The social worker's role in the hospital: seen through the eyes of other healthcare professionals

Social workers in hospitals necessarily work alongside other healthcare professionals, and the perspectives on social work held by doctors and senior nurses are relevant both to their relationship with social workers and to the smooth running of the hospital. An exploratory investigation in the East Anglian Region has produced profiles of perceived social work practice in six different patient-care categories: surgical and orthopaedic, accident and emergency, medicine for the elderly, psychogeriatric medicine, psychiatry and paediatrics. The social worker's functions are recognized as including statutory responsibilities in child protection and mental health, and there are some secondary roles that often reflect a social worker's personal interest or sphere of expertise. The social worker's primary role, however, is deemed to be that of discharge planning - a task which has been given statutory force under the National Health Service (NHS) and Community Care Act 1990. The nurses and doctors interviewed rated the quality of social work practice predominantly by the extent to which the social worker was seen to identify unambiguously with the hospital and its ethos; but they also set great store by the presence and easy accessibility of a social worker, and they preferred regular contact with the same person. They saw the social worker as a key agent within the health care framework, and acknowledged that the social care role and the social worker's link with the community were crucial components of good hospital practice.     

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.     

Occupational stress among paramedical staff working in primary health care centers in Abha, Saudi Arabia

Occupational stress among paramedical staff in Primary Health care centers was not extensively studied as in medical or hospital nursing staff. The aim of the present study was to reveal the work characteristics in the PHC centers in Abha city, Saudi Arabia, with its stressful hazardous conditions as perceived by the working paramedical staff. The study revealed that this staff is facing heavy workload with low decision and control latitude. This is the most hazardous condition generating stress among working populations. As most of them are foreigners the language barrier compounds the problem. It was noticed however that most of them enjoy good social support from both colleagues and home members that might play a modifying role alleviating stress. This group of workers needs special care and continuous evaluation of mental stress induced by their working conditions.     

The Challenges of Health Care Reform for Hospital Social Work in the United States

This article examines the potential impact of the Patient Protection and Affordable Care Act (ACA) of 2010 on the practice of hospital social work in the United States and its implications for social work education and training. It briefly traces the history of hospital social work, outlines some contemporary issues in the health care field, particularly those that create persistent health disparities, summarizes the major provisions of the Act that have implications for social work practice, and discusses how social workers in hospital settings might respond effectively to the changes produced by the legislation.     

The experiences of pediatric social workers providing end-of-life care

Pediatric social workers working in acute care hospital settings may care for children and their families in end-of-life circumstances. This qualitative study is part of a larger study focusing on the experiences of health care providers working with dying children. This study consisted of 9 semi-structured interviews of acute care pediatric social workers who work with dying children and their families. Themes included the role of social work with dying children, the impact of their work and coping strategies. Authors suggest a hospital-worker partnership in supporting staff and promotion of supportive resources.     

The Role of the Social Worker in the Adult Critical Care Unit: A Systematic Review of the Literature

Social workers provide care to patients and families in the adult critical care unit. We conducted a systematic review of the literature to more clearly identify the role of the social worker practicing in the intensive care unit. We conducted a comprehensive search of the literature using the Pubmed, Embase, ISI, Scopus, and Social Work Abstracts databases using the terms “intensive care,” “critical care,” and “social work.” Articles were selected for review if they met the following criteria: formal studies or opinion papers whose primary focus was the role or scope of practice of the social worker in the adult critical care unit. Articles were selected and reviewed independently by two social work investigators. Our search retrieved 550 potentially relevant articles. Twelve full-text articles were deemed eligible for abstracting. Three of the articles were studies that examined different aspects of social work practice including implementation of a family assistance program, social work response to anxiety levels of families in critical care and common activities of critical care social workers. Nine articles were primarily opinion pieces. All of the opinion articles described psychosocial support and counseling as a primary role of critical care social work. Other frequently identified roles were crisis intervention, psychosocial assessment, facilitating communication, end-of-life care, and practical assistance. There is little empiric data describing the role of the critical care social worker. Consistent themes from the articles identified include the role of social workers as counseling professionals, facilitators of communication, and resource agents. Further research to identify formal assessment tools and outcome studies of specific counseling techniques will provide important information for best practice guidelines in this area.     

