The role and the interventions of the Hospital Social Service (HSS) for the integration of the health and social activities: a comparative survey between 2008 and 2014 in the Social Service of the "Azienda Ospedaliera Universitaria Policlinico Umberto I" in Rome, Italy.

INTRODUCTION: In the Azienda Ospedaliera Universitaria Policlinico Umberto I in Rome, the Hospital Social Services (HSS) is located within the Directorate of Health, reporting directly to the Chief Medical Officer, providing counselling and supporting clinical services. The HSS is part of a network with its own technical, professional and assessment independence. It often serves as liaison between the hospital and the territory, facilitating the development of services and contributing to public health recovery and maintenance, therefore improving the citizens' standard of living thanks to aid projects and specific interventions. METHODS: The present Report is based on two different studies carried out in 2008 and 2014, both examining the work of the Hospital Social Service in the "Azienda Ospedaliera Universitaria Policlinico Umberto I" in Rome. The purpose is to compare these surveys and work out the results. The data collection is based on a number of social records from the HSS archives (814 records in 2008 and 790 in 2014). The research project followed subsequent stages: planning a draft of the research, where ethnomethodology was used as empirical evaluation technique; collecting data from the HSS's paper and file archives (biographical, clinical and social data); revising, analysing and elaborating the data which showed relevant changes leading to interesting conclusions. RESULTS AND CONCLUSIONS: The comparative analysis of data showed a higher demand of HSS healthcare services, despite a smaller number of beds and hospitalisations available in standard regime. Also, it indicated an increase of patients below 18 years and a decrease of the over-65s age group. As for the geographical origin of patients reported to the HSS, there was a decrease in the percentage of Italian citizens, while the percentage of irregular non-EU and EU patients increased by over 5%. Significant results were found comparing the days between the report to the HSS and patient discharge. Data concerning the 'more than 7 days' group was steady over the years, being more consistent for both the variables considered and increasing in 2014. In the comparative analysis, the interventions with more significant differences were those aimed at promoting homecare and entering sheltered housing. In the former cases, a considerable decrease was observed, if compared to the activation of the integrated health and social homecare services, while there were more requests for homecare assistance; in the latter ones the analysis highlighted a sharp decrease in the percentage of the variable called "assessment to enter Extended Care Units". The causes of these changes are remarkable and have to be found in the political, historical and cultural scenario: - a first factor is the increase in the more recent migratory flow from non-EU countries to Italy, which could explain the rising percentage of foreigners taken over by the HSS; - regional policies, economic cuts imposed on healthcare and higher income limits in order to calculate the patient's economic participation in the costs of institutionalisation have affected the above-mentioned changes; - the innovations in the regulatory field of Latium Region have brought structural changes in long-term care facilities and in the level of care in Extended Care Units (ECU).

Evidence that supports the value of social work in hospitals.

The value of hospital social work is supported by one hospital's tracking system that monitored social work discharge services and compared outcome with non-social work discharges. The sample consisted of a total of 64,722 patients admitted to the "med-surg" hospital unit over a two and one-half year time period from 2002 to 2004. Of the total patients in the sample, 15.7% (n = 10,156) had social work involvement. Sixty percent of the social worker patients were age 70 or over compared with the mean age of the sample of 56.2 years. The mean length of stay for social work served patients was 11.4 days (sd = 13.9) compared to 4.3 days (sd = 6.3) non-social work patients, a difference that was significant (t =-68.3; p = .000). The authors attribute the longer lengths of stay to social workers' receiving older and more difficult-to-place patients. An evidence-based case is made for the cost-containment value of social workers in hospitals and for the creation of a tracking infrastructure to aid in monitoring the daily achievements of medical/surgical social workers.

Collaborative models of patient care:new opportunities for hospital social workers.

Hospitals are increasingly recognizing the importance of moving away from the traditional medical model of care to more collaborative models that integrate patients and families into the planning and delivery of healthcare. A few existing studies suggest that collaborative models of care result in higher levels of consumer satisfaction, treatment compliance, effective team performance, and increased care coordination (Gance-Cleveland, 2005; DiMatteo et al., 2002; Reid Ponte et al., 2004; Institute for Family-Centered Care, 2004). Key values underpinning social work practice make medical social workers well-positioned to play leadership roles as hospitals make the shift to more patient-centered care. Specific strategies are presented for medical social workers to use in advocating for change in the way health services are planned and delivered within hospital settings.

Continuing to care in changing times. Keynote address.

While oral presentations do not always translate well into print, the enthusiastic response of the audience to Bill Tietjen's keynote address to the 14th Discharge Planning Symposium, Oct. 23, 1993, prompted DPU to put this editorial maxim to the test. Considering the relevance of the symposium's theme to the upheavals that health care reform will invariably impose, we offer Tietjen's keynote address here, in a somewhat shortened version to accommodate the print medium.

Enhancing social work influence in the hospital: identifying sources of power.

Social workers need to develop interest and skills in hospital politics. Turbulent health care systems, combined with the unique organizational attributes of health care organizations, create environments where political skills are essential to achieve social work goals and objectives. This article identifies sources of social work power within the hospital. Power resides not only in the political acumen of the individual but also in the structural attributes associated with the work group. Discussion focuses on resource control and network centrality as structural sources of social work power.

Computerized information systems for social workers in health care.

Social workers' contributions to preventive medicine; discharge planning; and effective integration of hospital, family, and community resources are becoming increasingly important within the changing context of health care delivery. Information technology can be a powerful tool for developing efficient, accurate, and comprehensive patient records. In spite of the potential that information technology offers health care social workers, the actual use of computerized patient data has been limited and slow to develop. This article describes the development of a prototype information system that supports the diverse tasks of health care social workers in ambulatory care, shows how a shared computerized database can improve coordination of patient care among multiple health care disciplines, and addresses emerging issues as a growing number of social workers in health care use computerized information systems.

