Creating Roles for Social Work in Changing Health Care Organizations

SUMMARY

Social work has historically been influenced by and influential in periods of social change. The current health care environment poses challenges to the profession whose function is to maximize adaptation. In addition to helping patients and families adapt to a rapidly changing health delivery system, social workers can develop roles that affect the direction and impact of organizational change, substantively if not fundamentally. This includes assisting staff to work professionally and maintain client-focus during organizational stress and chaos. This article develops one example of how social work expanded its role during a time of transition through staff education of another discipline at Mount Sinai Medical Center in New York City, USA. The authors conceptualize the need for such practice, describe and analyze the program, and extrapolate practice principles for expanding social work roles in a changing work organization.     

The Writing Series Project: A Model for Supporting Social Work Clinicians in Health Settings to Disseminate Practice Knowledge

Social work clinicians across health care settings are uniquely positioned to disseminate valuable practice experience, thereby contributing to knowledge development within their field of practice and across disciplines. Unfortunately, practitioners tend to shy away from writing and research, and are often reluctant to publicly disseminate their expertise through peer-reviewed journals and conference presentations. To better support health social workers in scholarly endeavors, we developed and implemented The Writing Series Project in southeast Queensland, Australia. This article reports on the development, programmatic challenges and practitioner feedback that offer insight into the benefits and pitfalls that we encountered.     

Interprofessional Leadership Training in MCH Social Work

The need to train health social workers to practice interprofessionally is an essential goal of social work education. Although most health social workers have exposure to multidisciplinary practice within their field work, few social work education programs incorporate interprofessional learning as an integrated component of both course work and field experiences (McPherson, Headrick, & Moss, 2001; Reeves, Lewin, Espin, & Zwaranstein, 2010; Weinstein, Whittington, & Leiba, 2003). In addition, little is written about the kinds of curricula that would effectively promote interdisciplinary training for social work students. These findings are particularly puzzling since there is increasing and compelling evidence that interdisciplinary training improves health outcomes (IOM, 2001). This article describes a social work education program that incorporates an Interprofessional education and leadership curriculum for Maternal and Child Health Social Work (MCHSW) at the University of Maryland's School of Social Work. The University of Maryland's Interprofesisonal Training Model is described along with the components needed to formulate an interdisciplinary learning experience. Various outcomes and lessons learned are discussed.     

Creating a professional development platform to transform social work clinical practice in health care

ABSTRACT

Since U.S. Congress’ 2010 passing of the Affordable Care Act and the creation of numerous care coordination programs, Mount Sinai Hospital’s Department of Social Work Services has experienced exponential growth. The Department is deeply committed to recruiting and developing the most talented social workers to best meet the needs of patients and family caregivers and to serve as integral, valued members of interdisciplinary care teams. Traditional learning methods are insufficient for a staff of hundreds, given the changes in health care and the complexity of the work. This necessitates the use of new training and education methods to maintain the quality of professional development. This article provides an overview of the Department’s strategy and creation of a professional development learning platform to transform clinical social work practice. It reviews various education models that utilize an e-learning management system and case studies using standardized patients. These models demonstrate innovative learning approaches for both new and experienced social workers in health care. The platform’s successes and challenges and recommendations for future development and sustainability are outlined.     

Hospital Social Work in Australia: Emerging Trends or More of the Same?

Social work in health care has been established for more than 100 years and is one of the largest areas of practice for social workers. Over time, demographic changes and growth in the aging population, increased longevity rates, an explosion in rates of chronic illness together with rapidly increasing cost of health care have created serious challenges for acute hospitals and health social workers. This article reviews the Australian health care system and policies with particular emphasis on the public hospital system. It then examines current hospital social work roles, including the continued role in discharge planning and expanding responsibility for emerging client problems, such as patient complexity, legal, and carer issues. The article concludes with a discussion of evolving issues and challenges facing health social work to ensure that social work remain relevant within this practice context.     

