Differences and similarities between social work and nurse discharge planners

Identifying and Assisting Burn Patients and Their Families With Needs Through Administration of an Assessment Tool on Admission

Using a modified Safe Environment for Every Kid Questionnaire (Needs Survey), we previously showed a significant correlation between adverse childhood experiences (ACEs) and family needs. Herein, we retrospectively assessed whether patients' and their families' needs identified using the Needs Survey were addressed prior to discharge. We hypothesized that, without the knowledge gained by administering this tool, many basic needs may not have been fully addressed. Seventy-nine burn patients and families previously enrolled in our ACE studies were included. Answers to the Needs Surveys were reviewed to identify families with needs. Medical records were reviewed to determine if a social worker assessment (SWA) was completed per standard of care and if their needs were addressed prior to discharge. Of the 79 burn patients who received inpatient care and completed the Needs Survey, family needs were identified in 67 (84.8%); 42 (62.7%) received an SWA, and 25 (37.3%) did not. Those who did not receive a SWA had a shorter hospitalization and suffered less severe burns. Demographics, socioeconomics, ACEs, and identified needs were similar between the groups. Our study showed that SWA was performed on many patients with basic needs. However, with the focus of SWAs being on discharge arrangements, not all needs were addressed, and individualized resources were often not provided. Administering the Needs Survey on admission may help our social workers streamline and expedite this process to help support successful recovery for our burn patients and their families.

Social Services Involvement in Care Transitions and Admissions in Nursing Homes

Care transitions (CT) are critical junctures in the healthcare delivery process. Effective transitions reduce the need for subsequent transfers between healthcare settings, including nursing homes. Understanding social services (SS) involvement in these processes in nursing homes is important from a quality and holistic care perspective. Using logistic regression, this study examines structural and relational factors identified with higher involvement of SS in care transitions and admissions. SS directors from 924 nursing homes were evaluated in relation to SS involvement in care transitions and admissions processes. Results suggest the level of SS involvement in care transitions and admissions are associated with structural factors such as size of facility, geographical location, ratio of FTE's to beds, ownership status, and standalone SS departments, as well as relational factors, including perceptions and utilization of SS staff by facility leadership, coworkers, and family. Additionally, SS staff with higher levels of expertise and with social work degrees are less involved in admissions tasks.

Transitional care during COVID-19 pandemic in Japan: Calls for new strategies to integrate traditional approaches with information and communication technologies

Transitional care is indispensable in successfully transitioning patients from hospital to home and preventing adverse events during this process. There were restricted services in several hospitals for minimizing the spread of COVID-19. Therefore, hospitals could not provide adequate transitional care that possibly resulted in poor post-discharge outcomes in patients. Some hospitals have now combined infection prevention with face-to-face opportunities, i.e., requiring reservations for transitional care consultation and restricting pre-discharge conferences. Several hospitals started providing pre-discharge conferences using apps, where patients/family caregivers and care teams could have face-to-face discussions about medical and nursing care plans, goals, and preferences. However, building a relationship between patient/family and medical/nursing staff and providing decision-making, psychological support, and risk assessment generally performed in person are still in demand. New hybrid strategies should be developed and evaluated to provide transitional care while using online systems and minimal face-to-face support during the pandemic.

Social workers, nurses, or both: Who is primarily responsible for hospital discharge planning with older adults?

This study examines the profession primarily responsible for discharge planning in all hospitals serving older adults in Minnesota. Quantitative analyses determined that the majority of hospitals in Minnesota serving older adults are small, rural hospitals with critical access designations, are private nonprofit, and are affiliated with a health care system. Social workers are primarily responsible for discharge planning in half of the hospitals, nurses in a quarter and either a nurse/social worker team or both nurse and social worker separately in the remaining quarter. Multinomial logistic regression determined that in critical access hospitals nurses are more likely than social workers to be the profession primarily responsible for discharge planning.

Implementation of Discharge Planning in Hospital Inpatient Room by Nurses

Introduction: Discharge planning is still become a problem for health services in hospital in-patient rooms. Discharge planning commonly is only done when the patients leave hospital by giving them an explanation about the content of the controlling card. Discharge planning is a routine activity that must be done by nurses in order to give information to the patients about their condition and any actions can or should be undertaken by them. In fact, the importance of discharge planning is not yet balanced, nor effectively applied in field. This research was conducted to find out about the implementation of discharge planning by nurses in one of the hospital in-patient rooms at the hospital of study.Methods: This research was a qualitative research study conducted with the phenomenological approach. The informants were 6 patients and 6 nurses in first, second and third class nursing wards. The instruments used in this research were the researchers themselves with interview guidance, field notes and a tape recorder. The data was collected through an in-depth interview.Results: There were three themes found through the analysis, which were 1) the information dimension involving room orientation, rights and obligations, and patient health problems as the sub-themes; 2) the understanding dimension with knowing and understanding the discharge planning as the sub-themes; 3) the implementation dimension with the time of implementation and content of discharge planning as the sub-themes.Discussion: Complete information given to the patients will bring about a positive impact, so then they can help themselves in relation to their curing time at home. A lack of and unclear information will bring about negative impacts such as mistakes when taking drugs, poor diet, neglecting activity while staying at home

Social Workers' Perceived Role Clarity as Members of an Interdisciplinary Team in Brain Injury Settings

This study investigated social workers' role clarity as members of an interdisciplinary team in traumatic and acquired brain injury treatment settings. A total of 37 social workers from 7 Western countries completed an anonymous online survey questionnaire. The majority of participants have more than 10 years of experience working in brain injury treatment settings (59.5%), and about 54% have been in their current employment for more than 10 years. Findings revealed that there were significant positive correlations between perceived respect, team collaboration, and perceived value of self for team with role clarity. Multiple regression analysis revealed that perceived value of self for team was a significant predictor of role clarity (p < .05).

