, compassionate care to each patient and family member.
• Planned hospice care for elderly and disabled patients.
• Responded to emergency situations with speed, expertise and level-headed approaches to provide optimal care, support and life-saving interventions.
• Helped patients and families feel comfortable during challenging and stressful situations, promoting recovery and reducing compliance issues.
• Assessed patient conditions, monitored behaviors and updated supervising physicians with observations and concerns.
• Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
• Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
• Observed strict safety measures, including checking medication dosages before administration to patients.
• Coordinated with healthcare team to establish, enact and evaluate patient care plans.
• Administered oral, IV and intra-muscular medications and monitored patient reactions.
• Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
• Monitored diet, physical activity, behaviors and other patient factors to assess conditions and adjust treatment plans.
• Delivered information regarding care and medications to patients and caregivers in comprehendible terminology.

• Implemented Hospital at Home model of care in partnership with the operations and clinical teams.
• Established and maintained relationships with medical directors, and ancillary providers
• Coordinated acute care and post acute care services for patients over a 30 day episode of care

My greatest strengths include:

• Coordinating inpatient level of care in patient homes, including transportation, infusion, acute care RN services, telehealth rounding with physician, identifying gaps in care and need for outpatient services including home health, hospice and palliative care and follow up appointments with PCP, specialists and diagnostics.
• Working knowledge of Epic, Word, Excel, Power Point
• Expertise is multiple levels of care including acute care, HH, Hospice, SNF

• Led a 12 member team of clinicians working throughout the Houston area in acute and post - acute facilities.
• Met Monthly with acute facility leadership and post - acute facility staff,
• Developed reports to identify trends, interpret and present data analytics,
• Performed routine documentation audits, ongoing staff education.
• Maintained 100% staff retention over a 2 year period,

My greatest strengths include:

• Working knowledge of multiple levels of care including HH, hospice, SNF, and IRF
• Engagement with patients and families
• Mentoring fellow colleagues
• Relationship building with acute and post- acute leadership and facility staff.
• Strong working knowledge of Microsoft Word, Excel, Power Point, reporting and data analytics.

• Provided care coordination for acute to post acute level of care services
• Supported clinical staff in regional markets, requiring frequent travel.
• Collaborated with others to discuss improved patient outcomes

My strengths include:

• Engagement and relationship building with patients and families
• Strong computer and technological skills.
• Program development and implementation.

• Coordinated post acute care services in skilled setting using clinical skills, critical things and severity adjusted data analytics and measurement tools to provide decision support for discharge planning.
• Interacted with interdisciplinary team and patients and families.

My strengths include:

• Unique skill set in the post-acute care arena in several value based care initiatives.
• Essential skills in influencing without authority.
• Decision support for discharge planning to facility staff, patients, families, guiding discussions related to Medicare guidelines.

• Educated caregivers on the basic skills required for providing end of life care.
• Provided educational support to hospice staff and our partners' clinical staff on assorted end of life topics.
• Collaborated with Quality team and Clinical staff to develop and implement a program to improve documentation in preparation for Joint Commission survey and changes in Medicare guidelines.

My strengths include;

• Ability to work with interdisciplinary team to provide positive outcomes for patients and families.

• Provided support to hospice patients in their home as part of the Interdisciplinary Team
• Facilitated life review with hospice patients and their family.
• Recorded interviews through video and audio
• Produced video and audio projects to completion
• Compiled archive of over 300 projects.
• Photographed multiple events, including many published photos on our collateral and quarterly newsletters.
• Provided support for our bereavement program, through Legacy Projects, Memorial Tributes and Camp Healing Hearts.
• Presented at multiple conferences regarding the production and benefit of Legacy Projects, including the Better Life Conference and P.A.P.A.

My strengths include:

• Patient engagement
• Photography
• Collaboration with interdisciplinary team

• Coordinated weekly and daily schedules for RN and HHA staff,
• Provided education and support to clinical staff, audited initial assessments, daily visit notes and re-certifications.
• Facilitated weekly IDT team meetings.
• Performed supervisory staff visits for HHA and RN staff.

My strengths include:

• Decision making skills
• Prioritizing and managing deadlines.

• Coordinated schedules for RN and HHA staff
• Provided education and support to clinical staff, Audit initial assessments, daily visit notes and re-certifications.
• Supervised staff visits for HHA and RN staff.

My strengths include:

• Assessment and evaluation of home care patients.
• Documentation
• Medicare Guidelines

• Coordinated schedules for RN and HHA staff
• Provided education and support to clinical staff Audit initial assessments, daily visit notes and re-certifications
• Supervised staff visits for HHA and RN staff.
• Performed primary care, assessment and evaluation of home care patients.