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Sewell KM, Kao D, Asakura K. Clinical supervision in frontline health care: A survey of social workers in Ontario, Canada. SOCIAL WORK IN HEALTH CARE 2021; 60:282-299. [PMID: 33593244 DOI: 10.1080/00981389.2021.1880532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/05/2021] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
Researchers have documented diminishing staff supervision in health care settings, while noting the complexity and dynamic nature of health care systems. A secondary data analysis of a survey of the Ontario Association of Social Workers (N=666) explored the contemporary receipt of different types of supervision in frontline health care. Most social worker participants were involved in supervision, receiving administrative and supportive supervision. Only 52% engaged in clinical supervision, even though most spent over 50% of work time with clients with complex needs. Factors related to the receipt of clinical supervision included setting, experience, gender, and availability of clinical practice leaders.
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Affiliation(s)
- Karen M Sewell
- School of Social Work, Carleton University, Ottawa, Ontario, Canada
| | - Dennis Kao
- School of Social Work, Carleton University, Ottawa, Ontario, Canada
| | - Kenta Asakura
- School of Social Work, Carleton University, Ottawa, Ontario, Canada
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Abstract
INTRODUCTION Leadership skills are an integral part of effective social work practice in health and mental healthcare settings. Social workers require critical leadership skills to effectively support, treat and advocate for the complex needs of those most vulnerable. Despite an increasing focus on social work leadership within the last decade, there has been a paucity of research on social work leadership competencies within the realm of health and mental health service provision. To bridge this gap, this scoping review will synthesise and map the current literature on social work leadership competencies in health and mental healthcare. METHODS AND ANALYSIS Arksey and O'Malley's five-stage framework for scoping reviews will guide our search of six academic databases including: PsycINFO, OVID Social Work Abstracts, OVID Medline, Sociological Abstracts, Social Services Abstracts and CINAHL Plus with Full Text. Selected articles that meet inclusion criteria will then be reviewed and charted. Recurrent themes will be reviewed through a qualitative thematic analysis, and reported in both text and figures. ETHICS AND DISSEMINATION Findings will highlight key social work leadership competencies as they relate to social work practice, team dynamics, and client outcomes within health and mental healthcare. Material retrieved in this scoping review was selected from publicly available sources, and thus as an obtrusive research method, this review does not warrant ethics approval. Findings from this review will be disseminated through published scholarly material, as well as presented at conferences pertaining to social work research, practice and education.
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Affiliation(s)
- Amina Hussain
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Rachelle Ashcroft
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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Dobrof J, Bussey S, Muzina K. Thriving in today's health care environment: strategies for social work leadership in population health. SOCIAL WORK IN HEALTH CARE 2019; 58:527-546. [PMID: 31002293 DOI: 10.1080/00981389.2019.1602099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 06/09/2023]
Abstract
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.
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Affiliation(s)
- Judith Dobrof
- a Mount Sinai Health Partners , Mount Sinai Health System , New York , NY , USA
| | - Sarah Bussey
- a Mount Sinai Health Partners , Mount Sinai Health System , New York , NY , USA
| | - Kristin Muzina
- a Mount Sinai Health Partners , Mount Sinai Health System , New York , NY , USA
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Sheaff R. Achieving Integrated Care for Older People: What Kind of Ship? Comment on "Achieving Integrated Care for Older People: Shuffling the Deckchairs or Making the System Watertight for the Future?". Int J Health Policy Manag 2018; 7:870-873. [PMID: 30316236 PMCID: PMC6186479 DOI: 10.15171/ijhpm.2018.44] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 04/28/2018] [Indexed: 11/09/2022] Open
Abstract
This paper considers an implication of the idea that proposals for integrated care for older people should start from a focus on the patient, consider co-production solutions to the problems of care fragmentation, and be at a system-wide, cross-organisational level. It follows that the analysis, design and therefore evaluation of integrated care projects should be based upon the journeys which older patients with multiple chronic conditions usually have to make from professional to professional and service to service. A systematic realistic review of recent research on integrated care projects identified a number of key mechanisms for care integration, including multidisciplinary care teams, care planning, suitable IT support and changes to organisational culture, besides other activities and contexts which assist care 'integration.' Those findings suggest that bringing the diverse services that older people with multiple chronic conditions need into a single organisation would remove many of the inter-organisational boundaries that impede care 'integration' and make it easier to address the interprofessional and inter-service boundaries.
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Sheaff R, Brand SL, Lloyd H, Wanner A, Fornasiero M, Briscoe S, Valderas JM, Byng R, Pearson M. From programme theory to logic models for multispecialty community providers: a realist evidence synthesis. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06240] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
The NHS policy of constructing multispecialty community providers (MCPs) rests on a complex set of assumptions about how health systems can replace hospital use with enhanced primary care for people with complex, chronic or multiple health problems, while contributing savings to health-care budgets.
