Harbor:Social work - Revision history

Jscottgeorge at 06:11, 5 March 2022

2022-03-05T06:11:31Z

← Revisión anterior		Revisión del 06:11 5 mar 2022
Línea 3:		Línea 3:

	*Consult Social Work early if you anticipate any issues so they can get things during business hours and get to families before they leave. Consult by placing a social work order in Orchid (documents consult time).		*Consult Social Work early if you anticipate any issues so they can get things during business hours and get to families before they leave. Consult by placing a social work order in Orchid (documents consult time).
	* Refer also to [[~~https://wikem.org/wiki/~~Harbor: Social_EM_resources]]		* Refer also to [[Harbor:Social_EM_resources\|Social EM Resources]]
	* When discharging Homeless patients but still waiting for Social Work:		* When discharging Homeless patients but still waiting for Social Work:
	** ED Provider discharges patient, and fill out the Homeless Discharge Form in the depart process (offered a meal, Hep A or COVID vaccines, weather appropriate clothing, outpatient medical and/or mental health resources, prescriptions, etc.)		** ED Provider discharges patient, and fill out the Homeless Discharge Form in the depart process (offered a meal, Hep A or COVID vaccines, weather appropriate clothing, outpatient medical and/or mental health resources, prescriptions, etc.)

Bchap23: /* 3. Patient who are homeless: */

2022-02-22T17:14:11Z

3. Patient who are homeless:

← Revisión anterior		Revisión del 17:14 22 feb 2022
Línea 78:		Línea 78:
	====3. Patient who are homeless:====		====3. Patient who are homeless:====

	a. Homeless Task Force - ~~Business hours, 310-848-3325.~~		a. Homeless Task Force - p1735
	*looking for patients with chronic illness (HTN, diabetes, psych, etc) who have had 2+ visits.		*looking for patients with chronic illness (HTN, diabetes, psych, etc) who have had 2+ visits.
	*Put in s/w consult and choose "Homeless" under reason for consult, NOT "Discharge planning/placement".		*Put in s/w consult and choose "Homeless" under reason for consult, NOT "Discharge planning/placement".

Andreawu at 23:29, 14 February 2022

2022-02-14T23:29:16Z

← Revisión anterior		Revisión del 23:29 14 feb 2022
Línea 3:		Línea 3:

	*Consult Social Work early if you anticipate any issues so they can get things during business hours and get to families before they leave. Consult by placing a social work order in Orchid (documents consult time).		*Consult Social Work early if you anticipate any issues so they can get things during business hours and get to families before they leave. Consult by placing a social work order in Orchid (documents consult time).
	* Refer also to [[https://wikem.org/wiki/Harbor:Social_EM_resources]]		* Refer also to [[https://wikem.org/wiki/Harbor: Social_EM_resources]]
	* When discharging Homeless patients but still waiting for Social Work:		* When discharging Homeless patients but still waiting for Social Work:
	** ED Provider ~~drop house~~ and fill out the Homeless Discharge Form in the depart process (offered a meal, Hep A or COVID vaccines, weather appropriate clothing, outpatient medical and/or mental health resources, prescriptions, etc.)		** ED Provider discharges patient, and fill out the Homeless Discharge Form in the depart process (offered a meal, Hep A or COVID vaccines, weather appropriate clothing, outpatient medical and/or mental health resources, prescriptions, etc.)
	** ED RN: discharges and departs patient off the track, places a patient sticker on a paper log at the Router Desk for SW/HTF		** ED RN: discharges and departs patient off the track, places a patient sticker on a paper log at the Router Desk for SW/HTF
	** SW/HTF will assess patient, explore placement opportunities and give resources as available for patient.		** SW/HTF will assess patient, explore placement opportunities and give resources as available for patient.
Línea 16:		Línea 16:

