Social Worker (LMSW)

About the role

Come lead with us at Houston Methodist Baytown Hospital. The weekend Social Worker (LMSW) will ensure safe, timely, and efficient patient discharges and care transitions. The weekend hours are 10-hour shifts, 8 AM–6 PM, every Thursday, Friday, Saturday, and Sunday.

Responsibilities

• Provides comprehensive, compassionate, clinical social work and discharge planning to patients and their families of a targeted patient population on a designated unit(s).
• Collaborates with physicians and the interprofessional health care team to sensitize providers to the social and emotional aspects of a patient’s illness and facilitate efficient, quality care and desired treatment outcomes.
• Holds joint accountability with the Case Manager for discharge planning and continuity of care, ensuring psychosocial issues are addressed and treated as needed across the continuum of care.

Essential Functions

People

• Communicates actively, positively, and effectively with all health care team members; reports pertinent patient care and family data comprehensively and without bias; listens and responds to others’ ideas.
• Uses therapeutic communication to establish relationships with patients and families and communicates the discharge plan to facilitate transitions and hand-offs.
• Supports patients and families in clinical or ethical issues using a patient- and family-centered approach.
• Maintains ownership of the psychosocial component—assessments, diagnosis, and treatment—of the discharge planning process on assigned units.

Service

• Serves as a unit-based participant for comprehensive case management activities: assessing patients, identifying at-risk patients, participating in daily Care Coordination Rounds, and identifying barriers to efficient patient throughput.
• Develops and implements a comprehensive psychosocial treatment plan using appropriate clinical social work diagnoses, treatments, and interventions, including crisis intervention, brief individual, marital and family therapies, and patient, family, and caregiver groups.
• Assists with screening, identification, diagnosis, management, and treatment of victims of abuse, neglect, and domestic violence and of mental health and/or substance abuse problems in patients and family members.
• Completes a full assessment based on the social work assessment, identifying social determinants of health; completes screening via patient/family interview, medical record review, H&P, labs, test results/findings, plan of care, physician orders, nursing and progress notes; uses clinical knowledge and screening tools to identify need for case management and/or social work intervention.
• Establishes mutual educational goals with patient and family, provides appropriate resources, and incorporates planning for care after discharge.
• Uses knowledge of levels of care to ensure discharge disposition is to the appropriate level and facilitates transfers.
• Provides brief, goal-directed counseling services to assist patients/families in coping more effectively with transition.

Quality/Safety

• Modifies care based on continuous evaluation of the patient’s condition using problem-solving, critical thinking, and evidence-based analytical approaches.
• Ensures documentation reflects completed patient screening/assessment and reassessment upon admission and concurrently as needed.
• Considers variables that impact treatment plans, including emotional, social, and environmental strengths and problems related to illness, treatment, and/or life situation.
• Continuously reviews the patient for opportunities for care facilitation and discharge planning needs.
• Works with the case manager for routine discharge and anticipates, prevents, manages, or elevates emergent situations with specific focus on the discharge plan and elimination of psychosocial barriers.
• Collaborates with the interprofessional health care team on safety data to improve outcomes and the safe transition of care through effective patient handoffs.

Finance

• Completes timely and thorough assessments on all unfunded patients to identify community resources required for effective transition and utilizes alternative resources to fill gaps in established community resources.
• Establishes an effective community resource knowledge base and the judgment to select and coordinate available resources, including referrals to regulatory agencies (e.g., CPS/APS).
• Provides timely, efficient, pertinent patient information to the health care team when coordination with significant or intensive resources is necessary for effective discharge planning outcomes and decreased length of stay.

Growth/Innovation

• Provides education to unit-based physicians, nurses, and other health care providers on community resources and psychosocial impact on care needs.
• Identifies areas for improvement based on evidence-based practice literature.
• Assists in evidence-based practice/performance improvement projects by offering solutions and participating in unit projects and activities.

Qualifications

• Master’s degree in social work from an accredited university.
• Required: LCSW or LMSW state license.

Experience

• 0 years of experience.
• New graduate with hospital internship preferred.
• One year hospital social work experience preferred.

Skills and Abilities

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations.
• Sufficient proficiency in speaking, reading, and writing English to perform essential functions, especially regarding activities impacting patient or employee safety or security.
• Ability to communicate effectively with patients, physicians, family members, and co-workers in a manner consistent with a customer service focus and positive language principles.
• Knowledge of community resources and health care financial and payer issues, and eligibility for state, local, and federal programs (acquired within 6 months of hire).
• Collaboration, negotiation, and mediation skills.
• Progressive time management and prioritization skills.
• Demonstrates critical thinking skills at all times.
• Well versed in the entire Microsoft Office Suite (Access, Excel, Outlook, PowerPoint, and Word).
• Maintains individual competencies around critical social work functions including payor rules and regulations, psycho-social assessments, and discharge planning methods.
• Maintains level of professional contributions as defined in the Career Path program.

Supplemental Requirements

• Work Attire: Business professional.
• On-Call: Yes (employees may be required to be on-call during emergencies regardless of selection).
• Travel: May require travel within the Houston Metropolitan area and outside the Houston Metropolitan area.