Behavioral Health Access & Assessment Nurse

As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women's Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.

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Mass General Brigham (MGB) Behavioral & Mental Health (BMH) is the enterprise clinical service supporting the design of MGB's behavioral and mental health care around patients' needs; delivering high quality, evidence, and team-based, compassionate care to MGB patients, employees, and their families, while increasing access, improving health equity, optimizing systemwide assets and advancing new and innovative approaches to care. The MGB BMH team supports and collaborates with all Psychiatry Departments & services across the MGB network.

In October 2022, MGB BMH launched a Central Access Team to address the behavioral health capacity crisis across the hospital system. This team shifted the administrative burden of bed-finding from the frontline clinical teams to a central team, which has supported more focused patient care, a reduction in duplicative work and better overall experience for patients and providers. This effort has supported reopening of behavioral health inpatient beds, reduction in boarding times, and a 10% increase in inpatient behavioral health census across MGB. A goal of the next phase of this effort is a greater focus on the specific behavioral and medical needs of each patient to ensure that each is placed in the setting that will most appropriately meet their needs as efficiently as possible, whether at the time of admission or at the time of discharge. Beyond these specific patient needs, additional focus is on assessment and recommendations pertaining to current and future resourcing on inpatient behavioral health units across MGB; ensuring that the resources available within MGB are meeting the needs of the patients being served.

Reporting directly to the MGB BMH Medical Director for Acute Care Services with an indirect reporting relationship to the MGB BMH Vice President of Nursing and, on a daily basis, working in very close collaboration with the MGB BMH Central Access Manager. The MGB BMH Access & Disposition Nurse plays a critical role serving as a clinical expert on the behavioral and medical needs of complex behavioral health patients within several different contexts:

* Admissions: The Nurse serves as a key member of the BMH Central Access Team using knowledge of inpatient medical competencies and medical clearance criteria to support early identification of placement barriers while helping to provide clarity around a patient's needs and the most appropriate treatment setting in which to meet them. The Nurse works closely with sending and receiving clinicians to identify and recommend resources that may be necessary to secure timely care for behavioral health patients. This individual will play a key role in advancing the work to update unit capabilities and competencies and will track and communicate, on a regular basis, trends in barriers to admission. In addition, this individual will work with the team to track and communicate trends in external referrals as well.

* Discharge: The MGB BMH Central Access & Disposition Nurse works closely with behavioral health leaders systemwide to support the complex disposition planning for patients in behavioral health units, using knowledge of post-acute medical competencies and complex patient resource needs to proactively identify patients at risk of prolonged admission, specifically identifying barriers to discharge and resource needs. The Access and Disposition Nurse works closely with clinical leadership across MGB inpatient behavioral health units, emergency departments and medical/surgical settings to support behavioral health throughput systemwide.

* Acuity and Resource Need Identification and Assessment: Spanning both contexts above, the MGB BMH Central Access & Disposition Nurse plays a key role in developing a new tool within the medical record to help quantify patient behavioral and medical acuity and resource need to better report both patient needs, inpatient unit acuity and nursing workload status. This initiative will involve high levels of clinical expertise in the area of psychiatric mental health nursing, data analysis, stakeholder engagement and systemwide collaboration.

A demonstrated commitment to access to care, operational efficiency, and implementation of technology and innovation are key tenets of this new role. Success in the role will be dependent upon an interest in and ability to lead in a remote, data-driven, technology-enabled environment. This individual plays a key role in the refinement of data analytics to assess unit and patient acuity. A strong interest and competency in data analytics and clinical implementation experience within a matrixed environment is strongly preferred. It is critical that the MGB BMH Central Access & Disposition Nurse have a 'system mindset' and a strong ability to build and maintain multidisciplinary and cross-site relationships within an integrated healthcare system. They will coordinate closely and collaborate openly with multidisciplinary and institutionally diverse teams including MGB BMH employees, as well as physicians, nurses, and capacity leaders for each MGB asset. They will have knowledge of service capabilities at all MGB hospitals and other assets, and a dedicated approach that matches patient need to site of care in the most timely and efficient manner possible. Experience and comfort with change management and complex capacity and demand constraints will be crucial for success in this role. The MGB BMH Central Access & Disposition Nurse will be a valued member of the Behavioral & Mental Health team and their input, feedback, and recommendations will be regularly sought by leadership to further strengthen our system-based capacity management and achieve our collective goals to improve patient care.

