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Day AT, Sood A, Emmet TR, Eary RL, Prestwood CA, Salley J, Huffman A, Doenges J, Mayfield Arnold E, Tiro JA, Lee SC. Supportive Care Needs Among Head and Neck Cancer Patients Prior to Oncologic Treatment: A Prospective, Nested Cross-Sectional Qualitative Analysis. Ann Otol Rhinol Laryngol 2023; 132:1443-1452. [PMID: 37005576 DOI: 10.1177/00034894231162686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
OBJECTIVES To qualitatively characterize pretreatment head and neck cancer (HNC) patients' supportive care (SC) needs, attitudes toward SC, and barriers to SC utilization. MATERIALS AND METHODS A prospective, nested, bi-institutional, cross-sectional pilot study design was employed. Participants were sub-selected from a representative sample of 50 patients newly diagnosed with mucosal or salivary gland HNC or sarcoma of the head and neck. Eligibility criteria included reporting ≥2 unmet needs (according to the Supportive Care Needs Survey-Short Form 34) or clinically-significant distress (National Comprehensive Cancer Network Distress Thermometer score ≥4). Semi-structured interviews were performed prior to initiation of oncologic treatment. Audio-recorded interviews were transcribed and thematically analyzed using NVivo 12.0 (QSR Australia). Thematic findings and representative quotes were interpreted by the entire research team. RESULTS Twenty-seven patients were interviewed. One-third were treated at the county safety-net hospital and the remainder were treated at the university health system. An equal proportion of patients presented with oral cavity, oropharyngeal, and laryngeal or other tumors. Two significant findings were identified on semi-structured interviews. First, patients did not perceive the relevance of SC prior to treatment. Second, anxiety surrounding the HNC diagnosis and impending treatment dominated in the pretreatment phase. CONCLUSION Improved HNC patient education about the relevance and importance of SC in the pretreatment setting is needed. Integration of social work or psychological services in HNC clinics is warranted to address patients' cancer-related worry-a discrete, dominant pretreatment SC need.
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Affiliation(s)
- Andrew T Day
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Anubha Sood
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, USA
| | - Thomas R Emmet
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Rebecca L Eary
- Department of Family and Community Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Courtney A Prestwood
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jordan Salley
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Alexandra Huffman
- Support Services, Simmons Comprehensive Cancer Center, Dallas, TX, USA
| | - Jacquelyn Doenges
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | | | - Jasmin A Tiro
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, USA
| | - Simon Craddock Lee
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, USA
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DiBiase J. Social Workers as Leaders for Facilitating Trauma-Informed Palliative Care in the Outpatient Palliative Care Clinic. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2023; 19:296-308. [PMID: 37768197 DOI: 10.1080/15524256.2023.2262157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Palliative care social workers are trained to identify how trauma manifests over the course of serious and chronic illness. This expertise can guide patients and team members to ensure a trauma-informed experience of care. This paper identifies the growth of outpatient palliative care clinics as an opportunity for palliative care social workers to emphasize this clinical skill set and assume a leadership role in the implementation of trauma-informed practices early in the trajectory of serious illness.
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Affiliation(s)
- Jennifer DiBiase
- Brookdale Department of Geriatrics and Palliative Medicine, Mount Sinai Beth Israel Hospital, New York, New York, USA
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3
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Zuchowski I, McLennan S. A Systematic Review of Social Work in General Practice: Opportunities and Challenges. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2023:1-41. [PMID: 37264677 DOI: 10.1080/26408066.2023.2202665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE This study identified the nature of social work practice in primary health care and described the reported patient outcomes, benefits, challenges, and enablers of social work in general practice [GP] settings. METHOD A systematic literature review applying the Prisma framework was conducted. RESULTS A total of 26 studies met the inclusion criteria. Social work practice in GP assists in delivering positive health outcomes for patients, improved patient care, offers value for money, and supports interdisciplinary teams. Identified challenges include funding impediments, organizational barriers, and a lack of understanding of and undervaluing the social work role. DISCUSSION AND CONCLUSIONS The review outlined the benefits of social work practice in GP practices; however, these must be further evidenced. Funding for social workers in primary health care was identified as a challenge when it was lacking, and as an enabler when it was available. Further research to evidence the patient outcomes and overall benefits, the fiscal value of social work and funding pathways in primary health care is recommended.
