Position Description
Date:
January 2013
Title:
Service Coordinator/Kaitautoko
Responsible to:
Branch Manager Te Whiringa Ora
Staff Reports:
Branch Manager Te Whiringa Ora
Business Unit:
Te Whiringa Ora, Eastern Bay of Plenty
Functional Relationships
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General practices’ staff
Secondary health services
Primary Health Organisation
Primary Health Organisation Chronic Care
Outreach nurse
District Nursing Services
Public health nurses
Whakatane and Tauranga Healthcare New
Zealand
Maori health, providers and local iwi
Allied clinical community providers (eg.
dietician, podiatrist, physiotherapist,
psychologist, pharmacist, exercise advisor)
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Social care services
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Voluntary services including conditionspecific patient support groups
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Housing services
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Other relevant community agencies
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Other relevant health professionals
ORGANISATIONAL:
Healthcare of New Zealand Ltd (Healthcare), established in 1988, is the largest provider of communitybased health and disability support services in New Zealand.
Healthcare services range from specialist nursing, home support services, rehabilitation services,
through to a range of clinical and residential services for people with intellectual and physical
disabilities. See our website www.healthcarenz.co.nz for more information.
With a staff of approximately 6000, Healthcare provides Health and Disability Support Services to over
17,000 people daily, in 38 locations from Auckland to Invercargill. Head Office is in Wellington.
PURPOSE OF THE POSITION:
To provide confidential support to people with long-term conditions looking to improve their health by
encouraging and supporting people to lead a healthier lifestyle, providing relevant health information
and helping people access the right local health services (community based, primary or secondary
care).
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The person will be responsible for:
1. coordinating access to resources that will support self-management for clients affected by or at
risk of long-term conditions;
2. monitoring the progress of clients in achieving their goals;
3. assessing potential barriers to clients making healthy lifestyle choices and have the knowledge
of, and access to, appropriate resources that will resolve these barriers.
PRINCIPAL ACCOUNTABILITIES
The Kaitautoko will be responsible for the key result areas of their job area and is required to meet
these as part of their ongoing performance.
Key Result Areas:
1. Key Result Area – Establish and maintain excellent client communication
Tasks/Accountabilities
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Be an active listener to ascertain potential access
barriers and need areas.
Provide written communication in the form of progress
notes, reports and goal/ achievement plans.
Have an understanding of tikanga Maori and Whanau
Ora frameworks and the ability to communicate in ways
acceptable to Maori.
Provide and receive routine information with tact.
Key Performance Indicators
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Client records are accurate
and up to date.
Client satisfaction reflected in
survey results.
No Client complaints.
2. Key Result Area – Build and Maintain Strong Community Networks
Tasks/Accountabilities
Key Performance Indicators
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Establish strong working links with community health
providers to work in partnership.
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Relationships with other
relevant agencies are positive.
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Develop new relationships and opportunities with other
organisations, primary health and community providers
in relation to improving the health and wellbeing of the
clients.
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Relationships reflect the
stakeholder engagement plan.
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No Client/ Stakeholder
complaints.
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Develop and maintain relationships and networks with
community groups in areas of high needs.
3. Key Result Area – Provide client centred self management support, coordination and
navigation.
Tasks/Accountabilities
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Use a completed Flinders assessment tool, to work
Key Performance Indicators
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Client satisfaction/ quality of
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with clients/whanau to identify their health and
development needs and what barriers prevent them
from accessing or making healthy choices.
life improvements reflected in
survey and questionnaire
results.
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Facilitate the use of Telemed technology to collect
clinical measurement data and facilitate questionnaire
delivery.
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Care plans completed and
goals met within agreed
timeframes.
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Support and motivate clients/whanau to learn how to
make better health choices and support them in
initiating and sustaining appropriate behavioural
changes.
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Adhere to Telemed policies
and procedures manual.
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Apply learning’s from the Te
Whiringa Ora training
programme.
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Help clients/whanau identify and use the right health
services.
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Visit clients to offer health information.
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Connect clients with general practice teams and other
health/social service providers.
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Advise clients of their health care rights and
responsibilities.
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Assist clients in navigating their way through the health
system.
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Work to ensure health delivery is a client focussed
multidisciplinary approach to care that is culturally safe.
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Develop, review and implement lifestyle improvement
programmes for clients or groups of clients which are
appropriate to their goals, needs and values.
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Establish effective working relationships with clients,
their families, Whanau and carers. This will include
promoting individual rights and recognizing and
respecting their contributions to care planning and
delivery.
