Clinical Social Worker - Transitional Care

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Department:
Transitional Care

Works under the direction of the Clinical Social Services Manager.

Provides clinical social work services to patients and their families including psychosocial assessment, counseling/therapy, and resource referral as appropriate.

Provides clinical assistance to other hospital professionals involved in patient care.

Assists in program planning for The Department and Hospital.

Represents the hospital at community committees and agencies and requested.

Utilizes knowledge of human growth and development to provide care appropriate to the age of patients served.

Performs other duties as assigned.


* Screens all patient admissions for high-risk cases according to criteria.


* Evaluates referrals within two workdays.


* Conduct diagnostic interviews with patients and their families to assess psychosocial needs and appropriate therapy and/or referral services.


* Provides counseling/therapy services to patients and families.


* Provides referrals to hospital and community services/agencies.


* Serves as liaison between patients/family, doctors, other hospital departments, and outside agencies.

Participates in team rounds to provide information to assist in formulating patient care plan.

Provides consultation to the medical team; selects, utilizes and coordinates community care.


* Documents social work activities in patient medical records.


* Participates in departmental and hospital meetings and patient/family case conferences.


* Provides and participates in in-service training for hospital staff and community groups.


* Actively participates in Hospital and Department based performance Improvement Activities.


* Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patients served on his/her unit.


* Reports to the clinical Social Work Manager any professional issues, including consultations, statistic, complex cases, etc.

NICU Specific Specifications:


* Participates in direct patient care by providing psychosocial assessments to each one of the cases at NICU that includes:
+ Parents adjustment to infant's illness and hospitalization
+ Parents ability to communicate with the medical team
+ Parents coping skills
+ Parent/infant bonding attachment
+ Assessment of family's access to resources and support system

Implements interventions such as:


* Supportive counseling regarding parenting a sick infant in the intensive care setting


* Adjustment counseling related to the loss of the ideal birth experience, hospitalization, prematurity, birth anomalies and/or illness


* Facilitate communication with the medical team and family by articulating the family's concerns and level of understanding of medical information
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