Overview

Provides clinical social work services related to patients? and family members? current and post-acute psychosocial and clinical needs. Completes psychosocial assessments; provides crisis intervention, emotional support, and short-term counseling with regard to diagnosis, treatment, and post-discharge plan; and creatively identifies and accesses resources to optimize effective and efficient patient care outcomes in collaboration with other members of the multi-disciplinary team.Serves patients with acute episodes of severe and persistent mental illness and/or patients with new onset psychiatric and mental health needs. Utilizes principles of individual, group and family therapy theories. (Behavioral Health)

Responsibilities

Completes psychosocial assessments. Identifies patients for whom Clinical Social Work services would be beneficial. Completes and documents assessments using departmental procedures and within required timeframes. Obtains information about patient's clinical status through collaboration with healthcare team and incorporates into assessment process. Identifies and applies information about patient's health behaviors, cultural influences, and belief or value system. Identifies, addresses, and re-assesses based upon potential barriers to plan and works with healthcare team to address. The weight for Inpatient Rehab is 25%. Specific to Behavioral Health: Provides clinical social work services to patients with acute psychiatric and mental health needs. Identifies the patient's personal goals for hospitalization and discharge planning and applies information about patient's health behaviors, cultural influences, and belief or value system. Proactively seeks input from other members of the multidisciplinary team and identifies, facilitates and delivers appropriate clinical and psychosocial interventions accordingly. Identifies, addresses, and re-assesses based upon actual or potential barriers to treatment and/or discharge plan and works with healthcare team to address. Documents the patient's clinical status, plan of care and discharge plan according to CH and BHH policies and/or expectations of regulatory bodies.--------------------------------------------------Facilitates healthcare delivery process/coordinates care planning. Anticipates patients' and families' discharge needs, developing and implementing plans of care which enhance quality, access, and cost-effective outcomes, and identifying and addressing barriers to progression, in a timely manner. Creatively identifies and links patients to appropriate organizational, financial and community resources in order to achieve optimal outcomes and compliance with regulatory agency requirements. Works with departmental leadership to identify the need for and develop resources to achieve optimal outcomes. The weight for Moses Cone Hospital Outpatient Clinic is 0%. Specific to Behavioral Health: Anticipates the acute psychiatric and mental health needs of patients and family members related to the diagnosis and treatment. Provides crisis intervention, emotional support and short-term therapeutic individual, family, and group counseling. Provides clinically relevant and engaging treatment according to best practice models. Educates others on the healthcare team about the crisis when the disease/hospitalization/discharge plan is impacted and according to regulations governing confidentiality. Analyzes and documents group process. Identifies and recommends patients for family sessions and ensures family sessions occur in a timely and effective manner. Communicates patients' needs and prognosis to family members.--------------------------------------------------Addresses complex clinical issues. Anticipates complex psychosocial or clinical issues or behaviors creating or contributing to non-compliance, over-utilization of resources, and/or readmissions. Develops and implements plans of care which enhance quality, access, and cost-effective outcomes. Evaluates and updates patients' progress and identifies and addresses barriers to progression in a timely manner. Ensures patient's participation in the treatment planning process. Creatively works with departmental and organizational leadership and Physician Advisor to address these issues in order to achieve optimal outcomes and compliance with regulatory agency requirements. The weight for Inpatient Rehab is 25%.Specific to Behavioral Health: Anticipates the acute psychiatric and mental health needs of patients and family members related to the hospitalization and discharge plan; develops and implements plans of care which enhance quality, access, and cost-effective outcomes. Evaluates and updates patients' progress and identifies and addresses barriers to progression in a timely manner. Effectively communicates patient's progress in groups and family sessions. Ensures patient's participation in the treatment planning process. Creatively identifies and links patients to appropriate organizational, financial and community resources in order to achieve optimal outcomes and compliance with regulatory agency requirements.--------------------------------------------------Provides clinical social work interventions. Anticipates and intervenes appropriately and effectively in patient/family crises and ensures implementation of appropriate plans for resolution and post-discharge follow-up. Provides crisis intervention and emotional support and, when indicated, short-term therapeutic counseling to patients and family members. Educates others on the healthcare team about the crisis when the disease/hospitalization/discharge plan is impacted, and according to regulations governing confidentiality. Anticipates and intervenes appropriately with patients, family members and/or physicians with regard to end of life issues and decision-making when appropriate, initiating discussions with the healthcare team as needed. Assists patients and physicians with completion of advance directives, Out of Facility Do Not Resuscitate Orders, and MOST forms as needed. Specific to Behavioral Health: Conducts suicide risk education. Identifies and recommends patients in need of suicide risk and prevention education. Provides suicide risk and prevention education prior to discharge from BHH or as soon as possible for all patients with a history of suicidal/homicidal ideation, attempts, or other safety concerns and their families/significant others and documents in accordance with departmental requirements. Formulates and communicates patients' needs and prognosis to family members/significant others and coordinates with ancillary family members. Conducts family sessions or family contact in a timely manner.--------------------------------------------------Advocates for patients, family members and organization; contributes to the professional development of self and others. Educates other disciplines about the importance of communicating appropriate clinical and psychosocial information to clinical social work staff, and intervenes when appropriate. Ensures patients and family members are actively informed of and participating in the care process and are able to make informed decisions about hospitalization and post-discharge care. Advocates for patients' cultural and religious beliefs and value systems, and ensures that this information is communicated to others on the healthcare team so that they are incorporated into the care plan; educates healthcare team about the impact of these factors on patients' healthcare decision-making and health and wellness outcomes. Assists with orientation and mentoring new staff and students as requested. Provides on-call and weekend coverage as assigned. Adheres to the National Association of Social Workers' Code of Ethics.--------------------------------------------------Participates in quality improvement. Participates in data collection in accordance with departmental policies and procedures, and with accuracy and within requested timeframes. Reviews, interprets and applies clinical and financial data relevant to assigned patient populations. Maintains awareness of and shares literature relevant to current psychosocial interventions and issues. Recognized as an expert resource; provides ongoing educational opportunities to enhance the knowledge of the healthcare team and/or community with regard to the psychosocial issues of the patient population. --------------------------------------------------

Qualifications

EDUCATION:Masters, Social Work, requiredRequired: MSW (Master of Social Work) from a program accredited by the Council on Social Work EducationEXPERIENCE:Required: Minimum of two (2) years of recent experience in a health-related environmentOne to two (1 to 2) years of recent inpatient or outpatient clinical experience (Behavioral Health)Preferred: Equivalent combination of education and experience may be consideredLICENSURE/CERTIFICATION/REGISTRY/LISTING:REQUIRED:Required: LCSWA (Licensed Clinical Social Work Associate)CPR is required for Clinical Social Workers in SW-Transitions of Care department. Current employees must obtain CPR certification by 9/30/2023. (BLS (CPR) - American Red Cross or AHA Healthcare Provider)PREFERRED: