1. Woods, Anitra RN, ALNC, BSN

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Should you choose to become a nurse liaison, you'll act as an advocate for the patient and his family. Others will rely on you to keep the lines of communication open between healthcare providers and patients and their families. You'll also be considered a troubleshooter, with the goal of making things run smoothly.

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As a nurse liaison, you may practice in settings such as hospice, acute care, rehabilitation, and long-term acute care (LTAC). In this article, I'll focus on the role of a nurse liaison in the LTAC setting because that's where I work. (See What's a long-term acute care hospital?)


A nurse liaison in a LTAC facility can assist staff members as well as patients and families. If you choose to become a nurse liaison in the LTAC setting, your roles and responsibilities will include assessing and reviewing medical records to determine if patients meet criteria for admission, assisting patients and families through the admission process, communicating with case managers and physicians, managing insurance precertification, providing marketing to healthcare providers, and maintaining relationships.


In the LTAC setting, you'll be expected to review medical records and assess them to determine if patients meet the criteria for a LTAC admission according to Medicare guidelines, when the patient is covered by Medicare. Once you determine that the patient meets the criteria for admission, you'll let the case manager or the physician know that the patient can be admitted to the LTAC hospital.


Smoothing admissions

You'll also be responsible for securing a physician for the patient. When the patient's attending physician doesn't have privileges at your facility or chooses to be only a consulting physician, you'll have to approach another physician to admit the patient. As you become more familiar with the physicians, this task will become easier. To help you with this duty, most likely you'll keep the physicians' privilege list updated.


Secondly, you'll be expected to assist the patient and his family through the admission process. You'll explain the care and services that your facility will provide to the patient as well as the length of time he can stay in the LTAC hospital. As the nurse liaison, you'll answer questions and address concerns of the patient and his family.


Thirdly, the nurse liaison must maintain regular communication with internal and external case managers or physicians. You might communicate internally with a case manager or physician about a patient who has already been admitted to the facility. External communication would include any case manager or physician outside of the LTAC hospital, including the host hospital (the hospital the patient is coming from).


In some cases, you may be required to complete the precertification process for any patient with commercial insurance or some Medicare replacement plans. The precertification process will include calling the patient's insurance company before admission and verifying his benefits and coverage. If the patient has a benefit for LTAC, then you'll be asked to send clinical information to the insurance company. Often you'll get a response from the insurance company in 24 to 48 hours. If you don't complete this process, your facility could be denied payment.


Handling special issues

Should difficult issues arise after the patient has been admitted, you may be asked to step in and open the lines of communication between the family and the physicians and nurses. For example, you may need to get involved when family members can't come to an agreement about the patient's advance directive for healthcare, including what to do if his pulse and respirations cease.


In this case, you'd approach the family, letting them voice their concerns, and then provide better insight to the healthcare providers involved, including physicians and nurses.


Tooting your horn

Finally, marketing is a common responsibility for the nurse liaison because you're expected to develop and maintain relationships. Marketing includes going outside of your facility to make contact with any healthcare providers who may benefit from your hospital's services. These contacts include nurses, physicians, case managers, and social workers. To market to these healthcare professionals, you must be very familiar with your facility's services. For instance, if you work at a LTAC hospital, you'd want to explain to the healthcare provider the services your facility can provide, such as ventilator weaning, wound care, and long-term I.V. antibiotics, as well as other services.


You can use one of several ways to relay this information to healthcare providers. Most often, you'd present a staff-development program or an informal talk, perhaps over lunch for the providers and staff.


As a nurse liaison, remember that what's best for the patient should prevail over any other issues. After the patient's concerns are addressed, you should focus on developing and maintaining relationships with the healthcare providers.


For example, when conflict arises between a nurse and a patient or his family members, then it's your duty to step in and resolve the issue as quickly as possible. Any issues should be addressed immediately to help the parties involved mend their relationship and rapport.


As a nurse liaison, you'll learn that at times issues may not be easily resolved. When faced with this situation, you can tap others, such as a director or administrator, as a resource for other ideas.


Making a difference

At times your roles and responsibilities may seem overwhelming, but you'll feel rewarded when you resolve problems effectively. Because people depend on you, you must be reliable in carrying out your duties. Building and maintaining relationships will take time, but the benefits will greatly outweigh the risks. You'll not only increase patient satisfaction, but you'll help to maintain rapport among healthcare providers. And at the end of the day, you'll know you made a difference to your patients in your role as a nurse liaison.


What's a long-term acute care hospital?

A LTAC hospital may be located within a hospital or it may be freestanding. Its patients have chronic conditions requiring specialized intensive care. Patients are acutely ill and medically complex. On average, they need care for at least 25 days. Patients may be dependent on a ventilator, need wound care or I.V. therapy, or have multisystem problems. They need more intensive care than that provided in a long-term-care facility, but they don't need all of the services provided at a typical hospital. The patients at a LTAC hospital are expected to recover and go home.



Acute Long Term Hospital Association.