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Affiliation(s)
- Ines Zuchowski
- Social Work and Human Services, College of Arts, Society and Education, James Cook University, Douglas, Townsville, Queensland, Australia
| | - Simoane McLennan
- Social Work and Human Services, College of Arts, Society and Education, James Cook University, Douglas, Townsville, Queensland, Australia
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Couturier Y, Lanoue S, Karam M, Guillette M, Hudon C. Social workers coordination in primary healthcare for patients with complex needs: A scoping review. INTERNATIONAL JOURNAL OF CARE COORDINATION 2022. [DOI: 10.1177/20534345221122952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Care coordination has been part of social work for some time. It has been recognized as contributing to care coordination for long-term care for the elderly and mental health but less is known about their contribution in primary care with patients with complex health and social needs. As social workers are increasingly present in primary healthcare, this scoping review aims to provide a synthesis of social workers’ coordination activities for patients with complex needs in primary healthcare. Methods CINAHL, Medline, Scopus, SocioIndex, Social Work Abstracts, and ProQuest databases were searched, from 2004 to 2020 for peer-reviewed literature. A thematic analysis using deductive and inductive approaches was used to conduct this scoping review. Results Eighteen studies on 11 different care coordination interventions were included. The care coordination activities have been classified into four categories: 1) activities that target the patient, family, and caregivers; 2) activities that target health and social care professionals and services; 3) activities that link the patient and family with health and social professionals and services; and 4) cross-cutting activities that support and enhance other activity. Discussion A variety of care coordination interventions conducted by social workers were identified, all of which included related but different activities. Still, the common aim is to reduce fragmentation of care. Social workers, because of their disciplinary skills characterized by linkages to nonmedical services, can make a significant contribution to the coordination of care in primary health care, in collaboration with nurses.
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Affiliation(s)
- Yves Couturier
- Department of Social Work, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Sèverine Lanoue
- Department of Education, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Marlène Karam
- Faculty of Nursing, University of Montréal, Montréal, Québec, Canada
| | - Maxime Guillette
- Department of Education, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Catherine Hudon
- Family Medicine and Emergency Medicine Department, Université de Sherbrooke, Sherbrooke, Québec, Canada
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5
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Feryn N, De Corte J, Roose R. The DNA of Social Work as a Partner in Primary Health Care. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:407-418. [PMID: 34927558 DOI: 10.1080/19371918.2021.2017381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There is a strong focus on primary health care (PHC), as rooted in a commitment to social justice and equity, to reduce social inequalities in health. Within PHC, interprofessional collaboration is emphasized to achieve these objectives. Social workers are a renewed partner within these collaborations, as principles of social justice and human rights are the core of this profession. However, it is unknown if and how social work implements these principles in primary health care settings. This systematic literature review examined the existing literature on the role of social work in primary health care settings on themes of social justice. Our results emphasize how valuable the presence of social workers in primary health care is because of their broad perspective on health. At the same time, we also reveal a few points of concern, as their focus on social justice remains rather individual. This review suggests the strengthening of a social justice based approach in primary health care, which is an issue that should be shared with other healthcare professionals. We discuss implications for practice, research and policy.
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Affiliation(s)
- Nele Feryn
- Faculty of Psychology and Educational Sciences, Department of Social Work and Social Pedagogy, Ghent University, Ghent, Belgium
| | - Joris De Corte
- Faculty of Psychology and Educational Sciences, Department of Social Work and Social Pedagogy, Ghent University, Ghent, Belgium
| | - Rudi Roose
- Faculty of Psychology and Educational Sciences, Department of Social Work and Social Pedagogy, Ghent University, Ghent, Belgium
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Rizzo VM, Rowe JM, Han W, Kang SY, Ewald B, Rothschild SK, Golden R. The effect of the Ambulatory Integration of the Medical and Social (AIMS) model on health risk and depression. SOCIAL WORK IN HEALTH CARE 2022; 61:353-368. [PMID: 35736662 DOI: 10.1080/00981389.2022.2092581] [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: 11/08/2021] [Revised: 06/09/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
Social needs are factors for health risk and depression that may negatively impact health outcomes and costly services use. Care management addresses social needs that can reduce health risk and depression. An exploratory study of the 5-step Ambulatory Integration of the Medical and Social Model (AIMS) was conducted to examine the effect of steps completed as part of AIMS on patients' depression and health risk outcomes at 6-months. Results reveal steps central to AIMS are significantly related to lower depression and health risk, suggesting AIMS is a valuable intervention for reducing health risk and depression.