The biopsychosocial model and quality of life in persons with active epilepsy

BACKGROUND

Despite a long recognized need in the field of the importance of the psychological and social factors in persons with epilepsy (PWE), the medical community has continued to focus primarily on seizures and their treatment (the biological-biomedical model). From the biopsychosocial perspective, a person's lived experience needs to be incorporated into the understanding of quality of life. While the biopsychosocial model has gained prominence over the years, it has not been studied much in epilepsy.

METHODS

The study sample included 1720 PWE from the 2003 and the 2005 Canadian Community Health Survey (CCHS). Data were analyzed using set correlation, as it allows for the examination of the relative contribution of sets of independent variables (biological, psychological, and social domains) and a set of dependent variables (quality of life) of interest, defined as self-rated health status, self-rated mental health status, and life satisfaction.

RESULTS

Results provide strong evidence that the full biopsychosocial model explained a significantly larger amount of variance in quality of life (R(2) = 55.0%) compared with the biological-biomedical model alone (R(2) = 24.8%). When the individual domains of the biopsychosocial model were controlled for, the psychological (R(2) = 24.6%) and social (R(2) = 18.5%) domains still explained a greater amount of the variance in quality of life compared with the biological-biomedical model (R(2) = 14.3%).

CONCLUSIONS

While seizure freedom will continue to be an important treatment goal in epilepsy, the psychological and social domains are an important consideration for both interventional programs and clinical research designed to improve quality of life in PWE. Better integration of social workers and psychologists into routine care may help address these disparities.

Expansion of discharge planning system in Japan: Comparison of results of a nationwide survey between 2001 and 2010

Background

In response to the rapid aging of the population in Japan, many care systems have been created in quick succession. Establishment of discharge planning departments (DPDs) in hospitals is one of them. In this study, we compared the distribution and characteristics of DPDs and the characteristics of the hospitals that have DPDs between 2001 and 2010 in Japan.

Methods

We mailed a questionnaire about the characteristics of hospitals and existence and situation of DPDs to all general hospitals with 100 or more general beds in 2001 and in 2010.

Results

In 2001, of the 3,268 hospitals queried, 1,568 (48.0%) responded and 1,357 (41.5%) were selected for data analysis. In 2010, among 2,600 hospitals, 940 hospitals (36.1%) responded and 913 (35.1%) met the inclusion criteria. The percentage of hospitals with DPDs increased from 30% to more than 70% between the two surveys. More departments were under the direct control of the hospital director and more physicians participated in discharge planning activities in 2010 than in 2001. In 2001, private hospitals and hospitals with an affiliated institution or agency tended to have a DPD; however, the relationship between these factors and the presence of a DPD had disappeared in 2010. Larger hospitals and hospitals with more nurses per patient tended to have a DPD both in 2001 and 2010.

Conclusions

Since 2008, the establishment of a DPD has been directly connected to medical fees so hospital administrators might have recognized the DPD as a “necessary and paid for” department. Having a DPD was the majority’s policy in Japan, and we must recognize the importance of quality assurance through DPDs from now on, especially in small hospitals.

Discharge planning from hospital to home for elderly patients: a meta-analysis

In the present healthcare environment, budget cuts, staff shortages, and resource limitations are grave concerns. The elderly in particular consume a considerable proportion of hospital resources. Thus, the discharge planner's role, particularly with respect to elderly patients, is extremely important. In this systematic review recent (within the last 10 years) randomized, controlled or quasi-experimental trials of discharge planning (DP) from hospital to home of patients age 65 years or older were examined. The most important finding was the paucity of investigations by social work professionals. A second important finding was the lack of appropriate reporting of methods and results. Where data were provided, an effect size was computed for statistically significant results (overall mean d = 0.51, SD 0.35). Large effects were noted for patient satisfaction, while moderate effects were evident for patients' quality of life and readmission rates. The integration and evaluation of current knowledge in this field may inform further research and may lead to the advancement of clinical practice and new policy development, with the ultimate goal of improving the quality of patient care and the quality of patient outcomes. The implications for social work clinicians and researchers are discussed.

Evidence that supports the value of social work in hospitals

The value of hospital social work is supported by one hospital's tracking system that monitored social work discharge services and compared outcome with non-social work discharges. The sample consisted of a total of 64,722 patients admitted to the "med-surg" hospital unit over a two and one-half year time period from 2002 to 2004. Of the total patients in the sample, 15.7% (n = 10,156) had social work involvement. Sixty percent of the social worker patients were age 70 or over compared with the mean age of the sample of 56.2 years. The mean length of stay for social work served patients was 11.4 days (sd = 13.9) compared to 4.3 days (sd = 6.3) non-social work patients, a difference that was significant (t =-68.3; p = .000). The authors attribute the longer lengths of stay to social workers' receiving older and more difficult-to-place patients. An evidence-based case is made for the cost-containment value of social workers in hospitals and for the creation of a tracking infrastructure to aid in monitoring the daily achievements of medical/surgical social workers.

Psychosocial severity, length of stay and the role of social work services

Data on excess length of stay (LOS)-the difference between actual LOS and target LOS for the medical problem-were analyzed for three acute care hospitals. For a sample of 2,642 cases, 29.2% of all hospital days were excess days for patients referred to social services. For a sample of 176 social service cases, a stepwise regression yielded two statistically significant predictors of LOS: (1) Medical problem (target LOS) and (2) severity of psychosocial problem (Person-in- Environment scale). The importance of psychosocial severity as a predictor of LOS has clear implications for the role social workers can play in making health care organizations more efficient.