	Those who need help connecting with resources (financial, placement, housing, food, transportation, etc)		Those who need help connecting with resources (financial, placement, housing, food, transportation, etc)
	*Community resources - food banks, gov benefits		*"Community resources" - food banks, gov benefits
	*Disability - how to apply for disability (not for filling out application itself)		*"Disability" - how to apply for disability (not for filling out application itself)
	*'''Discharge planning/placement''' - when a patient needs placement to a facility of lower acuity than an acute care hospital (not to be used if homeless)		*'''Discharge planning/placement''' - when a patient needs placement to a facility of lower acuity than an acute care hospital (not to be used if homeless)
	*'''Homeless''' - for housing/resources. If patient has chronic physical and mental health problems, ask for patient to be signed up for Housing for Health.		*"'''Homeless'''" - for housing/resources. If patient has chronic physical and mental health problems, ask for patient to be signed up for Housing for Health.
	*Hospice - still need to place a home-health order (only if going home on hospice, not a care facility)		*"Hospice" - still need to place a [[https://wikem.org/wiki/Harbor:Home_Health\| home-health order]] (only if going home on hospice, not a care facility)
	*[[https://www.wikem.org/wiki/Transportation_Needs\| Transportation Needs]]		*[[https://www.wikem.org/wiki/Transportation_Needs\| Transportation Needs]]
	*'''Crisis/Trauma''' - SW is consulted automatically for all TTAs. ~~Ask~~ for referral to Violence Prevention program if victim of violent crime (shooting/stabbing, etc)		*'''Crisis/Trauma''' - SW is consulted automatically for all TTAs. Consider also consult order for referral to Trauma Recovery Center and Violence Intervention Prevention program if victim of violent crime (shooting/stabbing, etc.)

	====Poor judgement/Substance Abuse====		====Poor judgement/Substance Abuse====

	*Behavioral issues		*"Behavioral issues"
	*'''EtOH related trauma''' - SW provides a screening & brief intervention		*'''EtOH related trauma''' - SW provides a screening & brief intervention
	*Non-compliance		*Non-compliance
Línea 38:		Línea 38:
	This category has a lot of overlap with psychiatry.		This category has a lot of overlap with psychiatry.

	*'''Adjustment to illness''' - for psychosocial assessment by SW, help provide coping skill		*"'''Adjustment to illness'''" - for psychosocial assessment by SW, help provide coping skill
	*Anxiety		*"Anxiety"
	*Crisis/trauma - see above		*"Crisis/trauma" - see above
	*Depression		*"Depression"
	*'''End-of-life issues''' - for family or patient, help with GOC discussions		*"'''End-of-life issues'''" - for family or patient, help with GOC discussions
	*Family conflict		*"Family conflict"
	*'''Grief/bereavement'''		*"'''Grief/bereavement'''"
	*HI
	*'''Mental health''' - SW can provide more resources than just the DMH list, provide full assessment of patient's financial abilities and other social factors		*'''Mental health''' - SW can provide more resources than just the DMH list, provide full assessment of patient's financial abilities and other social factors
	*New diagnosis - overlaps with Adjustment to Illness		*'''High risk pregnancy or Teenage pregnancy''' - provide resources & support
	*Poor coping
	*SI
	*'''Teenage pregnancy''' - provide resources & support

	====Regulatory/Legal Issues====		====Regulatory/Legal Issues====
Línea 66:		Línea 62:

	==== Other Social Determinants of Health Resources====		==== Other Social Determinants of Health Resources====
	~~<big>*WPC program ended 11/30/21.* However, below are some other available programs addressing social determinates of health:</big>~~

	* '''Re-entry''' (released from prison <6 months with medical, mental health, substance abuse, or social needs)		* '''Re-entry''' (released from prison <6 months with medical, mental health, substance abuse, or social needs)
Línea 73:		Línea 68:
	** ORCHID Message/Call/Text Rosario Aliviado - Social Work Supervisor. Please include MRN, pt phone number, and reason for referral.		** ORCHID Message/Call/Text Rosario Aliviado - Social Work Supervisor. Please include MRN, pt phone number, and reason for referral.
	*** 21x.294.8908. She will respond M-F 9:00-4:30 pm but you can ORCHID message/call/text/email anytime.		*** 21x.294.8908. She will respond M-F 9:00-4:30 pm but you can ORCHID message/call/text/email anytime.

