Social Work & Discharge Planning

Discharge planning in social work is one facet of the larger practice of case management, also known as care coordination, according to SocialWorkers.org. What exactly constitutes discharge planning is debatable and frequently depends on the setting. Broadly, the term implies linking individuals and their families with resources outside of the current setting for follow-up care.

Settings

• Discharge planning takes place in a wide variety of settings. The majority of formal discharge planning occurs in health care settings, specifically in medical and psychiatric treatment facilities. However, social workers in any setting will participate in discharge planning in as much as they coordinate follow-up services for clients and make referrals.

Steps

• Most discharge planning starts at the time of an individual’s admission. The social worker conducts a psychosocial assessment of the individual (or family) to determine current needs and appropriate referrals for follow-up care. Assessments typically evaluate psychiatric and socioeconomic factors, according to the Education Resources Information Center. The results of these assessments, as well as considerations of the individual or family’s wishes and the recommendations of treatment teams, are all taken into consideration when making plans for appropriate follow-up care.

Misconceptions

• Discharge planning is often falsely considered to be a simple process of connecting individuals with resources. This perspective implies that expertise is not needed, according to the Education Resources Information Center. However, social workers offer specific skills that make them invaluable resources for this task. For instance, social workers are trained to understand the perspective of the person-in-environment, and to help individuals and families navigate systems, such as hospitals and psychiatric treatment facilities, which can be confusing for people in psychiatric, medical or social distress.

Counseling

• Social workers also provide counseling and therapeutic support as part of discharge planning. For instance, medical social workers may utilize the process of discharge planning to help a patient and her family better understand the stress connected to illness, and the effect that this stress has on the family system as a whole. Similarly, a social worker may help an individual who is being placed in a hospice setting start to make meaning out of the end of life.

Ethical Considerations

• Within the field of health care, there are many obstacles that may hinder successful discharge planning. Barriers to successful discharge planning can include pressure to discharge clients within a certain time frame to save costs, inadequate planning on the part of a hospital or social service agency, lack of teamwork and collaboration and a shortage of resources, according to the Education Resources Information Center. These challenges may not be easy to face. One strategy is for social workers to remember to begin discharge planning upon admission, a practice that might help decrease length of stay and satisfy administrators looking to cut costs, without sacrificing client care. Social workers should also refer to best practice standards put forth by the National Association of Social Workers (NASW) for suggestions on ethical dilemmas in discharge planning.