Palliative social workers’ role on hospital-based palliative care teams: interprofessional perspectives on patient-centered care and prognostic understanding
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Abstract
In response to the systemic shortcomings of the U.S. healthcare system in adequately meeting the needs of patients with serious, life-limiting illnesses, palliative care has emerged as a holistic approach to addressing patients' physical, psychological, social, cultural, and spiritual needs. Supported by evidence linking palliative care to improved patient outcomes and healthcare cost savings, the demand for palliative care services within inpatient settings has surged over the past two decades. As the demand for palliative care continues to escalate, concerns about workforce capacity and sustainability have come to the forefront. In response, healthcare systems are both actively seeking to hire more specialty-trained palliative clinicians, including social workers, and encouraging hospital-based palliative care teams to adopt strategies that enhance efficiency and effectiveness.
This qualitative dissertation, employing interpretive descriptive methodology and thematic analysis, explores the roles, collaborations, and contributions of palliative social workers working on hospital palliative care teams through semi-structured interviews with 17 advanced palliative and hospice certified (APHSW-C) social workers and 24 of their interprofessional team members. Comprising three interrelated papers, this dissertation delves into the multifaceted role of APHSW-C social workers within hospital-based palliative care teams in promoting patient-centered care, fostering prognostic awareness and prioritizing the psychological, social, and cultural aspects of palliative care.
Paper 1 “Social Work’s Role in High-Quality Patient-Centered Palliative Care: Interprofessional Perspectives of Hospital-based Care Teams” examines the perceptions of interprofessional palliative care team members regarding the roles and contributions of social workers, utilizing the Patient-Centered Clinical Method (PCCM) as a conceptual framework. Findings underscore the centrality of social workers in building therapeutic alliances, facilitating difficult conversations, and supporting the well-being of both patients and the interprofessional team.
Paper 2 “Social Work’s Role in the Cultivation of Prognostic Awareness in Patients with Serious Life-limiting Illnesses: Interprofessional Perspectives of Hospital-based Palliative Care Team” uses Social Role Theory to explore the perspectives of specialty palliative social workers and matched physician colleagues’ perspectives on the practice of cultivating of prognostic awareness. The study highlights the skills and strategies palliative social workers utilize promote prognostic awareness and underscore the importance of role clarity, communication trust-building to promote effective interprofessional role sharing.
Paper 3 “Time to Act. Professional Opportunities and Challenges in Advancing the Leadership and Practice in Hospital-based Specialty Palliative Social Work” presents a comprehensive analysis of the professional opportunities and challenges facing palliative social workers in hospital-based specialty palliative care teams. It advocates for the recognition and support of social workers' expertise across clinical practice, education, and research domains, emphasizing the significance of national certification, expanded training opportunities, and increased research visibility.
Together, the three papers contribute to the palliative care literature through deepening our understanding of the evolving role and leadership potential of APHSW-C social workers in enhancing the quality of care provided to patients facing life-limiting illnesses.
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Attribution 4.0 International