	* '''Perinatal''' (high-risk pregnant mothers - homeless, mental health, substance abuse, domestic violence, no food) 844.376.2627

	* '''Homeless''' ... social work can help facilitate housing
	** Refer to Social Work
	*** Place order in ORCHID
	**** Consult to Social Work: reason for referral: homeless

	* '''Disabled and needs disability benefits (SSI)'''
	** Refer to Social Work
	*** Place Order in ORCHID
	**** Consult to Social Work: reason for referral: disability benefits

	* '''Mental Health'''		* '''Mental Health'''

Andreawu: /* See Also */

2022-02-14T23:08:49Z

Andreawu: /* 4. Patients whom family is no longer able to take care of */

2022-02-09T21:30:05Z

4. Patients whom family is no longer able to take care of

← Revisión anterior		Revisión del 21:30 9 feb 2022
Línea 110:		Línea 110:
	b. other community resources are available		b. other community resources are available

	c. consider home health referral		c. consider [https://www.wikem.org/wiki/Harbor:Home_Health home health] referral

	d. if family dumps patient and doesn't respond, s/w may file an adult protective services report		d. if family dumps patient and doesn't respond, s/w may file an adult protective services report

Andreawu: /* Social Work Consultation Guidelines */

2022-02-09T21:28:59Z

Social Work Consultation Guidelines

← Revisión anterior		Revisión del 21:28 9 feb 2022
Línea 3:		Línea 3:

	*Consult Social Work early if you anticipate any issues so they can get things during business hours and get to families before they leave. Consult by placing a social work order in Orchid (documents consult time).		*Consult Social Work early if you anticipate any issues so they can get things during business hours and get to families before they leave. Consult by placing a social work order in Orchid (documents consult time).
			* Refer also to [[https://wikem.org/wiki/Harbor:Social_EM_resources]]
	* When discharging Homeless patients but still waiting for Social Work:		* When discharging Homeless patients but still waiting for Social Work:
	** ED Provider drop house and fill out the Homeless Discharge Form in the depart process (offered a meal, Hep A or COVID vaccines, weather appropriate clothing, outpatient medical and/or mental health resources, prescriptions, etc.)		** ED Provider drop house and fill out the Homeless Discharge Form in the depart process (offered a meal, Hep A or COVID vaccines, weather appropriate clothing, outpatient medical and/or mental health resources, prescriptions, etc.)
Línea 69:		Línea 69:

	* '''Re-entry''' (released from prison <6 months with medical, mental health, substance abuse, or social needs)		* '''Re-entry''' (released from prison <6 months with medical, mental health, substance abuse, or social needs)
	** 844.804.5200 (24/7) and put patient on phone.

	* '''Medically Complex''' Transitions of care (includes 3 visits to ED in past year)		* '''Medically Complex''' Transitions of care (includes 3 visits to ED in past year)
Línea 111:		Línea 110:
	b. other community resources are available		b. other community resources are available

	c. consider [[home health referral]]		c. consider home health referral

	d. if family dumps patient and doesn't respond, s/w may file an adult protective services report		d. if family dumps patient and doesn't respond, s/w may file an adult protective services report
Línea 132:		Línea 131:

	a. Admit patient to obs/short stay for placement and PT/OT evaluation		a. Admit patient to obs/short stay for placement and PT/OT evaluation
	b. In rare circumstances, may need to order PT/OT to be done in the ED.		b. In rare circumstances, may need to order PT/OT to be done in the ED.


	==See Also==		==See Also==

Bchap23: /* Regulatory/Legal Issues */

2021-12-01T20:26:04Z

Regulatory/Legal Issues

@@ Línea 63: / Línea 63: @@
 *'''Unidentified person'''
 ** [[Harbor: Identifying Jane/John Doe, finding next of kin tips]]
 ====2. Transportation home:====

Bchap23: /* Regulatory/Legal Issues */

2021-12-01T20:22:16Z

Regulatory/Legal Issues

← Revisión anterior		Revisión del 20:22 1 dic 2021
Línea 62:		Línea 62:
	*'''Suspect elder/dependent elder abuse'''		*'''Suspect elder/dependent elder abuse'''
	*'''Unidentified person'''		*'''Unidentified person'''
			** [[Harbor: Identifying Jane/John Doe, finding next of kin tips]]

	====2. Transportation home:====		====2. Transportation home:====

Andreawu at 22:27, 21 October 2021

2021-10-21T22:27:06Z

← Revisión anterior		Revisión del 22:27 21 oct 2021
Línea 13:		Línea 13:
	Choose the indication that best fits your clinical need/question. Special instructions are helpful.		Choose the indication that best fits your clinical need/question. Special instructions are helpful.