Communicating With Pediatricians: Developing Social Work Practice in Primary Care

While social work models of interdisciplinary collaboration suggest that communication is important, the research literature on social worker–physician collaboration infrequently considers work with pediatricians or practice outside the hospital setting. A cross-sectional survey was sent to a stratified random sample of social workers to assess their communication satisfaction with pediatricians. The study found that social workers in health settings were more satisfied than those in mental health settings. The implications of this finding for the development of colocated, collaborative care models are discussed.     

Key factors impeding discharge planning in hospital social work: an exploratory study

Despite its long historical tradition in Northern Ireland, there is a dearth of research studies on the role of hospital social work and the professional challenges involved at the health and social care interface. This is the first small-scale exploratory study in Northern Ireland that sought to identify the key factors that hospital social workers perceive as impeding their practice in the discharge planning process. A 15-item postal questionnaire was developed and distributed to 30 hospital social workers from four hospital social work departments in a city in Northern Ireland. The study group comprised social workers based in a range of hospital directorates who had differing levels of hospital social work experience. Data generated from the questionnaires suggested that deficits in community resources impacted most negatively on social workers' practice in discharge planning. The length of time respondents had been in their current post was also shown to influence their responses to the perceived impediments in their discharge planning role. The implications of the study and recommendations are discussed in relation to in-service training, social work practice and continuing education in Northern Ireland.     

Making the Invisible Visible: Are Health Social Workers Addressing the Social Determinants of Health?

This study explored the ways in which health social workers (HSW) address the social determinants of health (SDH) within their social work practice. Social workers (n?=?54) employed at major hospitals across Toronto had many years of practice in health care (M?=?11 years; SD?=?10.32) and indicated that SDH were a top priority in their daily work; with 98% intentionally intervening with at least one and 91% attending to three or more. Health care services were most often addressed (92%), followed by housing (72%), disability (79%), income (72%), and employment security (70%). Few HSW were tackling racism, Aboriginal status, gender, or social exclusion in their daily practice.     

Hospital Social Work: Contemporary Roles and Professional Activities

Since its inception in the 1900s, hospital social work has been impacted by the ever changing hospital environment. The institution of Diagnostic Related Groups (DRGs), the era of reengineering, and the constant struggle toward health care reform make it necessary to evaluate and substantiate the value and efficacy of social workers in hospital settings. This study identifies current roles and activities carried out by social workers in acute hospital settings from across the nation in the aftermath of reengineering. Findings suggest the primary role of respondents in this study to be discharge planning with little to no involvement in practice research or income-generating activities.     

The costs of care: An ethnography of care work in residential homes for older people

The cost of social care, the work conditions experienced by care workers and the quality of care provided by residential homes for older people are all linked, yet we know very little about how this relationship works in practice. Drawing upon an ethnography of two differently priced residential care homes for older people in Southern England, I examine the implications of different financial regimes for care-giving practices. I show how the scheduling and allocation of resources—conveyed, for example, in formal routines and staffing levels—structure the care workers’ time, tasks and activities in each setting. This acts to symbolically demarcate what, or who, is valued. I argue that the availability of resources facilitates and impedes the symbolic culture of care work, shapes care workers’ ability to afford dignity to the individuals in their care and affects how care workers experience, and relate to, their labour. I conclude by discussing how current practices of funding and pricing social care have effects seeping beyond the practical and measurable, and into the realm of the symbolic.     

Medical social work positions: BSW or MSW?

Acute care social work positions face budgetary scrutiny in the current climate of fiscal restraint in Canadian health care. Managers may be faced with the question of whether a new or vacant medical social work position should be filled by a BSW social worker or an MSW social worker. This question is further complicated when experienced and less costly BSW social workers are available while MSW social workers with medical or hospital experience may be limited in supply. This paper reviews the literature relevant to medical social work practice and hiring. A small scale survey was conducted with inter­professional managers responsible for the hiring of medical social workers. The purpose of this research was to examine the current hiring practices and considerations for hospital medical social workers.     

