Quality of care and social work research

Abstract

What do we know about the of social work service? How, where, and why does vary? Most important, what do we know about how we might work improve the of care? For nearly two decades, of has been the focus of sustained attention in health care. Professional organizations, accrediting bodies, government regulating agencies, and researchers have worked advance conceptual and operational understandings of what constitutes of and develop markers or indicators guide assessment. A substantial research now focuses on the systematic exploration of variations in care, and improvement vigorously pursued. Serious concerns about persist. Indeed of recognized as ranking among the most pressing issues in current health policy. The National Academy of Science's Institute of Medicine (2001) recently concluded that [b]etween the health we have and the we could have lies not just a gap, but a chasm. Quality no less pressing a concern for social work. We have no reason believe that social work immune chasms such as those prevailing in health and mental health care. Quality assurance and improvement have been addressed by social work organizations for more than 25 years. Social work has addressed issues of largely through the professional model of improvement (Palmer & Adams, 1993), which through credentialing, education and certification, licensure, and standards for care. The National Association of Social Workers has established standards for in several areas, including clinical social work, cultural competence, school social work, and case management. The NASW Code of Ethics (2000) identities competence as a core value and component of the foundation for social work's unique purpose and perspective. Most of these standards are expressed in terms of the knowledge, training, and comportment of individual social workers. Standards for have been advanced by other organizations. Working with NASW, the Society for Social Work Administrators in Health Care, of the American Hospital Association, pioneered the development of high-risk screens and methods evaluate patient satisfaction. The current Society for Social Work Leadership in Health Care works advance its goal to foster and maintain the in social work practice through, in part, the establishment of standards of for domestic violence, child abuse/neglect, and elder abuse/ neglect. Likewise, such organizations as the Joint Commission on Accreditation of Healthcare Organizations and the Child Welfare League of America have established standards, standards of excellence, or standards of best The Child Welfare League of America requires agencies meet standards for assurance and offers technical assistance in creating and implementing assurance programs. At the local level, many individual agencies work creatively and energetically establish their own improvement indicators, largely of service processes such as timeliness in response client requests for service. The quality agenda may constitute yet another gap between social work research and practice. Although many social work organizations express commitment advancing standards for care, the topic of all but absent in the social work literature. Social work research reflects little if any attention such issues as how defined, what indicators in extant data bases or service records can appropriately reflect quality, or how and where of varies. The profession would be well served by sustained, concerted research on and particularly on the gap between care that is and care that could be. …