The Licensed Social Worker assesses the psychosocial functioning of patients and families, and intervenes as necessary to connect patients and families to necessary resources and supports in the community; provide supportive counseling or grief counseling; help the patient to expand and strengthen their network of social support; and/or ensure appropriate access to care and resources and an environment that is safe for discharge.
Psychosocial assessments, crisis intervention and linkage with community and financial resources may be provided for inpatients, outpatients, their families and significant others as appropriate.
The Licensed Social Worker serves as a liaison to community groups and promotes educational programs focused on healthy behaviors.
He/she may lead education and support groups as assigned.
The Licensed Social Worker provides care to all age groups and makes independent decisions within their scope of practice and in collaboration with team members to assist patients and families with complex social situations including hospitalization, illness, diagnosis, treatment, and/or life situations that may include emotional, mental, and substance abuse disorders.
This position has access to confidential patient, system and financial information
Job Duties:
Assesses the psychosocial needs of the patient and family, including evaluation of family/home/financial support, and other high risk social factors, to develop, communicate, and implement an effective and comprehensive plan for psychosocial interventions for all referred cases.
Documents assessment, plan, interactions, and interventions according to hospital and departmental guidelines and standards.
Actively participates in multi-disciplinary team and rounds on an on-going basis as assigned.
For assigned or referred patients/families, collaborates with the health care team to ensure effective, efficient, appropriate care in order to optimize health outcomes and assure a smooth transition between levels of care.
May work in collaboration with the assigned Patient Navigator to develop a comprehensive discharge plan for complex discharges, included but not limited to readmissions and high risk populations.
Refers patients and families to appropriate post-acute services and community resources in coordination with the Care Management team, including assigned Patient Navigators and Care Management Assistants, in accordance with state and federal regulations.
Evaluates patient/families coping with illness/hospitalization and family support systems.
Provides crisis intervention, education, support and advocacy as needed to assist families in understanding the implications and complexities of their medical situation and its impact on lifestyle.
Coordinates discussions/processes related to ethical or legal concerns (i.
e.
, patients, families, team conflicts related to medical plan of care, guardianship cases, end-of-life decisions, advance directives, and DNR orders).
Assesses, coordinates with appropriate state agencies, and provides patient/family support of abuse/neglect cases, domestic violence, substance abuse cases, and crime victims.
Performs legal reporting for suspected child abuse and elder abuse and domestic violence referrals when appropriate in accordance with state regulations.
Develops and maintains working relationships with community agencies and facilitates various support groups with patients and families as appropriate and assigned.
Participates on departmental and hospital committees, and taskforces as assigned.
Promotes effective communication between departments and entities, acting as a liaison to facilitate information sharing, collaborative problem solving and adequate provision of support services.
Provides ongoing Care Management related education for staff, physicians, nurses and allied health professionals
Education:
Bachelor's Degree
in Social Work or healthcare related field
LSW - Licensed Social Worker with current license in the state of Ohio; Valid Ohio Driver's License and proof of current insurance if working Home Care/Hospice; BLS - Basic Life Support
Experience:
Must have a minimum of 1 semester/2 quarters practicum in a hospital-based field OR 1 year social work experience in a healthcare setting or social service agency, either paid or unpaid; 2 years paid medical social work experience post BSW is desirable