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Affiliation(s)
- Victoria M Rizzo
- School of Social Welfare, University at Albany, State University of New York, Albany, NY
| | - Jeannine M Rowe
- Department of Social Work, University of Wisconsin-Whitewater, College of Letters and Science, Whitewater, WI
| | - Woojae Han
- Department of Social Welfare, Soongsil University, Seoul, Korea
| | - Suk-Young Kang
- Department of Social Work, Binghamton University, College of Community & Public Affairs, Binghamton, NY
| | - Bonnie Ewald
- Department of Social Work, Rush University Medical Center, Chicago, IL
| | - Steven K Rothschild
- Department of Family Medicine and Preventive Medicine, Rush University Medical Center, Chicago, IL
| | - Robyn Golden
- Department of Social Work, Rush University Medical Center, Chicago, IL
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7
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Zerden LD, Guan T, Shurer J, Kreitzer L, Book E. Social work, Parkinson's disease care, and COVID-19. SOCIAL WORK IN HEALTH CARE 2022; 61:139-157. [PMID: 35481456 DOI: 10.1080/00981389.2022.2069902] [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: 07/05/2021] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 06/14/2023]
Abstract
Parkinson's Disease is a neurological disease affecting over 10 million people worldwide. Interdisciplinary teams provide integrated care to people with Parkinson's Disease, including care for non-motor symptoms such as anxiety and depression, and many of these teams include social workers. This study sought to learn more about (a) clinical social work utilization across the continuum of care of PWP and their family care partners and (b) how patterns in utilization and service provision have shifted during the pandemic. This mixed method study identifies the breadth of roles performed by social workers in the comprehensive care of people with Parkinson's Disease (PWP). Findings underscore the important roles social workers play in providing comprehensive care for PWP and their families and their contributions to interdisciplinary teams providing holistic, integrated care, particularly during COVID-19 and into the future.
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Affiliation(s)
- Lisa D Zerden
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ting Guan
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- University of Syracuse, Falk College, Syracuse, NY, USA
| | - Jessica Shurer
- Parkinson's Foundation Center of Excellence, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Linda Kreitzer
- Faculty of Social Work, University of Calgary, Edmonton, Alberta, Canada
| | - Elaine Book
- Parkinson's Foundation Center of Excellence, University of British Columbia, Vancouver, British Columbia, Canada
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8
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Richman EL, Lombardi BM, de Saxe Zerden L, Forte AB. What Do EHRs Tell Us about How We Deploy Health Professionals to Address the Social Determinants of Health. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:287-296. [PMID: 34874813 DOI: 10.1080/19371918.2021.2001406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The objective of this study was to determine how well Electronic Health Record (EHR) documentation identifies which health professionals act to address patient social determinants of health (SDOH) and what interventions are documented. The Electronic Medical Record Search Engine was used to identify food and housing insecurity EHR notes. From the notes, researchers randomly sampled 60 from each SDOH category. Of 120 notes, which contained a reference to food or housing insecurity, 72% also contained information on an intervention taken. Interventions were documented by social workers 63% of the time, followed by dietitians and physicians. Addressing patient SDOH is a crucial part of comprehensive healthcare. Findings contribute to a broader conversation on the documentation and interventions in healthcare settings to address patients' SDOH. Findings support the critical importance of standardizing SDOH documentation in the EHR across more members of the health workforce to ensure patient needs are met.
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Affiliation(s)
- Erica L Richman
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brianna M Lombardi
- School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lisa de Saxe Zerden
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alexandria B Forte
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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9
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Cabin W. Pre-existing Inequality II: Social Workers Assess Impact of COVID-19 on Medicare Home Health Beneficiaries. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2021. [DOI: 10.1177/10848223211020433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is significant data on the adverse impact of COVID-19 on persons who were poor, minorities, had compromised physical or mental health, or other vulnerabilities prior to the COVID-19 pandemic. A significant portion of the Medicare population has such vulnerabilities. The Medicare home health beneficiary population is even more vulnerable based on gender, race, income level, living alone status, and number of chronic conditions. A literature review indicated there were no studies on the impact of COVID-19 on Medicare home health beneficiaries. In a previous issue of this journal, the author addressed the literature gap by presenting a study on home care nurses’ perceptions of the impact of COVID-19 on Medicare home health beneficiaries. The current study is a companion qualitative study to the nurses’ study. It is based on interviews of a convenience sample of 52 home care social workers from 11 different home health agencies in New York City between April 1 and September 30, 2020. Seven major themes emerged, 6 of which were identical to the themes identified by the nurses. The only new theme was limits on the ability to provide psychosocial interventions had more severe consequences. The 7 themes were: need for social service supports increased; loneliness and depression increased among patients; physical and mental health conditions became exacerbated; substance use and abuse increased; evidence of domestic violence against patients increased; there was limited staff and equipment to care for patients; and limits on the ability to provide psychosocial interventions had more severe consequences.