African centered family healing: an alternative paradigm

African centered family healing posits an alternative paradigm that can be used as a model for family healing. Effective intervention begins with the recognition that what we have been doing has not been working for African American families (Boyd-Franklin, 1989; Kambon, 1998; Logan, Freeman and McRoy, 1990; Owusu-Bempah, 1999; and Weaver, 1992). Social work intervention efforts must integrate mental health constructs that exist in the communities we are attempting to serve. One such concept is communal knowledge. Another such concept is communal values. When one joins communal knowledge and values, one begins to restructure the understanding of mental health in the African American family. The family unit must be viewed as interdependent. This understanding is requisite to family healing. It is therefore necessary that we change our thinking and then our actions. This article posits that social workers must become social healers.     

Social Work in the Veterans Administration Hospital System: Impact of the Work

Social workers in the Veterans Administration (VA) hospital system are faced with numerous challenges to best address the ongoing health and mental health needs of those who serve in the military. Social workers in the VA system serve diverse roles on the multidisciplinary medical teams and mental health services and are integral to the VA hospital environment. Most social workers feel positive about their work and their contributions to the care of the military. Despite positive feelings about their work, social workers are also prone to compassion fatigue and burnout as the work, especially with returning veterans from Afghanistan/Iraq, often extracts a toll. This article details the experience of social workers in the VA hospital system; it describes the impact of the work on the social workers, noting levels of compassion satisfaction, compassion fatigue, and burnout.     

Social work in the veterans administration hospital system: impact of the work

Social workers in the Veterans Administration (VA) hospital system are faced with numerous challenges to best address the ongoing health and mental health needs of those who serve in the military. Social workers in the VA system serve diverse roles on the multidisciplinary medical teams and mental health services and are integral to the VA hospital environment. Most social workers feel positive about their work and their contributions to the care of the military. Despite positive feelings about their work, social workers are also prone to compassion fatigue and burnout as the work, especially with returning veterans from Afghanistan/Iraq, often extracts a toll. This article details the experience of social workers in the VA hospital system; it describes the impact of the work on the social workers, noting levels of compassion satisfaction, compassion fatigue, and burnout.     

A Descriptive Study of Social Work Practice in Mental Health

Although mental health has become the predominant area of social work practice, there is a lack of concrete information regarding what social workers actually provide and to whom. This situation becomes more critical as social work competes for clients and concentrates on improving the profession's image. The data used in this study were obtained from questionnaire responses from a sample of 139 participants. The results indicated that 28,043 individuals were seen in all areas of practice during 1983. This information was then used to background attempts for social workers to become an official voting member of the Mental Health Needs Council.     

Hospital Social Work Practice in Zimbabwe

This article examines hospital work practice in Zimbabwe based on a literature review. It argues that the country is emerging from a ten year economic and political crisis which has affected the lives of the majority of the population. The health and education sectors have been the hardest hit since teachers, doctors, nurses as well as social workers have left the country in large numbers. The article highlights the various roles played by social workers in hospitals in Zimbabwe and the challenges they face in their day to day work. Solutions to these challenges are also suggested.     

They tried reality therapy, but he froze in a cave: curriculum deficits

Social workers increasingly are called on to work with mentally ill people, but in most cases they are not trained to do so. There is a significant lag between what researchers have found, particularly in the biological fields, and what educators teach in social work schools. This article describes curriculum deficits in teaching about mental illness and the devastating consequences of those deficits. It then outlines a suggested curriculum and appropriate teaching methods. Social workers are called to take the lead in curriculum reform; when they do, students will follow.     

HIV/AIDS Prevention in New York City: Identifying Sociocultural Needs of the Community

This article is a call for those who design social work courses to recognize the complexity and richness of aged care social work in health care and to social workers to shake off ageist attitudes and consider working with older people as a positive option in this rapidly expanding area of social work practice. A mixture of practice experience together with findings from the literature, this article explores social work practice with older people in hospital settings. Social work with older people has both therapeutic and practical components. The importance of integrating a therapeutic approach into all aspects of social work practice with this population cannot be overestimated.     

Social work with older people in a hospital setting

This article is a call for those who design social work courses to recognize the complexity and richness of aged care social work in health care and to social workers to shake off ageist attitudes and consider working with older people as a positive option in this rapidly expanding area of social work practice. A mixture of practice experience together with findings from the literature, this article explores social work practice with older people in hospital settings. Social work with older people has both therapeutic and practical components. The importance of integrating a therapeutic approach into all aspects of social work practice with this population cannot be overestimated.     

