Discharge planning and social work practice

Current health care practice discharge planning has emerged as a major professional function in hospital settings. To examine the tasks involved in discharge planning and how frequently they are being performed, 124 Alabama hospitals were contacted with a 72% rcsponse rate. Of the 178 surveys returned by discharge planners the core tasks were identified and ranked in terms of performance frequency. The results revealed that the tasks performed typically resembled that of generalist social workers. When specialization occurred, it was related to the populations served and not the specialized tasks or methods utilized. From this data recommendations are made for linking advanced generalist social work practice to discharge planning activities.     

The ecology of social work departments: empirical findings and strategy implications

Despite the fact that social work departments are dependent upon hospitals for resources and support, little research has been conducted to analyze organizational factors that promote or impede their development. The researchers hypothesized that departments are most likely to expand in hospital settings with missions that are supportive of clinical, preventive, and community-oriented services; that stress innovation; and that emphasize hospital-funded services and programs. Further, it was hypothesized that social work services would be most likely to expand in settings where hospital administrators perceive them to be relevant to practical needs of the institution. Findings from a survey of 50 non-profit hospitals in Los Angeles County in 1980 confirm these hypotheses and suggest that social workers need to use knowledge of the organizational context to develop high-level support for their departments.     

A longitudinal look at social work leadership in hospitals: the impact of a changing health care system

This article examines the responses of social work administrators to the changes occurring throughout their hospitals over three time periods in the 1990s; the major accomplishments of social work services in their facilities; and the failures, frustrations, and obstacles in the delivery of social work services. It compares the reports of social work director cohorts on the changes they experienced over an eight-year period with what they had expected in their settings. It also analyzes their perceptions over time of obstacles and opportunities for hospital social work administrators in response to these changes. The authors present the ways in which social work administrators understand and address the complexities they face.     

Hospital Work and Pregnancy Outcomes: A Study in the Danish National Birth Cohort

Abstract

In hospitals, women of reproductive age do a range of work tasks, some of which are known to carry potential risks. Tasks such as working with radiation, chemicals, and infectious agents, as well as performing heavy lifting or tasks requiring erratic sleep patterns have been reported to increase the risk of reproductive failures. Our aim was to study pregnancy outcomes in female hospital workers in Denmark. We performed a cohort study of 5976 female hospital workers and used as a reference group 60,890 women employed outside of hospitals. The reproductive health of hospital workers working during pregnancy is comparable to those of non-hospital workers for the majority of reproductive failures studied. However, an increased prevalence of congenital abnormalities was noted in some subgroups of hospital workers, which may indicate that some hospital work still entails fetotoxic hazards.     

论公立医院行政管理人员的绩效考评

公立医院行政管理人员绩效考评是对公立医院中行政管理人员的工作能力、工作成果和工作态度等多方面内容进行的综合评定。当前我国公立医院行政管理人员的绩效考评存在着缺乏对高层管理人员的绩效评估制度、忽视团队绩效等缺陷。我们应当在行政管理的各个环节中加大对市场化管理体制中合理因素的吸纳力度,建立高级管理人员的考评机制和团队绩效考评机制,完善我国的公立医院行政管理人员绩效考评体制。     

军队数字化医院建设与管理

医院数字化建设是现代化医院发展的必然趋势,军队医院必须首先根据实际情况明确数字医院建设目标和任务,制定基本架构,明确基本原则,充分利用医院信息资源,不断完善数字化系统,规范医院管理,提高医院整体运作效率和医疗市场行业竞争力,更好地赢得医院生存和发展空间。     

Hospital restructuring: positioning social work to manage change.

In the shifts to programmatic hospital organizations, social workers are having to learn to reframe their work, reorganize their thinking, and restructure their professional disciplines in order to survive. The experience is frequently one of frustration, anger, and impotence. Yet, social workers are masters of systems thinking in hospitals, and are well positioned to effect change. The beauty of shifting to a flattened hierarchy that is patient focused, is that it endorses change consistent with the social work mission in health. The challenge for social work is to grapple with the big issues: our belief in ourselves; defining our roles and functions and priorities; defining our vision in programmatic hospital organizations; being critical of what we do; and articulating what we have to offer. This paper identifies ways social workers can position themselves to effect positive change in hospitals undergoing restructuring.     

