Study On The Dilemma Of Weakening Social Workers' Roles In The Interprofessional Team Of "discharge Planning"

In recent years,with the continuous improvement of the level of Chinese medical technology,while all kinds of physiological ills can be overcome,in the meantime,it should also be seen that the quality of medical care for the people demand also shows an increasing trend in the context of prolonged life expectancy and the growing prevalence of chronic diseases.The "discharge planning" service acts as a specific embodiment of the "full-personalized" medical concept.Its purpose is to provide patients with an effective link between “hospital-outside hospital” medical and nursing resources through the interprofessional medical team cooperation approach based on the assessment of the patient's "physiological-psychological-social" comprehensive needs.“Discharge planning ” interprofessional teamwork acts as an important context for medical social workers to play specific role in the professional field of health care,it is not only the embodiment of medical institutions in response to the concept of modern medicine,but also a symbol that the social work professional value can be achieved within the medical system.Therefore,the paper adopts a qualitative research method based on the chance of the author's exchange learning in the first half of 2017 at Tunghai University in Taiwan,China,and through seizing the opportunities for professional internships in the social services section at Hospital C,Taichung City,Taiwan Province,centering on participatory observation and abiding by the principle of purposive sampling,6 participants from each category of the cross-field team in the “discharge planning” of the C Hospital were selected as the interviewees,and combining with the scale,performing investigation to the C Hospital's “discharge planning” interprofessional team operation process and social worker role status.The study shows that the role of social workers in hospital C was weakened in interprofessional teams in the “discharge planning”.After analysis,the causes mainly lies to the following 3 layers: Firstly,from a macro perspective,the professional status of medical social workers is being extruded at the policy level by Taiwan's universal health insurance and hospital assessment system;Secondly,in the medical field of Meso,and from the consideration of management philosophy,the internal staffing and organizational culture of the hospital have weakened the role of professional workers;At last,within the cross-domain team,due to the expansion of the boundaries of the health care profession,the social worker role and the role of the nursing staff overlap,further making the professional role of health care social worker in the cross-field team suffer from “Omnipotence” misunderstanding and “replacement” crisis.Aiming at above straits,the study reshapes the professional roles of medical social workers similarly from three layers: In terms of policy layer,emphasize the “quality” orientation of emphasis on service in medical evaluation and hospital professional systems,and advocate promoting rationalization of social worker force allocation and personnel structure on the basis of balancing costs;Secondly,in terms of “discharge planning” cross-field teams,emphasize the clarification of the power structure and professional roles among team members once again to prevent unreasonable role expectation and role conflict from happening.Thirdly,in terms of medic social workers,they should maintain the professional status in the hospital field effectively,first of all,they should achieve to be professional and confidential,and under this premise they should continue to expand their professional knowledge to find out the balance point between professional ideals and real value.Eventually,in terms of experience and reflection on the weakening of the role faced by medical social workers in the cross field team operation of the "discharge planning" in Taiwan region of China,and combining with the reality that the development of “discharge planning” service in Mainland China is in stages in germination,and the development of medical social workers is in the take-off period,stress that via the active participation of medical social workers and the improvement of their own resources link knowledge abilities,while promoting the diversification of service providers for mainland “discharge planning” and the effective development of service content,the depth and breadth of medical social workers integrated in the medical and health field should be deepened.