Hendrick Medical Center - Abilene, TX
posted 4 days ago
The social worker is responsible for assisting in meeting the patient's needs throughout the continuum of care. The Social Worker guides patients, families, physicians and the interdisciplinary team to the appropriate community and adjunct resources that foster quality of life. The social worker interviews patients/families/caregivers/support systems to obtain an age-appropriate psychosocial assessment. The social worker assists patients/families/caregivers/support systems in adjustments to illness, disabilities and the resolution of difficulties within the care management process. The social worker provides psychosocial assessments and develops an interdisciplinary plan of care with the patient and stakeholders to best meet the patient/family needs. The social worker implements and assists with discharge planning services particularly for the complex patient. In the ED, the social worker will facilitate the discharge of patients from the ED and for early intervention with patients being hospitalized. Responsibilities include crisis intervention (to include domestic violence, sexual assault, human trafficking and death), psychosocial assessments with a full range of psychosocial interventions for patients/families, transitional care, and when appropriate, follow-up phone calls and post discharge intervention. Services will also include concrete assistance (e.g., pharmacy (medication assistance), home care, transportation, entitlements, and referral for community services) and close collaboration with the social workers in the outpatient settings to whom ED patients may be referred for follow-up.
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