Wednesday, September 28, 2011

EAP Utilization Tip: Utilization Review & Hospital Social Workers

How many hospitals are in your town? Medical social workers or utilization review nurses might be the busiest occupation on the planet with the most stress. The cut-backs in hospitals and the personnel shortages they face, have made social workers busier than ever--that's if they have not been fired yet. Some hospitals have let all of their hospital social workers go. They have replaced the bulk with utilization review nurses who line up support and medical help post-discharge.

They could use some help. And they would love to refer employees from the company or companies you serve who've ended up in the hospital for one reason or another. You could lighten their load and get the utilization credit for your program. Remember family members could use EAP services too, so make sure your statistics include "employees impacted" by EAP services.

In many instances, medical social workers perform the same kind of  "brokerage" services for patients and their family members that EAPs do. (Brokerage is arranging services for the client without the client's involvement and then passing them off to that service or agency for continuing care or services.) Medical social workers interface with hospice services, meals on wheels, visiting nurse agencies, home health care, medical equipment companies, admission departments of nursing homes and assisted living facilities, social security disability and retirement offices of local government, many other services. If you have done this work as a medical social worker or hospital utilization nurse, you know that burnout is high. You're on the phone constantly.  Help these hospital professionals by letting them know you exist. When a patient is admitted to the hospital, the EAP (that's you) can be contacted to help arrange support or other services. They instantly become a new EAP client referred to your program. Note that you will need to reinforce your availability for assisting the hospital with patients who are also employees of the companies you serve. I would arrange six monthly letters to the person in the hospital who is head of insurance utilization. Send them monthly regardless. After that, your utilization will increase. Let me know what happens. This is a win-win for everyone, including your EAP client, especially.

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