The Role of Social Workers in Hospital Settings
Social workers are essential members of interdisciplinary healthcare teams who provide comprehensive psychosocial support, coordinate resources, facilitate communication between healthcare providers and patients/families, and ensure continuity of care during and after hospitalization. 1
Core Responsibilities
Psychosocial Assessment and Support
- Conduct comprehensive assessments of patients' and families' psychosocial needs 1
- Provide emotional support during hospitalization and medical crises 1
- Address stress and anxiety experienced by patients and families 1
- Assist with adjustment to illness, family conflicts, and social isolation 2
- Support patients through quality-of-life issues and advance directive planning 2
Resource Coordination and Navigation
- Identify and address practical problems including:
- Housing, food, and financial assistance needs
- Transportation challenges
- Employment or school concerns
- Cultural or language barriers
- Caregiver availability 2
- Connect patients with community resources that address social determinants of health 1
- Maintain up-to-date information on local and national resources 1
- Serve as patient navigators within complex healthcare systems 1
Discharge Planning and Transitions of Care
- Function as a critical link in transitional care management 1
- Coordinate appropriate post-discharge services 1
- Ensure continuity of care after hospitalization 1
- Mobilize community resources for moderate-to-severe psychosocial problems 2
Communication Facilitation
- Facilitate family meetings to improve communication between healthcare teams and families 1
- Act as advocates for patients within healthcare systems and with external agencies 1
- Provide education about diagnoses, treatment options, and available resources 1
- Document education provided to prevent duplicate or conflicting information 1
Specialized Areas of Social Work Practice
Distress Management
- Play a prominent role in providing psychosocial services for patients experiencing distress 2
- Assist with screening and triaging patients experiencing psychological distress 2
- Provide counseling and psychotherapy for moderate-to-severe psychosocial problems 2
Housing Support
- Advocate for medical respite beds for patients with high medical complexity 2
- Connect patients with housing programs while they await more permanent solutions 2
- Address unstable housing situations that impact health outcomes 2
End-of-Life Care
- Support patients and families during the withdrawal of life-sustaining measures 2
- Provide grief counseling and bereavement support 2
- Address end-of-life concerns including cultural and caregiver issues 2
Impact on Patient Outcomes
- Improve family satisfaction with hospital care 1
- Enhance adherence to medications and dietary regimens through social support 1
- Reduce patient-reported depression through targeted interventions 1
- Minimize caregiver distress through regular psychosocial assessment 1
- Potentially improve participation in cancer treatment through addressing distress 2
Challenges in Hospital Social Work Practice
- Large caseloads and lack of time can limit ability to address patients' social needs 2
- Competing demands and ambiguous accountability within healthcare systems 2
- Lack of clearly defined policies regarding social work roles in some settings 2
- Variable implementation of distress screening protocols across institutions 2
Emerging Trends
- Increased use of technology and automation for screening, triage, and referrals 2
- Growing focus on addressing social determinants of health 1
- Expanding role in community resource navigation outside traditional clinical settings 2
- Integration into medical teams earlier in the admission process rather than only at discharge 3
- Development of community health worker models that complement social work services 2
Social workers in hospital settings serve as the critical bridge between medical care and addressing the psychosocial factors that significantly impact patient outcomes, recovery, and quality of life.