Lens Widens: A Day in the Life of Social Workers in Health Care

Social workers in health care organizations are experiencing rapid policy changes that may impact practice, yet little is known about their daily work or the patients and families they serve. This study explored a day in the life of health social workers (HSW) at a major urban pediatric hospital with a focus on patient diagnosis, family social determinants of health and the skills and interventions used by HSW.

Methods: An interdisciplinary research team created a measure with questions (253) that included family demographics, health issues, social determinants and social work interventions. Following IRB approval, data was collected on May 7, 2014. Participating HSW completed surveys for (n=130) patients and families.  SPSS was used for analysis.

Results: Health social works are delivering a wider variety of interventions (37). HSW most frequently provided supportive counseling (44%), followed by therapy (15%), education (11%), financial (9%), assessment (7%) resources (6%), advocacy (5%), transportation (1%) and planning (1%). In minutes, interventions ranged from 8 (planning) to 36 (therapy). HSW were most likely to see patients that were complex compared to those that were not and spend the most time immediately post diagnosis. Patients with fewer positive social determinants of health were more likely to receive tangible interventions.  Patients that were determined to have complex cases and multiple SDH required the most HSW time.

Implications:Health social workers provide a wide range of interventions to an increasingly complex patient environment. Recommendations for enhanced policy and practice innovations will be provided.