Role changes of hospital social workers in South Korea

The roles of social workers in hospitals have changed in accordance with the environmental changes in the healthcare system. Since 1958, hospital social workers have performed important roles in providing care services in South Korea. Providing psychosocial services was considered to be the most important for more than 30 years from the 1970s to the 1990s. The healthcare system has since undergone major environmental changes, yet there has been little study on the role of hospital social workers in South Korea. In order to address this research gap, this study aims to explore how the roles of hospital social workers have changed since the 2000s. We recruited 198 hospital social workers who were active members of the Korean Association of Medical Social Workers as study participants. The average age of participants was 35.36 years old (SD = 8.27), and they had an average of 8.24 years in hospital social work experience (SD = 6.35). The results indicated that the roles of financial support and community resource linkage, which were regarded to be relatively less important until the 1990s, were recognized as the most important. Given the role changes of hospital social workers in South Korea, implications are discussed.     

The Perceptions of the Personal and Professional Factors Influencing Social Workers in Saudi Hospitals: A Qualitative Analysis

The perceptions of 10 social workers regarding the personal and professional characteristics influencing their practice at Saudi hospitals were examined using semi-structured interviews. A qualitative analysis employing a thematic approach informed by grounded theory was undertaken and produced three broad interrelated themes: “skills upgrading,” “departmental support,” and “personal experience in the workplace,” which subsequently informed the development of the overarching theme of “personal and professional factors.” The discussion illustrates social work practitioners are inhibited from effectively performing their roles. These include: (a) Deficiencies related to job training and professional skills updating where there is a lack of efficient and accessible inservice training programs, especially in relation to practical issues. Further, these perceptions relate to a lack of long-term educational opportunities that impact on individual practitioner's currency of skills, techniques and pedagogy enabling/disenabling him/her to excel at his/her job, (b) Obvious bureaucracy within the controlling hierarchy and difficulty with the dissemination of information between the social workers were perceived to detrimentally impact on a practitioner's ability to attend to one's work demands, and (c) Personal day to day work experiences, including counterproductive emotional feelings (high stress), increased dissatisfaction with the job, and ineffective communication within the workplace were seen as limiting the social workers' professional potential. This article will focus on how these themes were addressed in terms of qualitative interview data.     

Single Contacts with Hospital Social Workers: The Clients' Experiences

Decreasing lengths of stay in acute hospitals result in social workers often being unable to engage in planned interventions with clients over a number of sessions. Single session work is a reality for much social work practice. This article reports on a qualitative study of clients' experiences of a single contact with a social worker in a hospital setting. Building on prior research on hospital social workers' experiences of single session work, the study found that rapport building, empathy, non-judgmentalism, practical assistance, and advocacy are important features of the social work role in the intense and time limited context of single session hospital social work.     

Social Group Work

Abstract

Deconstruction of traditional social work departments can isolate social workers from their primary source of professional affiliation, leaving them without the support to take stands on controversial patient care issues. This paper describes an alternative: the building of a powerful social work collective based on social group work theory that potentiates professional practice while transcending management forms. The model includes group supervision, but moves beyond it to utilize the social work group as a central organizing principle. At the heart of the collective are the elements of professional accountability, support, autonomy, and collaborative decision-making within democratic peer group structures. The authors highlight current management theory, distinctions that create an authentic social work value-based practice, and outcomes for social workers, their clients, and colleagues.     

Understanding the Critical Role of Social Work in Safety Net Medical Settings: Framework for Research and Practice in the Emergency Department

Social workers in Emergency Departments (ED) provide counseling, community resource linkage, and discharge planning. The ED is a critical intervention point for patients with multiple unmet medical, psychological, and social needs, and little or no other contact with service providers. In part because of its role as a medical safety net for underserved populations, use of the ED has steadily increased over time. There is limited research examining the utility of social services in the ED. This article provides a brief history of hospital social work and a literature review of ED social work research with the goal of advancing current research and practice agendas.     

Social workers as care coordinators: Leaders in ensuring effective,compassionate care

The concept of care coordination is at the forefront of national conversations in the context of health care reform. As pediatric social workers, we are interested in how care coordination benefits our patients, and which disciplines are providing coordination services. We have determined that significant overlap exists between the work social workers are already doing in inpatient and outpatient medical settings and the literature’s definition of care coordination activities. This article outlines our process of literature review and creation of a working definition of care coordination, and frames the concepts we believe remain central to the process of care coordination.