Social Work & Discharge Planning

Our mission is to be the premier hospital-based social work program in the country. We strive to provide and to teach patient-centered care that is holistic, compassionate and culturally sensitive. We seek to maximize the rights of our patients through our roles with advance directives and discharge planning. Through our clinical skills and our community networking, we seek creative, cost-effective solutions to the bio-psychosocial needs of our patients and families. Our ultimate goal is for all patients to realize their abilities to the fullest.

Social Work
Time spent in the hospital often brings anxiety, fear and questions to be answered for patients, their friends and families. Doctors, nurses and other caregivers provide medical support, but it is the responsibility of the social worker to provide the emotional support during what can be a stressful time. This is essential to ensure a positive outcome.

Our social workers have been specially trained to work with individuals and families in dealing with personal and interpersonal crises caused by illness and hospitalization. The social worker's role is a varied and complex one, but in all cases, he or she plays a vital part in maximizing wellness during the hospital stay and in easing the transition back home or to a healthcare facility.

The goal of social work includes assisting patient with their advance directives, appropriate discharge planning and counseling for patients and family members related to the impact of illness and hospitalization.

Patient and Family Advocacy
During a patient's hospital stay, social workers facilitate family involvement with the entire treatment team. They keep the family apprised of the patient's progress and explain how the family can help the patient recover.

Social workers are trained to help patients and families help themselves. They assist in acquiring the tools to cope with troubling situations such as:

Traumatic and chronic illness
Alcoholism and/or drug dependancy
Financial and emotional strain of caring for a disabled family member
Marital difficulties due to illness
Adult and pediatric abuse and domestic violence
Bereavement

Discharge Planning
Responding to escalating costs and the growing complexities of modern health care, our social workers have taken the lead as discharge planning coordinators. In discharge planning, the social worker helps the patient, family and medical team identify the needs of the patient and target appropriate resources for follow-up care.

Whether a patient is going home or transferring to another healthcare facility, social workers make the transition as smooth as possible. They identify resources in the community that are best suited to the patient's medical and financial situation. They also recommend alternative care if the patient cannot return home.

Counseling Services
Through individual and group interventions, social workers help patients and families with psychological, social and family issues associated with illness, loss, hospitalization or outpatient treatment. They also provide counseling for personal or financial problems related to disability or chronic illness.

Advance Directives
Social workers are specially trained to assist patients in completing advance directives. These legal documents afford the patient the opportunity to communicate their wishes to their healthcare providers.