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Ensure services are offered and provided to meet the
needs of the individual including support to their
Whanau.
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Co-ordinate timely and effective multi-disciplinary and
multi-agency services, appropriate for client needs.
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Notify Case Managers regarding clients who may
require specialist oversight.
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4.
Key Result Area – Contribution to personal and team development.
Tasks/Accountabilities
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Develop own knowledge and skills with assistance of
Case Managers through identification of individual
learning needs, development of competencies to
ensure best practice in the direct management of
clients, in order to function as an effective motivator of
groups and clients, and a coordinator of support for
self-management.
Support others in their learning and development,
related to the concepts of self-management support
and how this fits within the wider chronic care
management framework.
Provide and receive peer support and mentoring
through shared education opportunities with allied
health professionals.
Key Performance Indicators
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Case Manager feedback.
Coaching notes.
Completed training plans.
Key Result Area – Accurate and Timely Administration and Documentation.
Tasks/Accountabilities
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Maintain accurate client records as required.
Supply necessary information to service providers as
indicated by client needs.
Initiate, learn and use new systems when required for
continuous service improvement.
Provide relevant reports and other documentation to
management, as may be required from time to time in
respect of the Kaitautoko’s area of responsibility.
All communications with Service providers and clients
including home visits, phone calls, meetings and
reviews are documented accurately in the client
management system.
All appointments for clients are rostered accurately and
in a timely manner.
Maintain accurate motor vehicle records and financial
records.
Key Performance Indicators
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Client
records
including
rosters and progress notes are
updated accurately and within
expected timeframes.
All reportable events
documented and reported to
branch within required time
frame.
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6.
Key Result Area – Enhanced service development.
Tasks/Accountabilities
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Work collaboratively with the community and other
relevant sectors to maintain an active database of local
resources that are available to support client selfmanagement.
Ensure the service is integrated into other services,
provided for clients with chronic disease.
Contribute to the audit of the service in relation to user
expectations, appropriateness and effectiveness of the
service and continuous improvement.
Key Performance Indicators
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Relationships with other
relevant agencies are
collaborative and positive.
Client and provider
satisfaction.
Core Competencies
LEADERSHIP COMPETENCIES
TEAM CENTRED
Team Development: Ability to work with others to achieve goals.
Relationship Development: Ability to build and sustain effective relationships both internally and
externally.
Communication: Ability to clearly convey thoughts; listens and understands others.
Cultural Appropriateness: Ability to provide culturally appropriate support; to identify / access the
appropriate community and health resources.
RESULTS DRIVEN
Self-Management: Ability to set standards for self; be self-directed and self motivated.
Fiscal Responsibility: Ability to make sound decisions related to expenditure; be accountable for
results.
Health and Safety: Ability to work responsibly under the Health & Safety Employment Act 1992.
QUALITY FOCUSSED
Analytical Thinking and Problem Solving: Ability to identify problems; systematically use information
to determine solutions and reach decisions.
Continuous Improvement: Ability to generate and implement innovative improvements to the
business.
Learning and Adaptability: Ability to adapt to change; develop competencies for current and future job
needs.
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OPERATIONAL COMPETENCIES
ADMINISTERING
 Record Keeping: Ability to maintain accurate and timely records that comply with legislation,
contract and company procedures.
 Data Entry: Ability to accurately enter data into required software.
 Computer Literacy: Ability to use computers to meet requirements of the job.
MANAGING RESOURCES
 Risk Management: Ability to identify and manage risk.
 Knowledge / Information Management: Ability to safeguard key information and systems; to
capture knowledge that will contribute to company growth.
 Project Management: Ability to manage projects and achieve objectives.
 Needs Assessment and Service Co-ordination: Ability to co-ordinate quality service delivery,
assess need and establish priorities.
 Legal Compliance: Ability to comply with relevant regulations and standards.
PROFESSIONAL
 Technical Competence: Ability to apply knowledge and understanding in area of specialty in
accordance with established standards, rules, regulations and a code of ethics.
CARING FOR OTHERS
 Behavioural Management: Ability to support a client with challenging behaviour to protect the
client, themselves and others.
 Planning and Service Delivery: Ability to utilise client care and lifestyle plans appropriately.
 Clinical Observation: Ability to provide information about the client’s situation through observation,
reporting and recording.
 Emergency Responsiveness: Ability to deal with emergency situations promptly and effectively.
QUALIFICATIONS / EXPERIENCE REQUIRED
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Extensive health/ community/ social work experience.
Diploma / Level 4 certificate in health, social service or other related area.
Health promotion experience preferable.
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