Our people in profile: Hospital-based care coordinator works with her team ‘behind-the-scenes’ to help clients return home sooner

Coleen Lewis, hospital-based care coordinator at the Halifax Infirmary site of the QEII Health Science Centre
Coleen Lewis, hospital-based care coordinator at the Halifax Infirmary site of the QEII Health Science Centre (contributed)

When people are hospitalized, we know that most want to return home as soon as possible. 

“My goal is to make that happen,” said Coleen Lewis, hospital-based care coordinator at the Halifax Infirmary site of the QEII Health Science Centre. 

With over twenty years of care coordination experience at different sites across the province, Lewis shares the behind-the-scenes workings of hospital based-care coordination. 

Even though Lewis works in the hospital, her job is coordinating the care and supporting clients that have the potential to return home with continuing care services.

Continuing care services allow people to receive care where they live, effectively improving quality of life and establishing a greater sense of fulfillment through meaningful relationships between care providers and their clients. 

“On my unit at the Halifax Infirmary our team is made up of a care coordinator, social worker, occupational therapist, physiotherapist, dietician, pharmacist and the physicians and nurses. I depend greatly on my team,” Lewis explained. 

“For example, the physiotherapist and the occupational therapist may say that the client needs special equipment to go home safely or therapy at home. From equipment, nursing services, home support services—I make sure all these things are in place.” 

Lewis also stresses the important role family members have helping getting clients back home.  

“As a care coordinator we do a lot of behind-the-scenes work—talking with the family, the client and the team on the unit to determine what the needs, the services and the level of support they need to return home and if we can meet those needs.” 

“Family is a big part of the client’s life. I help guide families and clients, and together we come up with a plan,” said Lewis. 

As a care coordinator you are always reviewing the plan, looking at what new supports are available, monitoring and coordinating the plan and evaluating the client’s progress. 

Good care coordination takes time as well as a team effort. 

“We all support each other. No matter where in the province we work. We share knowledge of the programs and services that we provide, the criteria around them and information about the agencies and how to connect with them.”

Support from your team is key she said. 

“The continuing care program is huge and having all those working parts in the background is what makes it work. I couldn’t function alone in the hospital setting. We have an excellent teams. There’s no stopping us.”