	======Lack of Resources======		=====Lack of Resources=====

	Those who need help connecting with resources (financial, placement, housing, food, transportation, etc)		Those who need help connecting with resources (financial, placement, housing, food, transportation, etc)
Línea 24:		Línea 24:
	*'''Crisis/Trauma''' - SW is consulted automatically for all TTAs. Ask for referral to Violence Prevention program if victim of violent crime (shooting/stabbing, etc)		*'''Crisis/Trauma''' - SW is consulted automatically for all TTAs. Ask for referral to Violence Prevention program if victim of violent crime (shooting/stabbing, etc)

	======Poor judgement/Substance Abuse======		====Poor judgement/Substance Abuse====

	*Behavioral issues		*Behavioral issues
Línea 34:		Línea 34:
	*'''Substance abuse''' - SW will provide screening & brief intervention		*'''Substance abuse''' - SW will provide screening & brief intervention

	======Psychosocial Support======		====Psychosocial Support====

	This category has a lot of overlap with psychiatry.		This category has a lot of overlap with psychiatry.
Línea 52:		Línea 52:
	*'''Teenage pregnancy''' - provide resources & support		*'''Teenage pregnancy''' - provide resources & support

	======Regulatory/Legal Issues======		====Regulatory/Legal Issues====

	*Adoption		*Adoption
Línea 76:		Línea 76:
	b. Can be given packet of resources by clerk's station or with SW discussion		b. Can be given packet of resources by clerk's station or with SW discussion

	====5. Patients whom family is no longer able to take care of====		====4. Patients whom family is no longer able to take care of====

	Please page social work asap - before family leaves - s/w will work with them to see if:		Please page social work asap - before family leaves - s/w will work with them to see if:
Línea 84:		Línea 84:
	b. other community resources are available		b. other community resources are available

	c. ~~help family brainstorm other ideas~~		c. consider [[home health referral]]

	d. if family dumps patient and doesn't respond, s/w may file an adult protective services report		d. if family dumps patient and doesn't respond, s/w may file an adult protective services report

	e. if the patient truly needs to be placed ~~and resources and strategies of a/b/c do not work~~, ~~per Dr. Wu~~, ~~please place in~~ obs ~~and the inpatient team will work on~~ placement ~~from there~~		e. if the patient truly needs to be placed, run Interqual, try to transfer/admit to obs/short stay for placement

	====6. Pt/family not happy with current skilled nursing facility (SNF)====		====5. Pt/family not happy with current skilled nursing facility (SNF)====

	a. generally, this is not an appropriate use of the ED - the family needs to work with the SNF s/w to facilitate transfer to another SNF, exception point c. below		a. generally, this is not an appropriate use of the ED - the family needs to work with the SNF s/w to facilitate transfer to another SNF, exception point c. below
Línea 98:		Línea 98:
	c. APPROPRIATE if pt needs a HIGHER level of care b/c of medical needs - then s/w at Harbor can help		c. APPROPRIATE if pt needs a HIGHER level of care b/c of medical needs - then s/w at Harbor can help

	~~d. Different levels of care are outlined in slides (attached) - shelter vs respite vs board and care vs SNF vs ?~~		====6. Clothing rack / clothing for patients====

	====7. Clothing rack / clothing for patients====

	Nursing and social work have access ('Harbor Rack' outside in ambulance entrance)		Nursing and social work have access ('Harbor Rack' outside in ambulance entrance)

	====8. Patients who need PT/OT for placement====		====7. Patients who need PT/OT for placement====

	a. Admit patient to obs/short stay for placement and PT/OT evaluation		a. Admit patient to obs/short stay for placement and PT/OT evaluation

Andreawu at 22:12, 21 October 2021

2021-10-21T22:12:09Z

← Revisión anterior		Revisión del 22:12 21 oct 2021
Línea 2:		Línea 2:
	===Social Work Consultation Guidelines===		===Social Work Consultation Guidelines===

	~~Generally, please call~~ Social Work early if you anticipate any issues so they can get things during business hours and get to families before they leave. Consult by placing a social work order in Orchid (documents consult time).		*Consult Social Work early if you anticipate any issues so they can get things during business hours and get to families before they leave. Consult by placing a social work order in Orchid (documents consult time).

