Social workers play a critical role in hospital settings by helping patients and families address the impact of illness and treatment. Tremendous stress often stems from hospitalizations that are sudden and, at times, related to catastrophic illness or injury. Stressors such as decreased personal control, information overload, change in functional ability and reduced financial resources, can lead to a range of emotional responses such as, anxiety, anger, and depression. Social workers, as part of the health care team, provide assessment and appropriate interventions to aid the patient in achieving optimum recovery/rehabilitation and quality of life. This includes maximizing the benefit the patient and family receive from their medical treatments and transitioning to risk-reduced, timely discharge. Social workers often have specific expertise in areas such as general medicine, emergency work, pediatrics, geriatrics, oncology, neurology, psychiatry, and palliative and end-of-life care.
Assess the biopsychosocial and ethnocultural needs of the patient, family and support system. ? Assess community and other large system factors impacting on patient health and treatment. ? Provide psychosocial interventions that facilitate patient and family adaptation and well-being. ? Facilitate family and team communication. ? Advocate for required services and navigate complex social systems. ? Provide crisis intervention and mediate conflict. ? Locate and negotiate potential resources. ? Educate patients and families on effective ways to mobilize existing resources. ? Develop and implement appropriate discharge plans
Social workers in health care commonly provide individual, couple, group and family counselling, crisis intervention, patient/family education, resource referral and advocacy, in inpatient and outpatient settings. Because social workers can provide both psychosocial care and other services to the patient and family, duplication of services is reduced. A mutually developed care plan for each patient/family is based on skillful psychosocial assessment. Consultation with medical and allied health professionals is implicit in developing and implementing treatment plans. Social work services can include all or some of the following:
Psychosocial Assessment: screen for high-risk; determine need/eligibility for services; identify strengths/coping capacities; assess informal network of support.
Counselling/Psychotherapy: assess role of emotional and social/cultural factors on health status and behaviour and provide appropriate intervention; enhance coping capacities related to feelings of loss, grief and role changes; assess and intervene related to mental health concerns such as anxiety, depression, anger management.
Patient/Family Education: educate patients and families to facilitate understanding of hospital processes; increase understanding of illness/disability on relationships; and facilitate life transitions when health conditions require a modified lifestyle.
Resource Counselling and Discharge Planning: identify and address barriers to discharge; locate resources; identify options and available supports; facilitate referrals and applications to government/community agencies; advocate for access to resources; coordinate referrals and/or placement plans; assist patient and family to emotionally prepare for transitions; prevent readmissions for non-medical reasons.
Supportive Care to Outpatients: assist outpatients to identify and receive appropriate resources and supports, thus enabling increased compliance with treatment and preventing crisis or unnecessary hospital admission. Consultation: provide expertise/serve as a resource to interdisciplinary teams.
When the patient has experienced significant loss or changes in abilities that will require individual and family adjustments, such as life-threatening diagnosis; changes in functional abilities, including intellectual competency; uncertain diagnoses. ? When there are concerns about a patient’s or family’s ability to adapt to health changes, such as: expressions of emotional distress/trauma; anger; or abuse/neglect or safety concerns. ? When there are concerns a patient or family does not have adequate resources, knowledge of formal sources of support to manage or ability to negotiate complex community systems to have adequate care at home. ? When there are concerns about the patient or family’s capacity to manage their own health care in the long-term, such as difficulties in goal-setting, problem-solving, negotiating support and future care planning.
Social workers have training in human behaviour, group process, teamwork, communication, negotiation and research. These skills can help further the broader goals of health care organizations through the participation of social workers in:
Risk Management: ensure effective communication, through psychosocial assessment and follow-up, with the patient and family to address potential conflicts/complaints or in response to a concern to reduce dissatisfaction and/or litigation.
Program Development: provide leadership and participation in program planning and evaluation within diagnostic or unit-specific teams, programs and corporate initiatives.
Community Linkages: chair or participate in hospital and community committees or boards.
Research: generate discipline-specific or interdisciplinary psychosocial research initiatives addressing psychosocial dimensions of illness and outcomes of interventions.
Teaching/Education: initiate and participate in teaching activities by presenting at workshops, inservices, rounds or conferences; provide training to health care colleagues, students and staff in community agencies; and offer education to patients and families