New Directions Social Worker or RN (Care Transitions Advocate)
Oregon Health and Science University
December 27, 2017
The New Directions Social Worker or RN will aim to meet the psychosocial needs of patients with complex problems who frequently rely on the Emergency Department (ED) to address medical, mental health, substance abuse, or social service access challenges. The program\u2019s goal is to identify, enroll and engage patients by conducting a thorough needs assessment and providing on-going intensive case management. Assessments and services may be provided in the Emergency Department, inpatient units, the patient\u2019s home, or in the community. The social worker or RN will coordinate treatment efforts with other OHSU departments, other healthcare organizations and community agencies. Further, the social worker or RN will be available to patients\u2019 families and support systems. Through these services, it\u2019s anticipated that patients enrolled in the program will experience a reduction in unnecessary ED visits and inpatient admissions due to improved problem-solving skills and access to services. The social worker or RN will participate in data collection for program evaluation purposes and will partner with other team members to establish operational systems to ensure effective and efficient implementation of the program.
As the state's only health and research university, OHSU brings together patient care, research, education of the next generation of health care providers and scientists and community service to improve the health and well-being of all Oregonians.The university is a conduit for learning for more than 2,800 students, providing training to interns, residents and fellows in postgraduate medical and r...esearch. It is the only place in Oregon that grants doctoral degrees in medicine, dentistry and nursing. OHSU cares for more than 251,000 patients each year from around the region and takes a leadership role in contributing to solutions involving the health of the state and the nation, such as health care access and transparency, ethics and workforce shortage. Beyond providing critical health care services, quality education and cutting-edge research, OHSU also is a key economic and social force in the Northwest. With an annual operating budget of $2.06 billion and more than 14,000 employees, OHSU is Portland?s largest employer. Its size contributes to its ability to provide many services and community support activities not found anywhere else in Oregon. For more information visit http://www.ohsu.edu/xd/about/index.cfm