A Social Work Perspective on Ethical Practice in End-Stage Renal Disease

Social workers increasingly are defining problems that they encounter in practice in health settings as ethical dilemmas. A distinction is made between those practice questions that can best be answered by an appeal to theoretical or empirical knowledge and expertise (clinical questions) and those with invoke values and ethical imperatives (ethical questions). End-stage renal disease poses in high relief the practice dilemmas that are encountered by social workers and offers an opportunity to explore and clarify issues resolving them. Using an exchange framework as a basis for analysis, common ethical problems of end-stage renal services are discussed.     

Privacy versus accountability: a health care dilemma

Social work practitioners are obligated both to document their services to clients and to protect information about their clients from unwarranted access and use. In the current environment of social work practice in the health care field, these obligations often conflict. This article describes and offers solutions to the dilemma of privacy versus accountability. If social workers maximize the protection offered by the four principles of privacy: confidentiality, anonymity, client access, and abridgment , they can safeguard personal information while still meeting accountability standards.     

Mental health recovery paradigm: implications for social work

Social workers have long been involved in developing, administering, and providing services for people with psychiatric disabilities. Critics of the system, including social workers and mental health consumer-survivor practitioners, have noted that the medical model has been a driving force in policy and services provision. This model is detrimental to consumers' self-efficacy and sense of hope and conflicts with a number of central social work values. The article argues that the values and beliefs of the consumer-survivor recovery movement are closely aligned with those of the profession, and that the movement offers social workers a more promising perspective from which to practice. The primary concepts and values of the evolving recovery paradigm are delineated, and implications for direct practice, administration, policy making, education, and research are discussed.     

Applying a theory of expertise in health social work administration and practice in Australia

Social workers in health care have been urged to identify the nature of their expertise and to articulate profession specific roles (Peckuconis et al., 2003). This paper reports on the use of a theory of professional expertise (Fook, Ryan, & Hawkins, 2000) in management and clinical practice within two Australian hospital social work settings. This theory, directly applicable to social work, was applied within these hospitals to differentiate levels in social work industrial awards, in staff selection, in supervision and continuing professional development. Specific and broader implications for application of this theory are discussed.     

Thriving in today’s health care environment: strategies for social work leadership in population health

The current healthcare environment challenges social workers to balance multiple constituencies – organizational, payer-related, and professional – and convey the value-added nature of clinical work with patients and families. As healthcare systems move towards population health, leadership opportunities abound. This article provides an historical overview of healthcare transformation and its impact on social work practice, and describes strategies implemented to bolster the clinical focus and organizational responsiveness of Mount Sinai Health System care management staff. The training and supervisory approaches offered make possible relatable and synergistic connections between clinical practice and organizational imperatives to decrease unnecessary utilization and healthcare costs.     

The International Exchange Program

Summary

This commentary presents personal reflections on the Social Work Leadership Enhancement Program in the Department of Social Work Services at the Mount Sinai Medical Center in New York. The value of the program, not only for the participants from other countries, but also the value of the exposure of social workers from other countries to the department staff is recognized. The international influence is unequalled. How if affects and nurtures global social work thinking, its impact on those taking part in the program, as well as the ever-expanding influence of the program on a growing network of social workers is noted.     

Learning from Each Other

Summary

Australian social workers in health care have become important members of hospital disaster response teams. The development of the role and its integration into the mainstream disaster response has progressed over the last two decades. Recent international events have given affirmation to the importance of this role.

The development of national and state based disaster management plans in Australia began in the mid 1970s. Recognition of the need for experienced, skilled workers to provide emotional support, practical assistance and grief and bereavement counselling has resulted in the inclusion of social workers in several key parts of the disaster management response including the specialised area of disaster victim identification.

Following the Bali Bombing in October 2002, social workers worked with the police missing persons unit to provide support to families and facilitate the collection of ante mortem information.

The process by which new services come about can be intricate and complex. In the field of health social work, the contribution of international programs such as the Mt. Sinai Leadership Enhancement Program cannot be underestimated. As the Social Work Director of Westmead Hospital, one of the largest hospital social work departments in the country, participating in this program provided opportunities to share professional experience with international colleagues, many of whom are experts in their field.

The social work role in disaster response has become internationally recognised and is an example of how collaboration and shared information and learning can result in a profession working together to support key principles and values of practice for the benefit of those in need.