Proyecto de rotación electiva

Este documento presenta el informe realizado luego del tránsito por la sede de rotación externa de elección libre de la residente de 3er año, la Lic. Olivares García Sofía. La rotación se llevó a cabo durante el período comprendido entre el 14 de febrero y 13 de mayo de 2022 por el Servicio Social del Hospital Ramón Carrillo de San Martín de los Andes, por los centros de salud "Arenal", "Cordones del Chapelco - Chacra 30", "Tiro Federal" y "Vega Maipú", y también por el Centro de Día de dicha ciudad, ubicada en la provincia de Neuquén. A continuación, se presenta la sede de rotación electiva, se expone la fundamentación sobre la elección de dicha sede, se explicitan objetivos del proceso de rotación, actividades realizadas, aprendizajes logrados, obstáculos hallados y aportes realizados a la institución. Para finalizar, se elabora una evaluación y se adjunta la evaluación de la institución.(AU)

[Preventive and social pediatric activity at a university pediatric clinic. Retrospect--prospects]. / Prophylaktische und sozialpädiatrische Arbeit an einer Hochschulkinderklinik. Rückblicke--Ausblicke.

Changes and results of prophylactic and socialpediatric activities at a childrens hospital are represented. The advantages of cooperation between prophylactic and curative spheres are emphasized, they are useful for research and education of students. Decrees are prepared for arrangement of such departments in every university childrens hospital corresponding to the future pediatric development.

The challenge of change: enhancing social work services at a time of cutback.

Little systematic attention has been paid to the process of cuts in resources in hospital social work departments and to the implications of such events over time. This article describes the activities of a social work department in response to hospitalwide downsizing. It outlines conceptual premises for action, recommends a step-by-step process for analysis and implementation, reviews implications of cutback, and describes outcomes for department and personnel. In this particular case, social work administration was able to make changes in department organization to improve quality, efficiency, and professional control of practice while modeling cutback and reorganization to the larger hospital community.

Staying in hospital social work.

Hospitals have traditionally been large employers of social workers. As workplaces they are often identified as being challenging and ambiguous environments for social work practice. In this study the experience of hospital work is explored. Social workers' 'tolerance' of the hospital environment is identified as a way of explaining 'staying.' Staying has both positive and negative features which arise from the interaction between workers' tolerance of the environment and their qualities of 'self-actualisation.' The identification of this relationship informs and challenges existing theories of retention and turnover of workers.

Responsiveness to need: social work's impact on health care.

Many factors and events have influenced the practice of social work in the field of health, but how has social work shaped health care delivery in turn? This examination of social work's impact indicates that the profession has succeeded in demonstrating the importance of considering the individual and his or her life as a whole in the provision of services.

DRGs and hospital social work: when policy guides practice.

Since the early 1980s cost containment policies have changed the practice of hospital social work. Diagnosis Related Groups (DRGs), a cost containment mechanism, have increased the caseloads of hospital social workers, and placed a greater emphasis on discharge planning. In this article DRGs are described, and their function is discussed from a social work perspective. The literature surrounding DRGs and the role of the hospital social worker is addressed. Recommendations are made for social workers to evaluate the policies affecting their practice. It is proposed that if social workers understand policies, their origins, and how policies affect practice, then they can have greater influence as advocates and policy makers.

The evolution of social work in a community hospital.

Since 1905 social work has had the privilege of working with great medical leaders who have respected and assisted our profession. As predicted in 1984 by Abraham Lurie, The social work department of the future will be more decentralized ... develop stronger links administratively ... knowledge of changing social problems ... legislation, research, computerization, data gathering and retrieval. The Columbus Regional Hospital Social Work department is still early in its development, yet the above predictors have occurred which strengthened social work role and professional practice. By 1992 the following areas served as a strong foundation for the department's continued growth: Resource acquisition Hospital Integration Physician Support We must continue to advocate for improved care along with providing an environment of compassion for the patients and their families who seek services. Through continued participation on hospital committees such as ethics, and utilization review, we can demonstrate our practice and influence the environment. By creatively accessing resources we can influence and shape opportunities for colleagues. As a social work manager I thank those who have come before me who laid framework, fought battles and defined territory. We need to continue to support one another through collaborative processes and shared experiential learnings.

Rethinking social work service delivery.

Providence Centre is a 577-bed, multilevel, geriatric health facility located in Scarborough, Ontario. This article outlines the transition from a traditional model of social work service delivery to a specialized case referral system. It describes the review process, creation of the alternative service model, implementation strategies, evaluation measures and outcomes of the undertaking. Through these efforts, the centre succeeded in creatively redefining and restructuring its social work service delivery and resource utilization in today's tough economic climate.

The impact of hospital restructuring on social work services: a case study of a large, university-affiliated hospital in Canada.

The study investigates the impact of organizational restructuring on social work practice at a large, university-affiliated hospital. The article first reviews relevant literature on the patient-focused care model and presents an overview of the study setting. Several hypotheses are then presented that informed the research process. Workload measurement, interview, and questionnaire data are analyzed to test these hypotheses. The results indicate that the shift to program management has had some intended effects, particularly regarding increases in direct services supporting patients. Social workers reported somewhat lower levels of job satisfaction than expected, which partly reflects the dismantling of the professional infrastructure. Finally, the authors discuss implications for the future of the social work profession under the program management model.

Changing patient populations: considerations for service delivery.

In keeping with a social work concern that pervades all fields of practice, social workers in health settings have always striven to respond to patients' individual needs. As the nature and needs of the populations that are social work's clientele change, so will the focus of the profession's efforts in delivering health care services.