This position provides clinical assessment, therapeutic interventions, care coordination, transition planning and emotional support to patients and families at PCH within their scope of practice. Participates as an interdisciplinary team member providing interventions with the patient/family that include a range of care from bio-psychosocial assessment, diagnosis, treatment planning, therapeutic interventions, crisis interventions, coordination of care, bereavement support, and transition/discharge planning. The position requires knowledge of family systems and interpersonal dynamics/relationships and is able to use that knowledge to assist patients and families in achieving therapeutic goals. Knowledge of mandated reporter responsibilities; use of financial, community and other resource networks; coordination with DCS, Police jurisdictions, and other governmental authorities; ability to advocate with outside systems; and, collaborate with medical staff. The position may provide individual, group, family therapeutic interventions for an assigned caseload. The position is responsible for implementation of patient treatment assignments, management of open patient records, and for collaborating with outside referral sources as applicable.
- Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
- Excellence in clinical care, service and communication
- Collaborative within our institution and with others who share our mission and goals
- Leadership that set the standard for pediatric health care today and innovations of the future
- Accountability to our patients, community and each other for providing the best in the most cost-effective way.
Psychosocial assessments and Interventions
- Assesses the bio-psychosocial status, which may include, but not be limited to, mental health status, diagnostic impressions, support systems, safety issues, risk for abuse/ neglect, suicide risk assessment, evaluates clients for appropriateness of placement, coping skills, family systems, and cognitive abilities, etc.
- Identifies therapeutic goals to assist patient and family in improving family functioning, mental health, goal attainment, enhanced self-sufficiency, improve medical adherence, etc.
- Identify any barriers that impeded treatment and/or recovery, and help patient/family identify strengths and build on protective factors to assist with success at discharge, and collaborate with the interdisciplinary team to identify treatment plan goals and objectives to facilitate timely and efficient discharges and to participate in proactive transition/ discharge planning.
- Completes clinical record documentation in a timely manner and provides information to coordinate care, confirm demographic information, provide recommendations to assist colleagues and medical team with disposition planning as required by facility procedures.
- Completes handoff documentation to Social Work Department per Department procedures
Coordination of Care
- Develops plans and coordinates effective treatment interventions, develops comprehensive treatment plans, designs and implements therapeutic interventions for patients, accordingly.
- Cultivates and maintains effective interaction/ communication with members of the medical staff, nursing staff, case managers, peers and families to facilitate care coordination provide and continuity of care.
- Develop treatment goals and objectives of disciplines involved in patient care, plans and coordinates effective treatment interventions, develops and implements discharge planning
- As necessary, initiate and/or attend care conferences, interdisciplinary team rounds, and/or critical incidents/stress debriefings
- Perform care coordination and monitor patients as they transition between outpatient and inpatient service.
- Refers cases identified as risk management issues, peer review issues, or quality issues to appropriate departmental units.
- Participates in hospital and departmental operations initiatives to improve care delivery methods.
- As unit based allotted, conducts or facilitates individual, group and family therapy meetings in the form of process groups, didactic groups; holds regular update meetings with families; provides patient and family education regarding
- Reviews open patient records to assure compliance with policy and procedures and delivery of services per treatment plan, accordingly.
- Develops home contracts, level contracts, goals and objectives, accordingly
- chemical dependency, behavioral health, relationship issues.
- Maintains professional competency by regularly participating in a variety of educational programs and in services, reviewing relevant professional publications, participating in community based committees related to service line responsibilities, and/or participating in professional societies to ensure ongoing awareness of current methodologies, practices and philosophies as applied to the patient care population.
- Maintains current knowledge of community and other resources networks to meet patient and family needs, provides relevant resources, and assist, as necessary with connecting the patient/ family to the relevant resources.
- Transplant social workers receive ongoing education in the field of transplantation.
- Participates fully in Clinical Supervision, as applicable, in accordance with Board of Behavioral Health Examiners requirements.
- Performs miscellaneous job related duties as requested.