	* When discharging Homeless patients but still waiting for Social Work:		* When discharging Homeless patients but still waiting for Social Work:
Línea 21:		Línea 21:
	*'''Homeless''' - for housing/resources. If patient has chronic physical and mental health problems, ask for patient to be signed up for Housing for Health.		*'''Homeless''' - for housing/resources. If patient has chronic physical and mental health problems, ask for patient to be signed up for Housing for Health.
	*Hospice - still need to place a home-health order (only if going home on hospice, not a care facility)		*Hospice - still need to place a home-health order (only if going home on hospice, not a care facility)
	*Transportation ~~- transportation home or to appointments, see section 1.2~~		*[[https://www.wikem.org/wiki/Transportation_Needs\| Transportation Needs]]
	*'''Crisis/Trauma''' - SW is consulted automatically for all TTAs. Ask for referral to Violence Prevention program if victim of violent crime (shooting/stabbing, etc)		*'''Crisis/Trauma''' - SW is consulted automatically for all TTAs. Ask for referral to Violence Prevention program if victim of violent crime (shooting/stabbing, etc)

Línea 63:		Línea 63:
	*'''Unidentified person'''		*'''Unidentified person'''

	~~======Nonspecific======~~

	*Other
	*Assessment

	~~J Singh 7/7/17~~

	====2. Transportation home:====		====2. Transportation home:====
Línea 75:		Línea 69:
	====3. Patient who are homeless:====		====3. Patient who are homeless:====

	a. Homeless Task Force - looking for patients with chronic illness (HTN, diabetes, psych, etc) who have had 2+ visits. Put in s/w consult and choose "Homeless" under reason for consult, NOT "Discharge planning/placement". If eligible - they will help sign up the patient - however, they may be on a waitlist for days to months~~. If an potentially eligible patient is stable for discharge, you may refer them to contact the Homeless Task Force with the following number: 310-848-3325.~~		a. Homeless Task Force - Business hours, 310-848-3325.
			*looking for patients with chronic illness (HTN, diabetes, psych, etc) who have had 2+ visits.
	b. Patients discharged overnight who are not safe to go out into the night CANNOT wait in the ED lobby. However, they can wait in the main hospital lobby in front of the social work offices to speak with social work for resources on housing in the AM. However, please try to consult SW during the ED visit if possible as there is overnight staff available.		*Put in s/w consult and choose "Homeless" under reason for consult, NOT "Discharge planning/placement".
			*If eligible - they will help sign up the patient - however, they may be on a waitlist for days to months.

	~~J Singh 7/15/17~~		b. Can be given packet of resources by clerk's station or with SW discussion

	====5. Patients whom family is no longer able to take care of====		====5. Patients whom family is no longer able to take care of====
Línea 107:		Línea 102:
	====7. Clothing rack / clothing for patients====		====7. Clothing rack / clothing for patients====

	~~a. s/w has a small stash in ED - consult/page to get~~ access		Nursing and social work have access ('Harbor Rack' outside in ambulance entrance)
	*Located behind double doors in ambulance ~~bay. NA-7 key for access.~~

	~~b. volunteers office has another stash but only open 8-5 M-F~~

	~~ED stash is in need of donations for men's pants, flip flops, sweat pants, sweat shirts~~

	~~J Singh 5/9/17~~

	====8. Patients who need PT/OT for placement====		====8. Patients who need PT/OT for placement====

	a. ~~place the~~ patient in obs for placement and PT/OT evaluation ~~- this way the hospitalist can then admit the patient from obs if they cannot get~~ PT/OT ~~(which they more likely than not cannot) - this is needed~~ to ~~document the need for PT/OT so we can get resources (it shows how many avoidable admissions there can~~ be as the ED ~~hospitalists are collecting this data manually)~~.		a. Admit patient to obs/short stay for placement and PT/OT evaluation
			b. In rare circumstances, may need to order PT/OT to be done in the ED.

← Revisión anterior		Revisión del 23:08 14 feb 2022
Línea 132:		Línea 132:
	a. Admit patient to obs/short stay for placement and PT/OT evaluation		a. Admit patient to obs/short stay for placement and PT/OT evaluation
	b. In rare circumstances, may need to order PT/OT to be done in the ED.		b. In rare circumstances, may need to order PT/OT to be done in the ED.

	~~==See Also==~~
	*[[Harbor:Main]]
	*[[Harbor:Whole person care]]

	==References==		==References==