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10
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Sable P, Ross A, Clock A, Corder B, Lamontagne N, McCaig J, Shanske S, Tvedte M, Cummings J, Chamorro P. Illustrating the value of social work: results of an open pilot trial of the psychosocial acuity scale in a large urban pediatric hospital. SOCIAL WORK IN HEALTH CARE 2021; 60:448-466. [PMID: 33993849 DOI: 10.1080/00981389.2021.1926398] [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: 11/20/2020] [Revised: 04/21/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
While Electronic Medical Records (EMRs) are an important mechanism used to document patient information and service provision, most interfaces prioritize collection of information required for medical billing purposes, rather than complexities of behavioral and social service needs. An emphasis on encounter data renders it challenging for social workers (SWs) to communicate statistically compelling explanations of contributions to team-based care and overall value to the health system. This paper reports outcomes of feasibility, acceptability, and appropriateness of integrating a validated psychosocial acuity metric into standardized social work (SW) documentation at a large, pediatric quaternary hospital in the northeastern United States. Approximately 20% (N = 42) of departmental SWs participated in an open pilot trial wherein participants were first trained in scale administration, utilized it for a circumscribed period following training, and evaluated implementation outcomes. Across five unique practice settings, results showed that the metric was feasible, acceptable and appropriate for use; 78% of participants were in favor of integrating it into the EMR interface as a required component of SW documentation. Assessing psychosocial acuity in every documented patient encounter facilitates intermittent review of psychosocial acuity at individual, setting, and programmatic levels and opportunities to evaluate how SW interventions address psychosocial acuity.
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Affiliation(s)
- Paige Sable
- Social Work Department, Boston Children's Hospital, Boston, United States
| | - Abigail Ross
- Social Work Department, Boston Children's Hospital, Boston, United States
- Fordham University, Graduate School of Social Service, New York, United States
| | - Annie Clock
- Social Work Department, Boston Children's Hospital, Boston, United States
| | - Brooke Corder
- Social Work Department, Boston Children's Hospital, Boston, United States
| | - Nicole Lamontagne
- Social Work Department, Boston Children's Hospital, Boston, United States
| | - Jessica McCaig
- Social Work Department, Boston Children's Hospital, Boston, United States
| | - Susan Shanske
- Social Work Department, Boston Children's Hospital, Boston, United States
| | - Matthew Tvedte
- Social Work Department, Boston Children's Hospital, Boston, United States
| | - Jennifer Cummings
- Social Work Department, Boston Children's Hospital, Boston, United States
| | - Pamela Chamorro
- Social Work Department, Boston Children's Hospital, Boston, United States
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11
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Rowe JM, Jang E, Rizzo VM, Kim Y, Ewald B, Vail MR, Drechsler K. Supporting free clinic patients' social needs with MSW interns: A pilot study. SOCIAL WORK IN HEALTH CARE 2021; 60:334-353. [PMID: 33657981 DOI: 10.1080/00981389.2021.1894307] [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: 04/11/2020] [Revised: 01/08/2021] [Accepted: 02/10/2021] [Indexed: 06/12/2023]
Abstract
Social needs, which are social risk factors including lack of access to stable housing, healthy food, or reliable transportation, are recognized as integral to health. Free clinics tend to serve patients with social needs, yet, few are screened or receive assistance. Lack of personnel, resources, and procedures to identify and assist patients are reasons few free clinics consider social needs. To address this service gap, a midwestern free clinic and neighboring Masters of Social Work (MSW) program established a partnership. A social needs screen was developed and integrated into health care practice. An MSW intern was also embedded as a member of the health care team to provide social needs assistance. A 6-month pilot study was conducted to assess the value of the screen and use of MSW assistance services. Of the 223 patients screened, 66.4% (n = 146) scored positive for social needs. Only four percent (n = 6) of the patients used MSW services. Chi-square analyses reveal significant differences in social needs by age, gender, race, education, and primary language. The findings suggest that the screening and MSW intern services are valuable; however, they further suggest that screening alone may be insufficient to encourage utilization of MSW services.
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Affiliation(s)
- Jeannine M Rowe
- College of Letters and Science, Department of Social Work, University of Wisconsin-Whitewater, Whitewater, USA
| | - Eunyoung Jang
- College of Letters and Science, Department of Social Work, University of Wisconsin-Whitewater, Whitewater, USA
| | - Victoria M Rizzo
- School of Social Welfare, University at Albany, State University of New York, New York, USA
| | - Yeongmin Kim
- College of Letters and Science, Department of Social Work, University of Wisconsin-Whitewater, Whitewater, USA
| | - Bonnie Ewald
- Social Work and Community Health, Rush University Medical Center, Chicago, Illinois, USA
| | - Matthew R Vail
- Community Health Equity and Engagement, Rush University Medical Center, Chicago, Illinois, USA
| | - Katherine Drechsler
- College of Letters and Science, Department of Social Work, University of Wisconsin-Whitewater, Whitewater, USA
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Nagelkerk J, Trytko J, Baer LJ, Tompkins A, Thompson M, Bouthillier M, Booth A, Nord C. Sustainability of an IPCP program within a federally qualified health center including interprofessional student team placements. J Interprof Care 2021; 35:869-877. [PMID: 33653192 DOI: 10.1080/13561820.2020.1816935] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In an effort to improve teamwork and collaborative care at a Federally Qualified Health Center (FQHC), the Midwest Interprofessional Practice, Education, and Research Center (MIPERC) collaborated on the implementation of an interprofessional collaborative practice (IPCP) program that included placement of multidisciplinary student teams. The MIPERC IPCP program supported staff, preceptor and student teams through interprofessional education and structured interprofessional activities for students, including daily huddles, interprofessional student team visits, and nurse triage phone calls. Results from the project's first year were previously reported (Nagelkerk et al., 2017b). Ongoing effects of IPCP on staff morale, IPE knowledge and practice efficiency were measured. Study tools included demographic forms, pre/post module knowledge tests, focus groups and program evaluations. The mean number of clinic patient visits per hour per medical provider was calculated to evaluate practice efficiency. Students (n = 26) and staff (n = 30) demonstrated improvement (p ≤.05) in knowledge test scores for Patient Safety, Team Dynamics and Tips for Behavioral Changes. Providers increased the number of patients seen per hour. Program evaluations and focus group data from providers, staff, and students indicated IPCP programs can be sustainable with ongoing intentional team care strategies.
