Social Work & Case Management
A PART OF NURSING DEPARTMENTS
The Department of Social Work and Case Management (SWCM) is committed to Respect, to Support and Care for our patients and their families.
Department of SWCM »
Overview
SWCM Engagement »
Collaboration and committees
Mission
To emotionally support, assist and empower patients, families and care providers to successfully navigate complex healthcare systems by providing exceptionally compassionate and well-coordinated care.
Vision
To set the national standard for Social Work and Case Management practice, multidisciplinary collaboration, and in a meaningful and supportive work community.
How We Work
Leaders & Experts
- We are solution-oriented, identifying solutions, not just problems
- We are leaders in multi-disciplinary collaboration
- We are experts in care coordination and patient & family advocacy
- We articulate what we do, share our knowledge, and are involved in professional organizations and our community
Practice Excellence
- We use evidence based assessment and intervention tools and strategies
- We have clear definitions of, expectations of, and orientation to our roles and practice competencies
- We are accessible and consistent in our practice while leveraging the unique expertise of our team
- We adapt our practice to the changing needs of our organization and community
Teachers & Learners
- We develop skill building competencies and strive to enhance our skills continually
- We seek to learn new skills and obtain knowledge about best practices in our fields
- We teach formally and informally
- We train the future professionals of social work, case management, and care coordination
Careers with SWCM
Case Manager
Social Work Clinician
Complex Care Managers
Support Liaison
Case Managers are licensed nursing professionals responsible for coordinating continuum of care and discharge planning activities for a caseload of assigned patients. Major responsibilities include:
- coordinating all facets of a patient's admission/discharge
- performing utilization review activities, including review of patient charts for timeliness of services as well as appropriate utilization of services
- ensuring optimum use of resources, service delivery, and compliance with external review agencies' requirements.
Case Managers act as consultants to the clinical team, service lines, and other departments regarding patient assessment and patient care and participate in program development and quality improvement initiatives.
In their role, Case Managers, by applying guidelines and collaborating with multidisciplinary teams, influence and direct the delivery and quality of patient care. A hospital-based case management system has as its primary goal to:
- ensure the most appropriate use of services by patients
- avoid duplication and misuse of medical services
- control costs by reducing inefficient services
- improve the effectiveness of care delivery
Objectives are:
- to facilitate timely discharge
- prompt, efficient use of resources
- achievement of expected outcomes
- collaborative practice; coordination of care across the continuum
- performance/quality improvement activities that lead to optimal patient outcomes
A Case Manager differs from other roles in professional nursing/health care practice in that it is not intended to provide direct patient care; rather, a Case Manager will be assigned to specific patients to ensure that the medical services and treatments required are accomplished in the most financially and clinically efficient manner.
The Social Work Job Family consists of three levels of professional non-supervisory social work in a health care institutional setting at SHC:
- Social Work Clinician,
- Licensed Clinical Social Worker
- Advanced Clinical Social Worker
This job family is limited to those positions that require a master's degree in Social Work (MSW) from an accredited school of social work.
As a member of a multidisciplinary health care team, Medical Social Workers provide appropriate intervention services and/or discharge planning to patients and/or clients as well as their families receiving services within any department of the Stanford University Medical Center.
Work typically involves a variety of bio-psycho-social issues, assessment of the social needs as related to the patient's/client's health status, and the development of a plan of services, including advocacy, discharge planning, referrals and practical assistance necessary to accomplish desired objectives.
The social worker also provides consultation, orientation and training to health care staff on the effects of bio-psycho-social, cultural and economic issues on the management of patient/client health needs.
Complex Care Managers are highly-skilled, licensed healthcare professionals responsible for maximizing the efficiency and effectiveness of health care interventions necessary for a patient to attain the optimal results from his or her plan of care. They are dedicated to patient and family centered care that values personal self-determination, enjoy managing multiple priorities at once, and engaging in creative, compassionate and ethical problem-solving. As a member of a multidisciplinary health care team, Care Managers perform comprehensive assessments and develop treatment plans that integrate the medical, social, and financial issues that impact individual patients, families, and populations.
Care Managers are responsible for working collaboratively with all healthcare team members to develop and implement treatment plans that support the patient-centered plan of care for both individual patients and the service-line. Care Managers act as consultants to the clinical team, service lines, and other departments regarding patient assessment and patient care and participate in program development and quality improvement initiatives.
In their role, Care Managers, by applying guidelines and collaborating with multidisciplinary teams, influence and direct the delivery and quality of patient care. Care Managers are assigned to a group of patients by medical specialty, unit, or clinic, and some activities may differ depending on the needs of the population.
Major responsibilities include:
- coordinating all facets of a patient's admission/discharge or outpatient visit/follow-up
- performing utilization review activities, including review of patient charts for timeliness of services as well as appropriate utilization of services
- ensuring optimum use of resources, service delivery, and compliance with external review agencies' requirements.
A health-system care management program has as its primary goal to ensure the most appropriate use of services by patients and, toward that end, to avoid duplication and misuse of medical services, control costs by reducing inefficient services, and improve the effectiveness of care delivery.
The Social Work & Case Management Liaison performs selected delegated functions related to discharge planning, utilization management and patient care coordination.
The Support Liaison communicates and collaborates with the Case Managers, Social Workers and other interdisciplinary team members in coordination of resources and services.
The Support Liaison communicates with review organizations, vendors, providers and other external customers. The Support Liaison is a member of designated patient care teams and works collaboratively under the direction of the Social Workers & Case Managers.
Case Managers are licensed nursing professionals responsible for coordinating continuum of care and discharge planning activities for a caseload of assigned patients. Major responsibilities include:
- coordinating all facets of a patient's admission/discharge
- performing utilization review activities, including review of patient charts for timeliness of services as well as appropriate utilization of services
- ensuring optimum use of resources, service delivery, and compliance with external review agencies' requirements.
Case Managers act as consultants to the clinical team, service lines, and other departments regarding patient assessment and patient care and participate in program development and quality improvement initiatives.
In their role, Case Managers, by applying guidelines and collaborating with multidisciplinary teams, influence and direct the delivery and quality of patient care. A hospital-based case management system has as its primary goal to:
- ensure the most appropriate use of services by patients
- avoid duplication and misuse of medical services
- control costs by reducing inefficient services
- improve the effectiveness of care delivery
Objectives are:
- to facilitate timely discharge
- prompt, efficient use of resources
- achievement of expected outcomes
- collaborative practice; coordination of care across the continuum
- performance/quality improvement activities that lead to optimal patient outcomes
A Case Manager differs from other roles in professional nursing/health care practice in that it is not intended to provide direct patient care; rather, a Case Manager will be assigned to specific patients to ensure that the medical services and treatments required are accomplished in the most financially and clinically efficient manner.
close Case Manager
The Social Work Job Family consists of three levels of professional non-supervisory social work in a health care institutional setting at SHC:
- Social Work Clinician,
- Licensed Clinical Social Worker
- Advanced Clinical Social Worker
This job family is limited to those positions that require a master's degree in Social Work (MSW) from an accredited school of social work.
As a member of a multidisciplinary health care team, Medical Social Workers provide appropriate intervention services and/or discharge planning to patients and/or clients as well as their families receiving services within any department of the Stanford University Medical Center.
Work typically involves a variety of bio-psycho-social issues, assessment of the social needs as related to the patient's/client's health status, and the development of a plan of services, including advocacy, discharge planning, referrals and practical assistance necessary to accomplish desired objectives.
The social worker also provides consultation, orientation and training to health care staff on the effects of bio-psycho-social, cultural and economic issues on the management of patient/client health needs.
close Social Work Clinician
Complex Care Managers are highly-skilled, licensed healthcare professionals responsible for maximizing the efficiency and effectiveness of health care interventions necessary for a patient to attain the optimal results from his or her plan of care. They are dedicated to patient and family centered care that values personal self-determination, enjoy managing multiple priorities at once, and engaging in creative, compassionate and ethical problem-solving. As a member of a multidisciplinary health care team, Care Managers perform comprehensive assessments and develop treatment plans that integrate the medical, social, and financial issues that impact individual patients, families, and populations.
Care Managers are responsible for working collaboratively with all healthcare team members to develop and implement treatment plans that support the patient-centered plan of care for both individual patients and the service-line. Care Managers act as consultants to the clinical team, service lines, and other departments regarding patient assessment and patient care and participate in program development and quality improvement initiatives.
In their role, Care Managers, by applying guidelines and collaborating with multidisciplinary teams, influence and direct the delivery and quality of patient care. Care Managers are assigned to a group of patients by medical specialty, unit, or clinic, and some activities may differ depending on the needs of the population.
Major responsibilities include:
- coordinating all facets of a patient's admission/discharge or outpatient visit/follow-up
- performing utilization review activities, including review of patient charts for timeliness of services as well as appropriate utilization of services
- ensuring optimum use of resources, service delivery, and compliance with external review agencies' requirements.
A health-system care management program has as its primary goal to ensure the most appropriate use of services by patients and, toward that end, to avoid duplication and misuse of medical services, control costs by reducing inefficient services, and improve the effectiveness of care delivery.
close Complex Care Managers
The Social Work & Case Management Liaison performs selected delegated functions related to discharge planning, utilization management and patient care coordination.
The Support Liaison communicates and collaborates with the Case Managers, Social Workers and other interdisciplinary team members in coordination of resources and services.
The Support Liaison communicates with review organizations, vendors, providers and other external customers. The Support Liaison is a member of designated patient care teams and works collaboratively under the direction of the Social Workers & Case Managers.
close Support Liaison
Aging Adult Services
Aging Adult Services provides education, resources, and care coordination for adults age 65 and older residing in San Mateo or Santa Clara counties. Patients are offered services up to 90 days after they are discharged from Stanford Hospital or from skilled nursing facilities, to home. The Aging Adult Services team includes nurses, a gerontologist, a social worker and an occupational therapist. Aging Adult Services is based on a continuum of care model.