EVALUATING SOCIAL-WORK-PRACTICE IN A MEDICAL SETTING - HOW DO WE MEETTHE CHALLENGES OF A RAPIDLY CHANGING SYSTEM

Social work's response to a rapidly changing health care system requir es an empirical approach to practice. However most empirical studies t hat evaluate social work services emphasize productivity and efficienc y instead of effectiveness. This article examines the following questi ons: (a) What is the nature of contemporary social work practice in a medical setting? (b) What accounts for the effectiveness of social wor k interventions? (c) Does the current practice of social workers meet the demands of a changing health care system? Social workers in a larg e metropolitan hospital collected data on 60 cases. Descriptive data r egarding the types of presenting problems, risk factors that complicat e these problems, interventions, and obstacles to service delivery are presented. Regression analyses showed that the obstacles were the str ongest predictors of the overall outcome of the cares, The authors dis cuss the implications of the rapidly changing medical system on social workers' activities.