This position is a hybrid position. It is anticipated that some on-site time at system hospitals will be required. In-person MGB BMH meetings will generally be held at Assembly Row in Somerville and some meetings will be held at other sites across the MGB system.

Responsibilities:

Inpatient Behavioral Health Services - This position spans our centralized and coordinated work around inpatient admissions and dispositions to other levels of care throughout the system.

* Provides expertise around the behavioral and medical needs of behavioral health patients, clearly identifying and communicating placement barriers and assessing most appropriate treatment setting based on inpatient competencies and the resources necessary to meet patient needs.

* Provides thought partnership related to behavioral health access and disposition, supporting efficient behavioral health throughput system-wide, at the time of admission, throughout admission, and at the time of discharge.

* Works closely with MGB BMH leadership to deliver on an established cadence, the performance and efficiency metrics to track, analyze, and present data demonstrating progress, impact, and areas for improvement. This individual plays a key role in continuous process improvement and enhanced performance metric development.

* Provides leadership around change management efforts, maintaining positive relationships with all layers of stakeholders to ensure active engagement and broad commitment to system-focused culture.

* Works closely with clinical leaders systemwide regarding escalation when placement barriers or challenges arise or when a dispute exists between the site leadership and centralized bed placement recommendation.

* Works closely with BMH leadership team to regularly monitor, compile, analyze, prepare, and report out data and outcomes related to central access and central disposition planning.

* Prepares and presents updates, findings, reports, and recommendations to internal and external stakeholders/leaders as needed for assigned projects.

* Serves as a liaison to the behavioral health inpatient and admissions nursing leaders across the system

System Collaboration

* Works closely with Clinical Leaders across the system to foster effective change management in the midst of systemwide integration, development and consultation regarding new inpatient behavioral health admissions workflows, data reporting requirements to enhance access across the system

* Establishes contacts and strong working relationships with clinical and administrative leaders across system entities and throughout the MGB BMH team to support program development and implementation activities.

* Manages projects as assigned by MGB BMH leadership.

* Performs other duties as assigned.

Qualifications:

1. Graduate of an accredited school of nursing, BSN required. Master's degree preferred. Current license to practice as a registered nurse in the State of Massachusetts, is required.

2. 10+ years inpatient psychiatry unit and/or emergency department experience required. 5-year Nurse leader experience required such as: flow coordinator, access nurse, bed control, supervisor in a psychiatric setting, inpatient behavioral health charge nurse or clinical coordinator. Continually updates clinical knowledge and skills through formal and informal education and review of the current literature.

3. Inpatient behavioral health assessment and service coordination experience required

4. Must work well independently and have sound decision making skills.

5. Decisions are made independently from the direct guidance and supervision of a physician.

6. Must have 1-2 years project management experience.

7. Team management experience, in a matrixed organization, preferred.

Skills/Abilities/Competencies:

1. Experience within Behavioral Health and inpatient admissions processes.

2. Strong time management and organizational skills, with an attention to detail, ability to work independently, manage multiple tasks and projects, meet deadlines, and manage schedule.

3. Interest in hospital-wide and other asset-based capacity challenges and understanding of downstream effects of patient flow on the whole system.

4. Self-motivated with high degree of initiative.

5. Interpersonal skills to interact effectively with intra-inter and outside hospital personnel.

6. Ability to manage critical issues relating to patient care and changing organization climate.

7. Data analytics skills; experience and commitment to operating within a highly transparent and visible data-driven decision-making environment.

8. Comfort and experience with working remotely; experience managing remote teams preferred.

9. Ability to document and communicate the status of progress against plans, taking corrective action as necessary.

10. Intermediate proficiency in Microsoft Excel, Word, Teams, and PowerPoint.

11. Commitment to use of technology and data platforms to drive workflows and performance measures; experience and/or willingness and interest to learn Tableau and other related data tracking software and platforms.

12. Demonstrated ability to develop effective relationships and trust with a broad array of people (different levels of management and clinical experts).

13. Demonstrated ability to use logic and a mixture of analysis, experience, and judgement to make sound decisions when faced with problems/barriers to moving projects forward.

14. Ability to remain calm under pressure and problem-solve both in real-time and in hindsight while representing MGB and BMH with the utmost professionalism and respect.

Working Conditions:

* Hybrid with some on-site work at Assembly Row campus and as well as local travel between Mass General Brigham sites.

* Provide rotating after-hours on-call coverage as needed; approximately one week monthly.

Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.