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Affiliation(s)
- Jean Nagelkerk
- Vice Provost for Health, Office of the Vice Provost for Health, Grand Valley State University, Grand Rapids, MI
| | - Jeff Trytko
- Program Director, Grand Valley State University, Grand Rapids, MI
| | | | - Amy Tompkins
- Facility Manager, Cherry Health, Grand Rapids, MI
| | - Margaret Thompson
- Associate Dean of Academic Affairs, Michigan State University, College of Human Medicine, Grand Rapids, MI
| | - Michael Bouthillier
- Associate Professor, Ferris State University College of Pharmacy, Grand Rapids, MI
| | - Andrew Booth
- Physician Assistant, Chair and Assistant Professor, Physician Assistant Studies Department, Grand Valley State University, Grand Rapids, MI
| | - Carl Nord
- Senior Statistician in Computation, Eli Lilly, Indianapolis, IN
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Abstract
PURPOSE OF THE STUDY The purpose of this study was to examine the time contribution of social workers in delivering AIMS (Ambulatory Integration of the Medical and Social), a care management protocol designed to address patients' nonmedical needs, and the association of time contribution with patients' depression outcomes. PRIMARY PRACTICE SETTING The study was conducted in 6 primary care provider clinics housed in a large, urban academic medical center located in the Midwestern United States. METHODOLOGY AND SAMPLE A longitudinal, quasi-experimental study employing survey procedures and a retrospective review of patient records was conducted. The study included 340 patients 50 years and older with unmet nonmedical needs. Half of the patients received AIMS, which was delivered by social workers. The other half received usual care (UC), which was delivered by other health care providers. RESULTS Chi-square analysis and independent-samples t tests were performed to compare time spent addressing nonmedical needs with differences in patients' depression levels at 6 months postenrollment. The findings reveal that social workers spend significantly more time with patients than UC providers addressing patients' nonmedical needs (p < .0001). At 6 months postintervention, reduced levels of depression were observed for AIMS patients when compared with UC patients (p = .026). IMPLICATIONS FOR CARE MANAGEMENT PRACTICE Including social workers as part of health care teams is valuable. Time spent with patients and engaging in care management activities to support patients' needs is linked with positive health outcomes. Given the benefits of care management, opportunities for reimbursement are enhanced.
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14
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Lehnerer S, Hotter B, Padberg I, Knispel P, Remstedt D, Liebenau A, Grittner U, Wellwood I, Meisel A. Social work support and unmet social needs in life after stroke: a cross-sectional exploratory study. BMC Neurol 2019; 19:220. [PMID: 31492151 PMCID: PMC6729017 DOI: 10.1186/s12883-019-1451-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 08/27/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Stroke patients are often affected by long-term disabilities with needs concerning social issues. There is relatively little consideration of social recovery of patients and the support required to return to work, receive social benefits, participate in daily life activities, maintain contact with family and friends and to organize financial affairs. In our study we aimed to investigate if existing tools record social needs adequately. We analyzed the current provision of social support provided in long-term care after stroke and whether unmet social needs were associated with quality of life, caregiver burden, overall function and degree of disability. METHODS Our analysis is part of the Managing Aftercare of Stroke study (MAS-I), a cross-sectional exploratory study of patient needs 2-3 years after initial stroke. Assessment tools included the Nikolaus-score (social situation), the EuroQoL (quality of life), the German Burden Scale for Family Caregivers (caregiver burden), the modified Rankin Scale (disability / dependence), Stroke Impact Scale (function and degree of disability) and the Stroke Survivor Needs Questionnaire (unmet needs). RESULTS Overall 57 patients were included in MAS-I, with ten patients classified in urgent need of socio-economic support according to the Nikolaus-score. Patients with lower than normal Nikolaus-score had a higher degree of disability. Thirty percent of all patients had never received professional social support. Social worker contact happened mostly during the stay in acute hospital or rehabilitation institution. Only four patients (11%) reported long-term support after discharge. Apart from social worker contact during acute care, 43% of patients had unmet needs in the long-term aftercare. Forty percent of all patients included in MAS-I were recommended for social work intervention after an in-depth analysis of their situation. Finally, we saw that unmet social needs were associated with lower quality of life and higher caregiver burden. CONCLUSIONS Our data suggest significant unmet needs in social care in long-term stroke patients. Screening tools for unmet social needs such as the Nikolaus-score do not holistically report patients' needs. TRIAL REGISTRATION Clinicaltrials.Gov NCT02320994 . Registered 19 December 2014 (retrospectively registered).
