The role of the social worker in the accident and emergency department of a district general hospital

Need for social work interventions in the emergency department

This paper reports findings from a qualitative study conducted on the Need for Social work interventions in the Emergency Department (ED) at a large tertiary care center in India. The emergency department is an important social work intervention point for individuals with various psychiatric, medical, and social needs who have little or no additional interaction with social services. Social workers are specially trained to understand the impact of social factors on health outcomes and provide interventions that address social barriers to improving health and accessing community resources; social workers are well prepared to provide services in the emergency department. However, limited research is available to understand the impact of psychosocial services in the emergency department. We aimed to identify areas which require integrated social work services and coordination to address the psychosocial issues within the ED. Interviews with 10 healthcare workers are analyzed thematically. Recurring themes throughout the interviews confirm the need for providing social work interventions to ensure the medical, psychological, and social care needs in the emergency department.

A Survey of Medical Social Services in Local Accident and Emergency Departments

This study is a structured questionnaire survey on all doctors and nurses working in 14 local Accident & Emergency Departments (EDs) on medical social services. The objectives of this study are to find out: (1) service provision and referral patterns in local EDs; (2) perceptions of doctors and nurses on the present service. In addition to routine referrals during office hours, nearly half of the respondents reported availability of on-site services per request, phone consults during office hours, and support during disaster activation. The most common social problems that doctors would refer to medical social service included child abuse, battered spouse, rape/sexual assault, deliberate self-harm and elderly patients with discharge problem. Over half of the doctors and nurses said the existing services were inadequate and the main shortcoming was no after office hours coverage. In cases of crisis intervention, 56% of doctors and 36% of nurses felt that medical social workers would only be helpful if they were available at short notice most time of the day. To improve the existing service, 62% of doctors and 43% of nurses thought that medical social workers should provide adequate feedback. Other areas for improvement included on-site service, 24-hour coverage and more experienced workers. (Hong Kong j.emerg.med. 2001;8:135–139)