Abstract: The Role of Social Work in Providing Mental Health Services and Care Coordination in the Urban Trauma Center Emergency Department (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Schedule:

Friday, January 13, 2017

Bissonet (New Orleans Marriott)

* noted as presenting author

Megan Moore, PhD, Assistant Professor, University of Washington, Seattle, WA

Lauren Whiteside, MD, Acting Assistant Professor, University of Michigan-Ann Arbor, Seattle, WA

Danae Dotolo, MSW, Doctoral Student/Master's Student, University of Washington, Seattle, WA

Jin Wang, PhD, Biostatistician, University of Washington, Seattle, WA

Leyna Ho, MSW, Social Worker, Swedish Medical Center, Seattle, Seattle, WA

Bonnie Conley, MSW, Director, University of Washington, Seattle, WA

Mollie Glosson-Forrester, MSW, Associate Director, University of Washington, Seattle, WA

Susan P. Fouts, Social Work Supervisor, University of Washington, Seattle, WA

Monica Vavilala, MD, Professor and Director Harborview Injury Prevention and Research Center, University of Washington and Harborview Injury Prevention and Research Center, Seattle, WA

Douglas Zatzick, Professor-Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA

Background and Purpose: This study examined the role of Emergency Department (ED) social workers, patient characteristics, categorized social work services (SWS) and determined predictors of services and length of stay.

Methods: Comprehensive medical record review from the population of patients treated in a level 1 trauma center ED from 01/01/2012 to 03/31/2013 (N=49,354) was conducted. Content analysis of chart notes was used to categorize SWS. Poisson regression assessed associations between demographic and clinical characteristics, SWS and length of ED stay.

Results: SWS were provided to N=18,532 (38%) patients. The majority were mental health services (54%), followed by care coordination (31%) and material support/other referrals (15%). Patients seen by social work were complex, presenting with mental health (18%), substance abuse (29%) or comorbid diagnosis (32%), injury (51%), and had multiple ED visits (26%). In adjusted regression analysis females (RR=1.15, CI=1.13-1.17), non-home discharge disposition (RR=1.44, CI=1.41-1.48), comorbid diagnoses (RR=1.80, CI=1.71-1.89), assault (RR=1.37, CI=1.31-1.44), and TBI (RR=1.20, CI=1.17-1.22) were associated with an increased likelihood of SWS. SWS were associated with an increased length of stay (RR=1.34, CI=1.27-1.41).

Conclusions and Implications: Social workers provided services to patients with multifaceted needs resulting from complex mental health, substance abuse, trauma and comorbid presentations. SWS resulted in a modest increased length of stay. There is a need for triage algorithms to target efficiencies, systematize ED SWS and improve access to needed services for all patients. Methods to expand ED SWS could be a productive area for future research, particularly if social work services prove effective in reducing ED recidivism.

Abstract: The Role of Social Work in Providing Mental Health Services and Care Coordination in the Urban Trauma Center Emergency Department (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

318P The Role of Social Work in Providing Mental Health Services and Care Coordination in the Urban Trauma Center Emergency Department