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Affiliation(s)
- Sophie Lehnerer
- Center for Stroke Research Berlin, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Department of Neurology, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- NeuroCure Clinical Research Center, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Benjamin Hotter
- Center for Stroke Research Berlin, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Department of Neurology, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- NeuroCure Clinical Research Center, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Inken Padberg
- Center for Stroke Research Berlin, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Clinical Epidemiology and Health Services in Stroke, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Petra Knispel
- Center for Stroke Research Berlin, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin Stroke Alliance (BSA), Charitéplatz 1, 10117 Berlin, Germany
| | - Dike Remstedt
- NeuroCure Clinical Research Center, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Andrea Liebenau
- Center for Stroke Research Berlin, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch 2, 10178 Berlin, Germany
| | - Ian Wellwood
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR UK
| | - Andreas Meisel
- Center for Stroke Research Berlin, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Department of Neurology, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- NeuroCure Clinical Research Center, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin Stroke Alliance (BSA), Charitéplatz 1, 10117 Berlin, Germany
| | - on behalf of the BSA Long Term Care Study Group
- Center for Stroke Research Berlin, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Department of Neurology, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- NeuroCure Clinical Research Center, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Clinical Epidemiology and Health Services in Stroke, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin Stroke Alliance (BSA), Charitéplatz 1, 10117 Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch 2, 10178 Berlin, Germany
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR UK
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15
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Rowe J, Rizzo VM, Guthrie D, Vail MR, Kang SY, Golden R. The Electronic Health Record: Documenting the Unique Contributions of Social Workers. HEALTH & SOCIAL WORK 2019; 44:123-128. [PMID: 30796826 DOI: 10.1093/hsw/hlz006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 08/08/2018] [Accepted: 08/29/2018] [Indexed: 06/09/2023]
Affiliation(s)
- Jeannine Rowe
- Jeannine Rowe, PhD, APSW, is associate professor of social work, Department of Social Work, University of Wisconsin-Whitewater, 800 West Main Street, Laurentide Hall 5213, Whitewater, WI 53190; e-mail: . Victoria M. Rizzo, PhD, LCSW-R, is associate professor of social work, School of Social Welfare, University at Albany, State University of New York. Deanna Guthrie, PhD, LCSW, is assistant professor of social work, Department of Social Work, University of Wisconsin-Whitewater. Matthew R. Vail, MA, LCSW, is project coordinator, Department of Health and Aging, Rush University Medical Center, Chicago. Suk-Young Kang, PhD, is associate professor of social work, Department of Social Work, Binghamton University, Binghamton, NY. Robyn Golden,MA, LCSW, is associate vice president of population health and aging, Department of Health and Aging, Rush University Medical Center, Chicago. Support for this research was provided by the Commonwealth Fund. The views presented here are those of the authors and not necessarily those of the Commonwealth Fund or its directors, officers, or staff
| | - Victoria M Rizzo
- Jeannine Rowe, PhD, APSW, is associate professor of social work, Department of Social Work, University of Wisconsin-Whitewater, 800 West Main Street, Laurentide Hall 5213, Whitewater, WI 53190; e-mail: . Victoria M. Rizzo, PhD, LCSW-R, is associate professor of social work, School of Social Welfare, University at Albany, State University of New York. Deanna Guthrie, PhD, LCSW, is assistant professor of social work, Department of Social Work, University of Wisconsin-Whitewater. Matthew R. Vail, MA, LCSW, is project coordinator, Department of Health and Aging, Rush University Medical Center, Chicago. Suk-Young Kang, PhD, is associate professor of social work, Department of Social Work, Binghamton University, Binghamton, NY. Robyn Golden,MA, LCSW, is associate vice president of population health and aging, Department of Health and Aging, Rush University Medical Center, Chicago. Support for this research was provided by the Commonwealth Fund. The views presented here are those of the authors and not necessarily those of the Commonwealth Fund or its directors, officers, or staff
| | - Deanna Guthrie
