Social Worker
6 days ago
JOB DESCRIPTION
The social worker provides a variety of professional services for patients and families, helping them cope with illness, disability, end-of-life, or compliance with treatment plan. Participates with the Case Management and Nurse Navigation Team and the attending physician in developing a transition plan and may facilitate coordination of the plan on behalf of the patient. The Social Worker serves as an advocate for the patient and family throughout the entire acute episode of care.
RESPONSIBILITIES
* Case Finding
* Collaborates with the Case Management/Nurse Navigation RNs to identify high-risk patients whose progress of care would benefit from psychosocial counseling.
* Individual workload is organized and prioritized within a team context to meet patient care needs based on medical plan, departmental policy and standards to minimize non-acute days.
* Prioritizes referrals and conducts patient/family psychosocial assessment to identify barriers that may impede recovery and/or the patient's safe return to the community.
* Interviews patients and families for suspected adult or child abuse/neglect. Confers with other team members and makes recommendations for treatment/discharge planning. Notifies local and/or state Adult and Children's Protective Services and completes and forwards mandated reports. Maintains liaison with reporting agencies and legal authorities.
* Provides psychosocial assessment for situations related to substance abuse or psychiatric illness and coordinates referrals from the emergency department and inpatient units to appropriate treatment services.
* Assesses patients for needs related to transportation, emergency or financial assistance. May refer to financial counselors or other community resources.
* Works with the Case Management team to assign patients to Swing Bed status and performs appropriate Social Work assessments and documentation to meet regulatory criteria.
* Clinical Responsibilities
* Individualizes the treatment plan according to the assessment of patient/family and age, developmental level or level of disability.
* Demonstrates skill in documenting appropriate information on the medical record in a clear, concise, logical, specific and thorough manner.
* Helps facilitate patient and family understanding of patient's clinical status through individual and/or group conferences.
* Helps patient/family understand, accept and follow medical recommendations within the context of self-determination.
* Demonstrates pro-active communication to advocate on behalf of the patient and organizational stakeholders.
* Uses interpersonal skills which convey a positive and supportive attitude (e.g., active listening, good communication, telephone etiquette)
* Uses appropriate skills in working with the geriatric population, such as speaking distinctly and slowly, providing time for decision making, verbalizing and moving, addressing patient as preferred, involving family or caregiver and considering barriers and limitations when planning for discharge.
* Provides information to patients and family members regarding Medicare /Medicaid and other financial assistance programs as indicated.
* Client Disposition
* Educates patient/family and health care team regarding community resources. May coordinate referrals to appropriate community services to assist with social, financial and environmental problems, and assists patient to resume life in the community.
* Demonstrates self-motivation and takes responsibility for professional self-improvement.
* Identifies opportunities to initiate changes, innovations and improvements in managing patients with chronic psychosocial challenges.
* Participates in hospital or departmental post-acute follow-up outreach programs.
* Collaborates with the CM/UR RNs to assist in planning and expediting post-acute service arrangements.
Additional performance Expectations: Functions as a member of a self-directed Case Management work team ensuring appropriate coverage as indicated by the needs of the department and population served. Communicates schedule and substitute coverage to program management in a timely manner.
* Participates on committees within the department, service lines, facility, and St Peter's Hospital community.
* Participates in performance improvement activities, as defined in the departmental plan.
* Participate in orientation of new employees
* Collects data essential to demonstrate the influence of the Social Work performance and interactions with patients/families.
* Using objective data, works with the department Director to prepare a monthly update of work accomplishments that can be incorporated into the department's quality report card.
* Participates in departmental functions.
* Works in harmony and unison with all personnel within the department and throughout St Peter's hospital.
* Promotes and assists in the smooth, efficient delivery of departmental services to patients and physicians.
* Completes and/or attends all required educational offerings annually.
* Demonstrates the ability to manage time, coordinate departmental functions and promote departmental and professional growth.
* Ability to use electronic software applications related to clinical resource management activities. Operates copying machine, fax machine, and computer. Handling AV equipment, materials, supplies, and patient belongings.
QUALIFICATIONS
KNOWLEDGE/EXPERIENCE :
* Minimum three years related clinical experience, preferably in a hospital setting.
EDUCATION :
* Master of social work from a school accredited by the Council on Social Work Education OR master's degree in related field (social work, counseling, sociology, gerontology, psychology, or health.
LICENSE/CERTIFICATION/REGISTRY : Licensure in the State of Montana required.
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