多元主体治理视角下医务人员工作积极性影响因素研究

目的从多元主体治理视角分析影响公立医院医务人员工作积极性的因素,为激发和调动医务人员工作主观能动性及潜能提供依据。方法采用定额抽样方法选取浙江省19家市、县级公立医院的1855名医务人员进行问卷调查,运用多重线性回归分析医务人员工作积极性的治理影响因素。结果政府对公立医院公益性的维护、对三医联动改革的领导协调、对综合改革措施的宣传解读、对培训方案的完善和对分级诊疗的引导政策影响医务人员工作积极性(P<0.05),医院内部收入分配制度、分工协作机制、战略目标、民主管理影响医务人员工作积极性(P<0.05),社会专业组织提供的高质量业务培训、对医疗事故鉴定的公平性、公共媒体及时报导医疗相关事件影响医务人员工作积极性(P<0.05),医务人员对所在医院形象及医疗行业环境的自我认知与态度影响其工作积极性(P<0.05)。结论政府治理职责履行、医院管理水平、社会治理职责履行和医务人员自身认知态度影响医务人员工作积极性,可从强化政府治理职责、加强医院科学管理、激活社会主体协同发力和重视医务人员思想工作建设4个方面调动医务人员工作积极性。     

Ethical dilemmas in general hospitals: social workers' contribution to ethical decision-making

Thirty-two hospital social workers, fourteen of them directors of social work services and eighteen direct practitioners, were interviewed about their perception of the factors influencing social workers' contribution to the resolution of ethical dilemmas in general hospitals in Israel. Findings revealed that while ethical decision-making in hospitals is an interdisciplinary process, social workers' contribution to the process is affected by rivalry between social workers and other members of the health team, personality differences, type of ward and the nature of the ethical dilemma. Participants of the study had quite a clear perception of their role and of the unique knowledge-base social work can offer, including knowledge of the individual and family life course, understanding and skills in coping with diseases, and systems thinking. In order to increase their influence in ethical decision-making, the hospital social workers felt they must put more effort into developing their relationships with the other professionals involved in ethical decision-making both by making themselves more indispensable and by making their contribution explicit through greater documentation of their activities. The findings also implied that in order to gain more power and be accepted as equal partners in multidisciplinary teams, hospital social workers should improve their communication skills when interacting with representatives of other heath care professions.     

从医院管理者角度谈如何做好医院建设

文章从医院管理者的角度对两所县级医院建设情况进行了介绍,分析和总结了院长作为医院主要管理者在医院建设中应发挥基本作用及影响。     

Ethical activism: strategies for empowering medical social workers

Little empirical research examines the extent medical social workers try to change attitudes, norms, expectations, and protocols to create a hospital environment that encourages their participation in ethical deliberations. The researchers developed an ethical activism scale that measured the extent medical social workers engaged in such ethical activism, confirming its reliability from data obtained from a sample of 162 medical social workers in 37 hospitals in the Los Angeles basin. They tested seven hypotheses that probed the extent specific ethics-training, organizational, and demographic variables influence the extent social workers engage in ethical activism. Data strongly suggest the need to expand ethics training to include tactics of ethical activism, since many social workers do not engage in ethical activism. Data also suggest the need to target such training to social workers in hospitals that are relatively unreceptive to social workers' participation in ethical deliberations, since social workers are least likely to engage in ethical activism in such settings.     

Preparing for increased union organizing. A commitment to deal justly with employees is the best response to the new bargaining unit rules

The U.S. Supreme Court recently upheld a National Labor Relations Board regulation giving unions of healthcare workers the right to organize as many as eight different kinds of hospital bargaining units. With the Court's decision, hospital administrators must prepare for increased union organizing by maintaining policies that evidence the institution's commitment to social justice in the workplace. Hospital administrators can reduce the potential for labor-management conflict by stressing the institution's commitment to social justice and establishing programs to educate managers and other employees about Catholic teaching on social justice. Facility administrators should also establish a written philosophy statement outlining the institution's position on unionization, institute labor relations training, survey employees' opinions of management and their work environment, conduct audits of managers' perceptions of the organization's effectiveness, and periodically review the state of labor relations in the organization.     

Evaluating social work discharge planning services for elderly people: access, complexity, and outcome.

