From here forward I am going to use the term Case Manager purposefully interchangeable with and replacing the term Social Worker. Since I will be doing this I thought I should explain why I feel this is appropriate in my perspective of how a Social Worker/ Case Manager should function in the hospital setting.
Social Workers need to be more fluent with the clinical side of cases and Nurse Case Managers should also be more fluent with the social aspects of cases. I want to focus on the need for Social Workers to increase their clinical knowledge and be more involved with the medical aspect of cases. I feel it is imperative for this to happen for Social Workers to remain relevant in the hospital setting.
For patient care to be efficient and effective in the hospital their needs to be an open line of communication with all parties involved. For this to happen all parties involved in the patient’s care need to have a working knowledge of all aspects involved in the case. In order for a Social Worker to be effective they must have a strong base of medical knowledge before they can make a plan for the patient’s discharge.
This knowledge needs to go beyond simply knowing what a diagnosis means. An effective Social Worker needs to be able to recognize the progress of a patient throughout their treatment in the hospital, and anticipate where the patient is at in their care and when they are able to continue their care as an outpatient. Also they should be able to proactively formulate ideas for different paths of care and discuss these with the physician and nurse. Only with this knowledge will relationships be able to form with the physicians and nurses that will allow for proactive discharge planning and seamless patient care.
If a Social Worker is unable to answer any medical questions for a patient or their family and can only refer them to the doctor or nurse then their function is no different than the Medical Equipment delivery person. When they begin to be able to answer some simple medical questions for patients and families they become part of the treatment team. They also begin to build a stronger level of trust with the patient and family that move them beyond being a valet for discharge.
Once the Social Worker can function in that fashion it opens up discussions with the physicians that begin to build a trusting relationship. This allows the Social Worker to bring ideas for discharge to the physician, and allows a two-way dialogue to begin. This is the point proactive discharge planning can begin, and truly when the Social Worker becomes involved in patient care.
This Case Management approach by the Social Worker paints them as a Medical Professional and not a Human Services worker to the patients and their families. It keeps the focus with the families on medical needs and guides them away from social needs unrelated to the patient’s medical care. Not to take away from the importance of those other needs, but they should be dealt with on an outpatient basis and the focus in the hospital should remain on the medical issues presented and arrangements for the care of those issues.
Once this focus is achieved I find that the term Medical Case Manager can easily replace Social Worker without any problem. In fact it seems to be more fitting and focused for the position. With the direction healthcare is moving in it is going to become increasingly important for Social Workers to become more medically relevant. I don’t think it is too far fetched to say eventually these 2 positions will become one. Without increasing the medical knowledge Social Workers have, they may begin to lose their place in the hospital to nurses and a hand full of visits by Social Workers from outside agencies.
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