Within the context of a team-based model of care and in collaboration with the Primary Care Provider (Family Physician or Nurse Practitioner) and other members of the PCN Interdisciplinary team, the Primary Care Social Worker assesses, plans, implements and evaluates social work care for patients/clients and caregiver(s). Develops and maintains partnerships with the Primary Care Provider in accordance with the local PCN care delivery model as co-designed by the PCN Partners (local Division of Family Practice, VCH Community of Care and First Nations Partners).The Social Worker cares for patients/clients and caregiver(s), who are experiencing health and/or social challenges. Provides direct care activities such as bio-psycho-social-spiritual assessments, short term counselling and related behavioural health supports, establishing therapeutic relationships and coordinating individualized goal-oriented treatment. In collaboration with the patient/client, the Social Worker provides continuity of care by liaising with team members, coordinating ongoing care, supporting transitions and navigating services. Practices in accordance with the established standards of professional practice as outlined by British Columbia College of Social Workers as well as within VCH vision and values, policies, standards, and decision support tools. Primary Care Networks (PCN) will be the backbone of the provincial Primary Health-Care Strategy. This new model of care is enabled and managed locally through a partnership between Health Authorities, Divisions of Family Practice and First Nations communities. PCNs include multi-disciplinary teams of nurses, pharmacists and allied health professionals, working alongside and supporting family physicians, nurse practitioners at primary care offices, Primary Care Community Health Centres, Urgent and Primary Care centres, and services delivered by not-for-profit community health partners. PCNs are expected to provide patients and primary care providers with strong, effective links to hospitals and diagnostic service providers. Team members involved in the patient’s care will work closely together, so that they can get a full picture of the health care needs. Under the new structure, patients will be able to more quickly and easily access a full range of health care options, have the ability to have a regular family physician or nurse practitioner and access to more health team members. Adopting team based care approach in Primary Care Networks aims to increase patients' access to primary care services, strengthen the ability of existing physicians to expand - or remain in - their practice, and broaden the set of specific skills and expertise available to patients as they are receiving care. And it will ensure that the systems and tools required to make that care function are in place, and are well supported in the patient’s journey to better health.
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Job Type
Full-time
Career Level
Mid Level