Toward a Better Understanding of Social Work Roles and Functions on Integrated Care Delivery Teams

Investigators: Brianna M. Lombardi, MSW, Lisa de Saxe Zerden, MSW, PhD, Erica L. Richman, MSW, PhD

Background: Social workers’ training and knowledge of psychosocial risk factors, behavioral health screening, assessment and intervention, and focus on the adaption of services to be culturally inclusive makes the profession uniquely positioned to assist in the treatment of the “whole person” in integrated care settings. However, there is a limited understanding of what social workers are currently doing in integrated care settings. Until now, work exploring social worker roles in integrated settings has been theoretical in nature and limited by sample size or geographical reach.

Objective: To address these gaps, this study used a convenience sample of Masters of Social Work (MSW) students throughout the US in integrated field placement settings and their MSW field instructors (N=395) to clarify how this workforce, not traditionally captured in workforce research contributes to integrated healthcare.

Methods: An electronic survey was developed using Qualtrics and administered to HRSA-funded Behavioral Health Workforce Education and Training (BHWET) MSW students and their field instructors. The survey focused on understanding the roles, tasks, and interventions of social workers in integrated health care.

Key findings:

  • The most commonly used skills were: team-based care; motivational interviewing; psychoeducation; using the social determinants of health; and adapting services to be culturally inclusive. The least used skills were medication management; SBIRT (screening, brief intervention, and referral to treatment); warm hand-offs; functional assessment of daily living skills; and behavioral activation.
  • Respondents had knowledge of or education related to most core competencies of integrated practice. However, many indicated they had not learned about SBIRT (34%); behavioral activation (25%); problem-solving therapy (19%); huddles (18%); or warm hand-offs (18%).
  • Most were co-located with the rest of the integrated care team (62%). About 80% talked with the team in person at least weekly, with more than 42% doing so daily. Participants who were co-located or worked in inpatient settings were more likely to communicate with team members in person
  • Over 53% reported that team members always have access to the same electronic health record (EHR), but 15% indicated team members never use the same EHR.

Conclusion: Findings suggest the importance of programs to train and deploy social workers in integrated settings, such as the BHWET federal funding mechanism, as MSW students appear to be learning the necessary skills needed to work in integrated care. However, social workers currently in practice still require retooling and training. The majority of field instructors indicated learning tasks and skills “on the job.” This education gap provides an opportunity for MSW educators to develop continuing education curriculums to support and re-tool the current social work workforce.

Project Products: 

Manuscripts

 

Policy brief
  • Jones C, Toles M, Beeber A, McCollum M, Neal M. Barriers and facilitators for the LPN-to-RN transition: Perspectives from practicing LPNs. Carolina Health Workforce Research Center. Policy Brief. October 2017.
View the brief

 

Presentations, webinars, and refereed conference papers and posters
  •  Lombardi B, Richman E, Zerden L. Using a Latent Class Approach to Better Understand Social Work Roles in Integrated Health Settings. Association of American Medical Colleges Health Workforce Research Conference. Tyson’s Corner, VA. May 2018.
  • Zerden LD, Lombardi BM, Richman EL. Working on the Interprofessional Team: Barriers and Facilitators to Social Work Practice in Integrated Care Settings. Poster. Society for Social Work and Research Annual Conference. January 2018. Washington DC.
  • Lombardi BM, Fraser M, Wu S, Fraher E, Richman E. 2017 October. Closing the Health Gap: Social Workers’ Roles in Integrated Primary Care. 2017 Council on Social Work Annual Program Meeting.
  • Lombardi B*, Zerden L, Fraher E, Fraser M, Wu S*. Social Work in Integrated Primary Care: A Systematic Review. Podium presentation. Association of American Medical Colleges Health Workforce Research Conference. Washington, DC. May 4, 2017.
  • Fraser M, Lombardi B*, Wu S*, Zerden L, Richman E, Fraher E. Social Work in Integrated Primary Care: A Systematic Review. Podium presentation. Society for Social Work and Research 21st Annual Meeting. New Orleans, LA, January 2017.
  • Lombardi B, Richman E, de Saxe Zerden. Using a latent class approach to understand social work roles in integrated health settings. Poster Presentation.
  • Lombardi, BM, Zerden, LD, Richman, E. (2019). Towards a Better Understanding of Social Work Roles in Integrated Health Settings: A Latent Class Approach. Oral Presentation, Society for Social Work and Research 23rd Annual Conference, San Francisco, CA.
  • Zerden, LD, Lombardi, B, Wu, S. (2019, January). Social workers roles in integrated primary care: A task analysis of a systematic review of RCT studies. Symposium paper presented at the Society for Social Work Research National Conference, San Francisco, CA.
  • Lombardi, B.M., Zerden, L.D., Richman, E.L. (2018). Social Workers on Interprofessional Integrated Healthcare Teams: Education and Practice Implications. Oral Presentation, CSWE APM, Orlando, FL.
  • Zerden, L.D., Lombardi, B.M., Richman, E.L. (2018). Promoting Health Equity: Describing Social Worker Education and Practice in Integrated Healthcare. Oral Presentation, CSWE APM, Orlando, FL.