In the article dated November 2018, I wrote about social work and health care and the important role a social worker can play within the medical environment.  That made me think…  I still remember the first time, like it was yesterday, when I walked into a hospital as a professional social worker.  It was a physical rehabilitation unit and I went for a job interview.  I don’t recall the job interview, or the emotions associated to that, but the large number of wheelchairs I saw.  For a patient to have his or her life changed due to illness or injury, learn to get around with their “new wheels” and still have a good quality of life, so many professionals need to work together to help the patient reach that point.  None of the involved professionals dare to work in isolation.  There needs to be a constant communication and sense of collaboration and unity towards one common goal, and that is the patient and to help them increase their ability to “survive” post the life changing event.

Why is it then that I often see professionals within the hospital environment, look like there are doing their own thing without taking in consideration their colleagues, or is it just the way I perceive it?

As a hospital social worker, I frequently see patients that are transferred from other units, especially an Intensive Care Unit to the medical ward, treated as a “new” admission to the hospital when they arrive in the ward.  This is often contributed to several factors, for example: poor handover which includes minimal collateral history; very little focus on procedures performed and prescribed treatment; poor to no communication with the family regarding the intended transfer and poor communication regarding the patient and or family’s expectations related to recovery and discussing potential outcomes, based on clinical information.  To ensure the safety of the patient by providing optimum medical care, the staff have no other choice but to treat the patient as a new admission.  In many cases, the patient and or family report their perceptions, that the medical team’s focus is to treat signs and symptoms, while their psychological and social experiences are ignored.

The above scenario is a common example of a system that is focused on care delivered by speciality, thus meaning where care is delivered in individual silos, rather than focusing on care centred around a person.  A patient’s individual condition, considering where and how they live as well as acknowledging their support system consisting of family and friends, are thus often ignored (Mate and Compton-Phillips, 2014, p. 3).

During a conversation with a colleague, she reported that we all know that fragmented healthcare is a global concept.  Have we become so used to it, or is it something we can aim to change?  I believe social work as a profession can play a big part in providing inclusive, patient centred care.  What do you, the reader think?  I would love to hear your comments!

Patient centred care is understood to consist of several dimensions, which are: respect; emotional support; physical comfort; information and communication; continuity and transition; care coordination, involvement of family and carers and access to care (Australian Commission on Safety and Quality in Health Care, 2010, p. 7).

Social Workers play an integral part in providing patient centred care, as they consist over the necessary insight into how mental and physical health interact and the overall influence it may have on a patient’s ability to participate in health care treatment.  This insight enables the social worker to formulate plans to ensure that the communicated message emphasises optimal, sustained functioning and wellness (Andrews et al., 2013, p. 67).  Social workers also understand that individuals exist as part of a bigger system, i.e. social networks, neighbourhoods and communities which can influence their health choices and whether they decide to participate in health care activities (Andrews et al., 2013, p. 67).

My wish for you, the reader, whether you are a professional or even a patient or family member, is to rethink your understanding of the healthcare system.  Consider what you can do to make healthcare less fragmented.

Until next time!

List of references

Andrews, C. M. et al. (2013) ‘Social Work and Implementation of the Affordable Care Act’, Health & Social Work, 38(2), pp. 67–71. doi: 10.1093/hsw/hlt002.

Australian Commission on Safety and Quality in Health Care (2010) ‘Patient – Centred Care: Improving Quality and safety by focusing care on Patients and Consumer (Discussion Paper)’, (September), pp. 1–75.

Mate, K. S. and Compton-Phillips, A. L. (2014) ‘The Antidote to Fragmented Health Care’, Harvard Business Review, pp. 1–4. Available at: