A Social Worker in health care is known as a Medical Social Worker. The Medical Social Worker (Med.SW) is part of the multidisciplinary healthcare team, providing interventions to support patients and their families, groups during recovery from and/or adjustment to illnesses. The role of a hospital social worker is to "restore balance in an individual’s personal, family and social life, in order to help that person maintain or recover his/her health and strengthen his/her ability to adapt and reintegrate into society" (Ordre professionnel des travailleurs sociaux du Québec, OPTSQ, 1999). A Medical Social Worker provides Psychosocial support, Case Management, Psycho-education, Counseling and referrals for other services or linking people to resources. They also perform health care administrative and service roles such as Program planning, day-to-day operations, service monitoring & media liaison, budgeting & policy development, programs management for health promotion and disease prevention and advocate to overcome or make availability & accessibility of certain healthcare services. A medical social worker in healthcare management works toward systems transformation through coalitions with various departments and in hospital operations.
At every stage in life, health is determined by complex interactions between social and economic factors, the physical environment and behavior; they do not exist in isolation from each other. The wider the income gap within a society the higher its mortality and morbidity rates. It is studied that half of all healthcare outcomes are linked to the social determinants. Hence, an actions taken by a social worker to reduce health inequalities will also have economic benefits.
Following are the functions of a Medical social worker.
Medical Social Workers help the patient's and their families to manage life crises due to acute or chronic medical conditions, and focus on improving their mental and physical well-being which is done by counseling, needs assessment and psychosocial assessments, which involves a thinking process that seeks out the meaning of case situations, puts the particulars of the case in some order and leads to appropriate interventions. Hospital services/Health care management as an executive to care-coordinator or administrator is a critical role for a medical social worker, administrative responsibilities entail to ensure efficient and effective unit operation; contributing to staff development by promoting and ensuring a supportive/collaborative learning environment based on the principles of adult learning and practice standards for nurses, students and ancillary staff; performing human resources responsibilities in collaboration with the other line managers; attending administration level meetings for program launch and evaluation, budgetary decisions, augmenting CSR activities ...etc.; liaising with members of the multidisciplinary team to ensure high standards of quality and optimal management of patient care outcomes (including data collection/reporting); staff stress management due to the competing needs in patient care and ongoing continuous improvement practices to strengthen clinic processes. Psychosocial interventions with Non-clinical hospital operations (Administrative support, Case Coordination, Health Information Management, Employee Health, Safety and Security, Supply Chain Management, Human Resources ...etc.) is a key distinction of a Medical social worker.
Patient counseling is an important part of the Medical Social Worker’s role. Medical Social Workers lead support group discussions, provide individual counseling, help patients determine appropriate health care and other health services, and provide support to patients with serious or chronic illnesses. Medical Social Workers also work in health and safety aspects of a hospital setting, there contributions lead to reduced Hospital-acquired infection (HAI). The social worker attempts to makes changes in poor workplace conditions (e.g., overworked staff, time pressures, lack of safety protocols or lack of appropriate supervision), as well as poor individual conditions (e.g., fatigue, stress or illness) to reduce medical errors. A study conducted by Dawson & Reid in 1997 found that health care professionals that are being awake 24 hours was equivalent to having a blood alcohol level of .10. (legally intoxicated by most standards) A self-assessment that qualifies fitness of health care professional to attend patient care was developed thereafter; It is IM SAFE (It basically asks questions to self whether the professional is suffering any Illness, Taking Medications, Stress Management, Using Alcohol, Fatigue, Eating timely). Another prime objective of a Medical Social Worker is assisting patients along with staff members to cope with psychosocial problems associated with ill health and thus promote the overall wellness of theirs.
In the hospital setting, Medical Social Workers play an important role in coordinating patient discharge planning and after-care services following the physician's notification that the patient is ready for discharge. There are a number of factors that influence the timing of discharge; in private, community hospitals, it can be costly to allow patients to remain inpatient when it is no longer medically necessary. Discharge delays can prove costly to the hospital and to the patient depending on the patient's funding source. Social workers also assist patients and families, access in-home health care services, arrange for in-home medical equipment, provide for transportation, coordinate follow-up treatments, and refer patients to a wide variety of community social service agencies. Medical Social Workers are often also responsible for helping patients access financial assistance and health insurance coverage. In some settings, Medical Social Workers work closely with public and private health insurers to determine the patient’s benefits and advocate for the patient.
Another skill required of medical social workers is the ability to work cooperatively with other members of the multidisciplinary treatment team who are directly involved in the patient's care. It is also the responsibility of the Medical Social Worker to manage any dispute in the multidisciplinary team. Medical social workers also need to have good analytical and excellent assessment skills, an ability to communicate the medical language (physiology of the disease and the types of treatment offered) with both patients and the family is necessary, and an ability to quickly and effectively establish a therapeutic relationship with patients. But of paramount importance, medical social workers must be willing to act as advocates for the patients, especially in situations where the medical social worker has identified problems that may compromise the well-being of patient or in any distress in the discharge process that might put the patient at risk. An understanding between "advocacy and collaboration" & "loyalty to the patient and the institution" is important for a hospital social worker.
For example, a medical provider may report that a frail elderly patient, who lives alone, is medically stable for discharge and plans to discharge the patient home with in-home services. After assessing the patient's psychosocial needs, the medical social worker determines that the patient does not have the ability to manage at home safely even with the intervention of a home care worker. The medical social worker informs the medical provider that the proposed discharge plan may place the patient at risk and the discharge plan is deferred pending further assessment. The medical social worker can then collaborate with multidisciplinary providers to develop a more appropriate discharge plan even if that leads to discharge delays.