- Jeannine Rowe, PhD, APSW, is associate professor of social work, Department of Social Work, University of Wisconsin-Whitewater, 800 West Main Street, Laurentide Hall 5213, Whitewater, WI 53190; e-mail: . Victoria M. Rizzo, PhD, LCSW-R, is associate professor of social work, School of Social Welfare, University at Albany, State University of New York. Deanna Guthrie, PhD, LCSW, is assistant professor of social work, Department of Social Work, University of Wisconsin-Whitewater. Matthew R. Vail, MA, LCSW, is project coordinator, Department of Health and Aging, Rush University Medical Center, Chicago. Suk-Young Kang, PhD, is associate professor of social work, Department of Social Work, Binghamton University, Binghamton, NY. Robyn Golden,MA, LCSW, is associate vice president of population health and aging, Department of Health and Aging, Rush University Medical Center, Chicago. Support for this research was provided by the Commonwealth Fund. The views presented here are those of the authors and not necessarily those of the Commonwealth Fund or its directors, officers, or staff
| | - Matthew R Vail
- Jeannine Rowe, PhD, APSW, is associate professor of social work, Department of Social Work, University of Wisconsin-Whitewater, 800 West Main Street, Laurentide Hall 5213, Whitewater, WI 53190; e-mail: . Victoria M. Rizzo, PhD, LCSW-R, is associate professor of social work, School of Social Welfare, University at Albany, State University of New York. Deanna Guthrie, PhD, LCSW, is assistant professor of social work, Department of Social Work, University of Wisconsin-Whitewater. Matthew R. Vail, MA, LCSW, is project coordinator, Department of Health and Aging, Rush University Medical Center, Chicago. Suk-Young Kang, PhD, is associate professor of social work, Department of Social Work, Binghamton University, Binghamton, NY. Robyn Golden,MA, LCSW, is associate vice president of population health and aging, Department of Health and Aging, Rush University Medical Center, Chicago. Support for this research was provided by the Commonwealth Fund. The views presented here are those of the authors and not necessarily those of the Commonwealth Fund or its directors, officers, or staff
| | - Suk-Young Kang
- Jeannine Rowe, PhD, APSW, is associate professor of social work, Department of Social Work, University of Wisconsin-Whitewater, 800 West Main Street, Laurentide Hall 5213, Whitewater, WI 53190; e-mail: . Victoria M. Rizzo, PhD, LCSW-R, is associate professor of social work, School of Social Welfare, University at Albany, State University of New York. Deanna Guthrie, PhD, LCSW, is assistant professor of social work, Department of Social Work, University of Wisconsin-Whitewater. Matthew R. Vail, MA, LCSW, is project coordinator, Department of Health and Aging, Rush University Medical Center, Chicago. Suk-Young Kang, PhD, is associate professor of social work, Department of Social Work, Binghamton University, Binghamton, NY. Robyn Golden,MA, LCSW, is associate vice president of population health and aging, Department of Health and Aging, Rush University Medical Center, Chicago. Support for this research was provided by the Commonwealth Fund. The views presented here are those of the authors and not necessarily those of the Commonwealth Fund or its directors, officers, or staff
| | - Robyn Golden
- Jeannine Rowe, PhD, APSW, is associate professor of social work, Department of Social Work, University of Wisconsin-Whitewater, 800 West Main Street, Laurentide Hall 5213, Whitewater, WI 53190; e-mail: . Victoria M. Rizzo, PhD, LCSW-R, is associate professor of social work, School of Social Welfare, University at Albany, State University of New York. Deanna Guthrie, PhD, LCSW, is assistant professor of social work, Department of Social Work, University of Wisconsin-Whitewater. Matthew R. Vail, MA, LCSW, is project coordinator, Department of Health and Aging, Rush University Medical Center, Chicago. Suk-Young Kang, PhD, is associate professor of social work, Department of Social Work, Binghamton University, Binghamton, NY. Robyn Golden,MA, LCSW, is associate vice president of population health and aging, Department of Health and Aging, Rush University Medical Center, Chicago. Support for this research was provided by the Commonwealth Fund. The views presented here are those of the authors and not necessarily those of the Commonwealth Fund or its directors, officers, or staff
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16
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González-Ramos G, Cohen EV, Luce V, González MJ. Clinical social work in the care of Parkinson's disease: role, functions, and opportunities in integrated health care. SOCIAL WORK IN HEALTH CARE 2019; 58:108-125. [PMID: 31307342 DOI: 10.1080/00981389.2018.1544600] [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: 06/22/2018] [Revised: 10/15/2018] [Accepted: 11/01/2018] [Indexed: 06/10/2023]
Abstract
Healthcare reform, including the focus on chronic illness, the growing role of neuroscience, the emphasis on collaborative interprofessional care, and more recently, on integrated medical and behavioral healthcare, have important implications for social work education and practice. Parkinson's disease, a chronic neurodegenerative illness exemplifying these trends, is an area in which social workers are increasingly involved. This paper provides (1) an overview of Parkinson's disease and its complexity, (2) a summary of role and functions identified in a survey of health social workers working with Parkinson's disease and/or neurology, and (3) education and practice recommendations for the social work profession.