Objectives
To use policy-makers’ assumptions to elicit an initial programme theory (IPT) of how MCPs can achieve their outcomes and to compare this with published secondary evidence and revise the programme theory accordingly.
Design
Realist synthesis with a three-stage method: (1) for policy documents, elicit the IPT underlying the MCP policy, (2) review and synthesise secondary evidence relevant to those assumptions and (3) compare the programme theory with the secondary evidence and, when necessary, reformulate the programme theory in a more evidence-based way.
Data sources
Systematic searches and data extraction using (1) the Health Management Information Consortium (HMIC) database for policy statements and (2) topically appropriate databases, including MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Applied Social Sciences Index and Abstracts (ASSIA). A total of 1319 titles and abstracts were reviewed in two rounds and 116 were selected for full-text data extraction. We extracted data using a formal data extraction tool and synthesised them using a framework reflecting the main policy assumptions.
Results
The IPT of MCPs contained 28 interconnected context–mechanism–outcome relationships. Few policy statements specified what contexts the policy mechanisms required. We found strong evidence supporting the IPT assumptions concerning organisational culture, interorganisational network management, multidisciplinary teams (MDTs), the uses and effects of health information technology (HIT) in MCP-like settings, planned referral networks, care planning for individual patients and the diversion of patients from inpatient to primary care. The evidence was weaker, or mixed (supporting some of the constituent assumptions but not others), concerning voluntary sector involvement, the effects of preventative care on hospital admissions and patient experience, planned referral networks and demand management systems. The evidence about the effects of referral reductions on costs was equivocal. We found no studies confirming that the development of preventative care would reduce demands on inpatient services. The IPT had overlooked certain mechanisms relevant to MCPs, mostly concerning MDTs and the uses of HITs.
Limitations
The studies reviewed were limited to Organisation for Economic Co-operation and Development countries and, because of the large amount of published material, the period 2014–16, assuming that later studies, especially systematic reviews, already include important earlier findings. No empirical studies of MCPs yet existed.
Conclusions
Multidisciplinary teams are a central mechanism by which MCPs (and equivalent networks and organisations) work, provided that the teams include the relevant professions (hence, organisations) and, for care planning, individual patients. Further primary research would be required to test elements of the revised logic model, in particular about (1) how MDTs and enhanced general practice compare and interact, or can be combined, in managing referral networks and (2) under what circumstances diverting patients from in-patient to primary care reduces NHS costs and improves the quality of patient experience.
Study registration
This study is registered as PROSPERO CRD42016038900.
Funding
The National Institute for Health Research (NIHR) Health Services and Delivery Research programme and supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.
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Affiliation(s)
- Rod Sheaff
- School of Law, Criminology and Government, University of Plymouth, Plymouth, UK
| | - Sarah L Brand
- Y Lab Public Service Innovation Lab for Wales, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Helen Lloyd
- Community and Primary Care Research Group, Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | - Amanda Wanner
- Community and Primary Care Research Group, Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | - Mauro Fornasiero
- Community and Primary Care Research Group, Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | - Simon Briscoe
- NIHR CLAHRC for the South West Peninsula (PenCLAHRC), Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Jose M Valderas
- NIHR CLAHRC for the South West Peninsula (PenCLAHRC), Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Richard Byng
- Community and Primary Care Research Group, Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | - Mark Pearson
- NIHR CLAHRC for the South West Peninsula (PenCLAHRC), Institute of Health Research, University of Exeter Medical School, Exeter, UK
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Stanhope V, Tennille J, Bohrman C, Hamovitch E. Motivational Interviewing: Creating a Leadership Role for Social Work in the Era of Healthcare Reform. SOCIAL WORK IN PUBLIC HEALTH 2016; 31:474-480. [PMID: 27191828 DOI: 10.1080/19371918.2016.1160338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
To better address the needs of individuals with a range of complex health conditions, the Affordable Care Act has shifted the focus from acute care to prevention through behavior change and promoted the integration of physical and behavioral healthcare systems. Central to healthcare reform is delivering person-centered care, which means actively engaging people in their treatment decisions and managing their wellness. Motivational Interviewing (MI) is perhaps the most widely used intervention to promote behavior change. Although MI is utilized across most health disciplines, social workers are uniquely positioned to lead dissemination and on-going training efforts in this area.
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Affiliation(s)
- Victoria Stanhope
- a Silver School of Social Work , New York University , New York , USA
| | - Julie Tennille
- b Department of Social Work , West Chester University , West Chester , Pennsylvania , USA
| | - Casey Bohrman
- b Department of Social Work , West Chester University , West Chester , Pennsylvania , USA
| | - Emily Hamovitch
- a Silver School of Social Work , New York University , New York , USA
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