Care Coordinator (Breast Cancer Programme) - 2 years contract
Overview and purpose of the position*
We are seeking a dedicated and compassionate Care Coordinator to join our Breast Cancer Programme team. The Care Coordinator plays a vital role in applying advanced knowledge of the health needs, preferences and circumstances of patients with Breast cancers to navigate the patient and family through the health system and optimize the individual’s health and well-being at various phases across the continuum of cancer care, including diagnosis, treatment, rehabilitation, follow-up, survivorship and palliative care.
The care coordinator will stay in close communication with the patient across the care continuum to ensure care coordination, efficient care delivery, and removal of care barriers.
The care coordinator will be an integral member of the multi-disciplinary Breast Oncology team at NCIS at NTFGH/NUH, which provides coordinated and systematic clinical care to comprehensively address the needs of patients with Breast Cancers.
Job Responsibilities
A. Direct care
1.Cancer navigation
•Provide individualized assistance (informational and emotional support) to patients and their families to overcome healthcare system barriers, improve continuity of care and quality of cancer care.
•Identify and navigate needy (high-risk) patients through the journey to ensure that they do not fall through the gaps and have access to the resources they need.
•Follow-up with patients through phone, where necessary. This will enable patients’ easier access to the medical team hence reducing unnecessary re-attendances to Emergency Department and potential admissions.
•Assist patients and their families to transit across different services and location.
•Communicate effectively with health care professionals in providing smooth transitions.
•Perform assessment to identify patients’ physical, psychosocial and spiritual needs, and barriers in accessing to health care system. Initiate interventions to address the identified barriers, and in meeting the physical, psychosocial and spiritual needs.
•Perform patient navigation outcomes evaluation.
2. Coordination of care
•Ensure compliance to care pathways and to streamline care within NUHS (primarily between NUH and NTFGH).
•Ensure smooth transition of care and right-siting of patients based on care pathways.
•Ensure timely and appropriate referral to specialist, allied health and support services
•Assist in coordination of care between services (medical, surgical or allied), and between settings (inpatient, outpatient and community
•Involve in close liaison with Medical Oncologists, Surgical Oncologists, Radiation Oncologists, Radiologists,other specialists and primary care providers, involved in the patient’s care.
3.Tumour board management
•Tumour board coordinator for the weekly tumour board.
•Assist in coordination of care between services (medical, surgical or allied health) based on decisions made at the weekly tumour board.
•Ensures tumour board database is complete.
•Manage and audit tumour board database.
•Cross cover other tumour boards to ensure continuity of service during colleagues’ leave.
B. Education
1.Patient education
•Patient and family education pertaining to cancer journey
•Triage patients to subspecialty care resources (e.g. stoma nurse, oncology APN, MSW, financial counsellor, etc.)
•Advise and guide patients regarding estimated treatment costs and financial counselling.
•Develop and update patient education materials in collaboration with multidisciplinary team
2.Staff resource
•Advise and guide clinic staff regarding cancer treatments, procedures and estimated cost for financial counselling.
•Support multidisciplinary team members pertaining to patient care matters
C. Data management
•Obtain key clinical and operational data at checkpoints (transitional points along patient journey) and enter into cancer database in a timely manner
•Compile data (from care pathways) in NUH and NTFGH (collaborating with Cancer Survivorship Program Coordinator) and build database with annual audits
•Assist in simple data analytics and participate in quality improvement projects that aim to improve coordination of care and optimize outcomes for individual and services.
•Support relevant teams at NUH (VDO or Ops and Admin) in performing outcomes evaluation of care pathways for NTF.
D. Research
•Liaise with research assistants, residents and research fellows working on projects related to Breast cancer.
E. Institutional support and flexibility (20%)
•Undertake other responsibilities as assigned by reporting officer or department head
Provide flexible support for cross-team initiatives and evolving institutional priorities
Requirements
Good Class Honours Bachelor’s degree preferably in Degree in Nursing or Allied Health relevant to the job. Required Competencies and Capabilities (Skills, Experiences and Professional Licences)
• Essential to have excellent interpersonal and communication skills
• Good command of English (spoken and written)
• Additional languages spoken is highly regarded
• Mature and pleasant personality
• Possess drive and initiative, with a can-do attitude
• Ability to work independently and well under pressure
• Collaborative and can work well in a team
• Efficient time management, able to prioritize, multi-task and be flexible
• Computer proficiency is essential – M365 (Microsoft Word, Excel, PowerPoint, Teams, Outlook)
• Proficiency in data base management and use of database tools e.g. Redcap, and EPIC EMR system, is highly regarded.