Subject(s)
Hospitals, Teaching/organization & administration , Patient Care Planning/organization & administration , Social Work Department, Hospital/organization & administration , Social Work , Education, Graduate , Health Care Rationing , Humans , Job Description , Ontario , Organizational Case Studies , Patient Discharge , Social Work/education , Social Work/organization & administration , WorkforceABSTRACT
All three cost-saving initiatives--the creation of a one-page application form to streamline the rehabilitation application process, the use of the resource specialist to assist with applications, and the development of an information package on cardiac rehabilitation--reflect a process whereby a creative idea, generating planning, activities, and follow-up resulted in a measurable effective change in practice. This process truly translated strategy into action (Kaplan, 1996) and is vital to the current rethinking in health care of how best to do our work (Coan, 1994). Because of this process, social workers in the cardiovascular surgical division of the cardiac program are better equipped to respond to the psychosocial needs of a growing cardiac population in a fiscally restrained environment.
Subject(s)
Cardiac Surgical Procedures/rehabilitation , Cardiology Service, Hospital/organization & administration , Social Work Department, Hospital/organization & administration , Cardiac Surgical Procedures/psychology , Cardiology Service, Hospital/economics , Cost-Benefit Analysis , Forms and Records Control , Hospitals, Teaching , Humans , Interdepartmental Relations , Ontario , Pamphlets , Patient Discharge , Patient Education as Topic/methods , Social Work Department, Hospital/economicsABSTRACT
Few hospitals have standard approaches to recognizing and treating victims of abuse. When staff at the Toronto Hospital realized they had no guidelines for handling such cases, they formed a task force to research the issue. The result was a set of policies and procedures which clearly outline the duties of staff who suspect abuse and, at the same time, make clear the hospital's role in addressing this serious issue.
Subject(s)
Domestic Violence , Hospitals , Organizational Policy , Aged , Elder Abuse/diagnosis , Elder Abuse/therapy , Female , Humans , Male , OntarioABSTRACT
OBJECTIVE: To determine whether the introduction of coordinated geriatric and discharge planning services at teaching and community hospitals in Toronto has changed the number of beds occupied by patients awaiting transfer to long-term care institutions. DESIGN: Retrospective review of social work records for the period 1985-1992. SETTING: Two tertiary and four primary acute care hospitals in Metropolitan Toronto. PARTICIPANTS: Hospitals were matched for location, acuity, and teaching affiliation. MAIN OUTCOME MEASURES: The numbers of beds occupied by patients awaiting transfer to nursing homes or chronic care hospitals were noted. RESULTS: In those teaching and community hospitals that had introduced coordinated geriatric and discharge planning services, there was a reduction in the percentage of beds occupied by patients awaiting long-term care placement (average-51%), whereas in hospitals without geriatric services, the percentage of beds occupied by patients awaiting long-term care placement increased (average + 25%) (P = .05 by Fisher's exact method, 95% confidence limit odds ratio 0, .9999). CONCLUSION: The introduction of coordinated geriatric and discharge planning services was associated with a decrease in the percentage of beds occupied by patients awaiting long-term care in both teaching and community hospitals.
Subject(s)
Geriatrics/organization & administration , Hospitals, Community/organization & administration , Hospitals, Teaching/organization & administration , Long-Term Care/statistics & numerical data , Patient Discharge , Aged , Bed Occupancy , Health Services Research , Hospitals, Community/statistics & numerical data , Hospitals, Teaching/statistics & numerical data , Humans , Least-Squares Analysis , Ontario , Patient Transfer , Retrospective Studies , Waiting ListsABSTRACT
When 54 year old Lisa was admitted to the Western Division of the Toronto Hospital in November 1987, it was for removal of a benign cranio-cerebral tumor. The pulmonary compromise she had lived with for many years--the result of a congenitally short spine--was accentuated during the months following surgery. With breathing difficulties and recurrent pneumonia, Lisa required assisted ventilation. And though she tolerated being off the ventilator for a total of five hours during the day, repeated attempts to wean her were unsuccessful.
