Understanding organizational reengineering in health care: strategies for social work's survival

Role changes of hospital social workers in South Korea

The roles of social workers in hospitals have changed in accordance with the environmental changes in the healthcare system. Since 1958, hospital social workers have performed important roles in providing care services in South Korea. Providing psychosocial services was considered to be the most important for more than 30 years from the 1970s to the 1990s. The healthcare system has since undergone major environmental changes, yet there has been little study on the role of hospital social workers in South Korea. In order to address this research gap, this study aims to explore how the roles of hospital social workers have changed since the 2000s. We recruited 198 hospital social workers who were active members of the Korean Association of Medical Social Workers as study participants. The average age of participants was 35.36 years old (SD = 8.27), and they had an average of 8.24 years in hospital social work experience (SD = 6.35). The results indicated that the roles of financial support and community resource linkage, which were regarded to be relatively less important until the 1990s, were recognized as the most important. Given the role changes of hospital social workers in South Korea, implications are discussed.

From organizational awareness to organizational competency in health care social work: the importance of formulating a "profession-in-environment" fit

Today's health care environments require organizational competence as well as clinical skill. Economically driven business paradigms and the principles underlying the Patient Protection and Affordable Care Act of 2010 emphasize integrated, collaborative care delivered using transdisciplinary service models. Attention must be focused on achieving patient care goals while demonstrating an appreciation for the mission, priorities and operational constraints of the provider organization. The educational challenge is to cultivate the ability to negotiate "ideology" or ideal practice with the practical realities of health care provider environments without compromising professional ethics. Competently exercising such ability promotes a sound "profession-in-environment" fit and enhances the recognition of social work as a crucial patient care component.

Hospital social work: contemporary roles and professional activities

Since its inception in the 1900s, hospital social work has been impacted by the ever changing hospital environment. The institution of Diagnostic Related Groups (DRGs), the era of reengineering, and the constant struggle toward health care reform make it necessary to evaluate and substantiate the value and efficacy of social workers in hospital settings. This study identifies current roles and activities carried out by social workers in acute hospital settings from across the nation in the aftermath of reengineering. Findings suggest the primary role of respondents in this study to be discharge planning with little to no involvement in practice research or income-generating activities.

A systematic approach for providing concrete services and discharge planning based on using information handouts

While information handouts are commonly used in healthcare education, this paper is about social workers systematically developing and using them to provide timely, efficient, and ultimately better patient care for concrete services and discharge planning. How to identify topics and suggestions for composing user-friendly handouts are discussed. Many clinical uses for handouts are considered including: engaging, assessing, and empowering patients, groups, and families. Related uses are considered such as educating the treatment team and students. How handouts can be a crucial bridge to developing a comprehensive, focused social resource database is considered. Follow-up survey results with an inner city VA social work staff (N= 41) confirm that social work discharge planners and non-discharge planners find systematically developed handouts valuable for providing efficient, better patient care.

A career in hospital social work: do you have what it takes?

Hospitals present a variety of complex challenges for social work practitioners. Clinical social workers deal with emotionally intense and potentially draining cases in a setting where they are often faced with threats to their identity or existence. They must balance their role as patient advocates with institutional needs and be able to adjust to ever-changing models of health care delivery. Why do some social workers thrive in this environment while others struggle to survive? This article draws upon the author's twenty-year career in hospital social work to provide a "snapshot" of the clinical social work role in teaching hospitals. Included in the discussion are observations about the unique aspects of clinical practice in the hospital and strategies for surviving power struggles, turf battles and hospital "politics."

Hospital social work: are we conducting the right type of research?

Given the current financial state of health care in the United States, intervention- or outcome-based research is essential for the survival of hospital social workers. The purpose of the current study was to systematically review the current literature on hospital social work to assess the effectiveness of hospital social work in implementing intervention- based research and to make recommendations for the future direction of research among hospital social workers. Over the 10-year period (1991-2001), a total of 44 peer-reviewed journal articles were identified for inclusion in the present study: 19 were qualitative articles and 25 were quantitative articles. Of these studies, only 5 studies were intervention based research. Possible strategies for increasing intervention research among hospital social workers were discussed.

The effect of organizational reengineering on job satisfaction for staff in hospital social work departments

The professional staff in five hospital social work departments participated in an exploratory study to assess the impact of organizational reengineering on job satisfaction, professional identity and other work related attitudes. A survey was used to explore how job functions had changed; whether or not staff felt adequately prepared to perform the new tasks; and whether the changes were consistent with their professional identities and academic preparation. Follow up focus group interviews were held to enrich the quantitative findings. The results of the study indicate that reengineering has a negative effect on job satisfaction and results in role changes that are experienced as inconsistent with the professional identity and academic preparation of social work staff. In addition to describing the results of the study, this paper provides a brief overview of reengineering, describes models of reengineering for hospital social work departments and suggests strategies for lessening the negative effect on staff.