The discharge planning role of hospital social workers has become increasingly important in services to elderly people. This article examines three issues: (1) the extent to which elderly people most in need receive social work services, (2) the extent to which the discharge planning performed is a professional task, and (3) the effectiveness of discharge planning for those who return to their homes after hospitalization. The study focused on 1,100 elderly patients from five Baltimore hospitals. Data were gathered from their social workers, from the patients themselves (by phone after discharge), and from medical records. Results show that only a minority of elderly patients who return to the community after hospitalization receive social work services while in the hospital but that those who do are likely to have posthospital needs. In most cases, the discharge planning uses professional skills, but 28 percent of cases are fairly routine. Finally, social work services were effective in reducing the level of unmet needs in the areas of nursing, medication, and physical therapy.     

Job-related stress and coping among home-care workers with elderly people

Little is known about the job-related stress of home-care workers from the point of view of the workers themselves. Thirty-two home-care workers from six community-based, home-care programs sponsored by New York area Catholic Charities agencies were studied. The subjects predominantly were female, white, observant Christians, with a median age of 49 years. Test scores revealed little reported stress; however, interviews revealed significant stress that resulted primarily from interpersonal interactions, affective tasks, and insufficient pay. Coping strategies appeared to include denial, identification with clients, altruism. Low pay was the workers' primary dissatisfaction. The authors suggest ways that social workers, administrators, and supervisors can improve their work with home-care workers and encourage advocacy and social action on behalf of these workers.     

Developing and sustaining a practice-based research infrastructure in a hospital social work department: Why is it important?

The future of hospital social work departments depends on their ability to demonstrate their effectiveness, efficiency, and consequently, their value to their host organizations. In order to demonstrate and enhance social work’s contribution, research activities of various kinds must be encouraged. These include research consumption as well as production and utilization by clinicians, supervisors, managers, and administrators. The authors sought to develop a sustainable research environment in a large social work department of an academic health system. Continued work is needed to understand practice-research “best practices” within hospitals and how to ensure their sustainability within an ever changing health care environment.     

Predicting Patterns of Social Work Staffing in Hospital Settings

One long-standing problem of social work departments in acute care hospitals has been their diverse patterns of staffing. The lack of a standard or guide has tended to diminish the utilization of social work services in hospital settings. Over a period of six years, the Society Hospital Social Work Directors of the American Hospital Association developed and revised a guide for inpatient staffing. The guide is designed to assist hospital and social work administrators establish an inpatient line staffing plan which is based on the number of hospital beds, the number of patients to be served and the number of functions carried. The logic of the inquiry and the findings can serve as a base for future research in inpatient, ambulatory care and other settings which serve special populations.     

Predicting patterns of social work staffing in hospital settings

One long-standing problem of social work departments in acute care hospitals has been their diverse patterns of staffing. The lack of a standard or guide has tended to diminish the utilization of social work services in hospital settings. Over a period of six years, the Society for Hospital Social Work Directors of the American Hospital Association developed and revised a guide for inpatient staffing. The guide is designed to assist hospital and social work administrators establish an inpatient line staffing plan which is based on the number of hospital beds, the number of patients to be served and the number of functions carried. The logic of the inquiry and the findings can serve as a base for future research in inpatient, ambulatory care and other settings which serve special populations.     

医务社会工作介入"分级诊疗"模式初探

医疗资源分配不均,是阻碍"健康社区"建设的主要问题,在分级诊疗的背景下,三级医院需发挥自身的医疗资源优势,深入社区建设.作为医院的人文服务提供者、资源链接者,医务社工理应承担起院内外的工作拓展职责.因此,本文主要探讨在分级诊疗推进的基础上,医务社会工作可发挥自身专业角色,运用社区工作等专业社会工作方法,结合三级医院的优质医疗资源,介入分级诊疗,从而构建社区"健康共同体",推动分级诊疗的真正落地实施.     

医务社工与志愿者在医院服务管理中作用的评价

目的 通过实证调查采集患者、医务工作者和志愿者对医务社工及志愿者工作的评价,解析医务社工及志愿者在医院服务管理中的作用.方法 采用问卷调查、文献查阅、深度访谈法,调研上海市3家三级甲等公立医院获取第一手资料.结果 调查结果显示,患者、医务人员及医务管理人员高度认可医务社工与志愿者在医院服务管理的作用.结论 医务社工和志愿者在医院服务管理中能发挥独特的作用,可以增进医患沟通,缓解或预防医患矛盾,给患者更多人文关怀和增值服务,一定程度上解决了医患之间的诊治经费问题,提升服务品质,降低人力成本,应当得到全社会更多的重视.     

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.