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Affiliation(s)
| | - Elaine V Cohen
- a Silver School of Social Work , New York University , New York , USA
| | - Virge Luce
- a Silver School of Social Work , New York University , New York , USA
| | - Manny J González
- b School of Social Work, College for Design and Social Inquiry , Florida Atlantic University , Boca Raton , USA
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17
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Xiang X, Zuverink A, Rosenberg W, Mahmoudi E. Social work-based transitional care intervention for super utilizers of medical care: a retrospective analysis of the bridge model for super utilizers. SOCIAL WORK IN HEALTH CARE 2019; 58:126-141. [PMID: 30424717 DOI: 10.1080/00981389.2018.1547345] [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: 04/11/2018] [Revised: 08/21/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
The present study was a retrospective evaluation of a social worker-led transitional care intervention that addresses the medical and social needs of inpatient super utilizers with ≥5 inpatient admissions in a 12-month period. Bivariate analyses revealed significant reductions in the total number of hospital admissions, 30-day readmission rates, number of emergency department visits, average hospital charges per episode, and total hospital charges per person after the intervention. This social work intervention may be of interest to providers and payers, particularly regarding addressing the psychosocial needs of complex patients who account for most of health care costs.
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Affiliation(s)
- Xiaoling Xiang
- a School of Social Work , University of Michigan , Ann Arbor , MI , US
| | - Ashley Zuverink
- a School of Social Work , University of Michigan , Ann Arbor , MI , US
| | - Walter Rosenberg
- b Social Work and Community Health , Rush University Medical Center , Chicago , IL , US
| | - Elham Mahmoudi
- c Department of Family Medicine , University of Michigan , Ann Arbor , MI , US
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18
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Pruitt Z, Emechebe N, Quast T, Taylor P, Bryant K. Expenditure Reductions Associated with a Social Service Referral Program. Popul Health Manag 2018; 21:469-476. [PMID: 29664702 PMCID: PMC6276598 DOI: 10.1089/pop.2017.0199] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Recent health system innovations provide encouraging evidence that greater coordination of medical and social services can improve health outcomes and reduce health care expenditures. This study evaluated the savings associated with a managed care organization's call center-based social service referral program that aimed to assist participants address their social needs, such as homelessness, transportation barriers, and food insecurity. The program evaluation linked social service referral data with health care claims to analyze expenditures in 2 annual periods, before and after the first social service referral. Secondary data analysis estimated the change in mean expenditures over 2 annual periods using generalized estimating equations regression analysis with the identity link. The study compared the change in mean health care expenditures for the second year for those reporting social needs met versus the group whose needs remained unmet. By comparing the difference between the first and second year mean expenditures for both groups, the study estimated the associated savings of social services, after controlling for group differences. These results showed that the decrease in second year mean expenditures for the group of participants who reported all of their social needs met was $2443 (10%) greater than the decrease in second year mean expenditures for the group who reported none of their social needs met, after controlling for group differences. Organizations that integrate medical and social services may thrive under policy initiatives that require financial accountability for the total well-being of patients.
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Affiliation(s)
- Zachary Pruitt
- Department of Health Policy and Management, College of Public Health, University of South Florida, Tampa, Florida
| | - Nnadozie Emechebe
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida
| | - Troy Quast
- Department of Health Policy and Management, College of Public Health, University of South Florida, Tampa, Florida
| | - Pamme Taylor
- Center for CommUnity Impact, WellCare Health Plans, Inc., Tampa, Florida
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Abstract
Community health centers (CHC) provide quality care for vulnerable patients, and a potentially contributing factor to this quality is the integration of a patient-centered medical home (PCMH). PCMH relies on a team-based approach, a principle in which social workers are trained and research examines in primary care environments. Less is known about team-based care in CHCs. An exploratory qualitative study with 14 CHC staff was conducted to examine the current state of team-based care and secondarily, to examine the role of social workers. Content analysis revealed four themes central to team-based care. Implications for CHCs and social workers are discussed.
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Affiliation(s)
- Kristi L Law
- a Department of Social Work , University of Wisconsin-Whitewater, College of Letters and Science , USA
| | - Jeannine M Rowe
- a Department of Social Work , University of Wisconsin-Whitewater, College of Letters and Science , USA
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