The Changing Face of Health Care Social Work, Third Edition by Dziegielewski Sophia F.;Sophia Dziegielewski Phd Lcsw;

Author:Dziegielewski, Sophia F.;Sophia Dziegielewski Phd, Lcsw;
Language: eng
Format: epub
Publisher: Springer Publishing Company, Incorporated
Published: 2013-08-15T00:00:00+00:00

ACUTE CARE MEDICAL HOSPITALS AND SOCIAL WORK PRACTICE

The current state of practice in the health care setting mirrors the turbulence found in the general health care environment (Darnell & Lawlor, 2012; Dziegielewski & Holliman, 2001; Lens, 2002; Mizrahi & Berger, 2005). For those who work in hospitals, this setting for social work has always been considered a place of fast pace with repeated and continuous access to emotionally charged areas of practice where, when cost cutting is considered central, the behavioral, social, and environmental components of health care are not given high priority (Ferguson & Schiver, 2012; Haber, 2010).

Today, in this turbulent environment, acute care social workers are forced to face numerous situations such as declining hospital admissions, and reduced lengths of stay, along with numerous other restrictions and methods of cost containment that do not directly affect direct patient care. Struggling to resolve these issues has become necessary based on the inception of prospective payment systems, managed care plans, and other changes in the provision and funding of health care (Lens, 2002; Saleh, Freire, Morris-Dickinson, & Shannon, 2012). To complicate this situation, research has linked not receiving services to higher rates of high-risk patient relapse (Duffy &

Healy, 2011; Hudson, 2001).

In most hospitals, the goal of discharge planning is the arrangement of an appropriate follow-up service plan for return to a lesser level of care. The role of the social worker does not end once the patient is discharged from the facility. Hospital social workers often report that they are being forced to discharge patients from services more quickly, and patients are being returned to the community in a weaker state of rehabilitation than ever before. Also, discharge plans need to take into account what will happen postdischarge and use the patient’s own resources as much as possible.

Acute care hospital social workers also may have different expectations of what they perceive as their role in the practice environment (Blumenfield & Epstein, 2001; Duffy & Healy, 2011). These different expectations may lead to blurring and overlap of the services that these health care professionals provide. When health care administrators are forced to justify each dollar billed for services, there is little emphasis placed on the provision of what some deem to be expendable services. These services include mental health and wellness services, as well as thorough discharge planning, in the hospital setting. Unfortunately, the services that the hospital social worker provides are often placed in this category, and as a result, they have been forced to adjust to the brunt of initial dollar-line savings attempts (Judd, 2010).

As discussed earlier, just the sheer numbers of allied health care professionals who are moderately paid provide an excellent hunting ground for administrators pressured to cut costs. These administrators may see the role of the hospital social worker as adjunct to the delivery of care and may decide to cut back or replace professional social workers with nonprofessionals with less training in human behavior, advocacy, research and evaluation, and critical thinking or essential medical personnel, such as nurses, simply to cut costs.

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