BackgroundLong-stay patients in acute hospitals commonly present with complex psychosocial needs and use high levels of hospital resources.ObjectiveTo determine whether a specialist social worker-led model of care was associated with a reduction in length of stay for medically stable patients with complex psychosocial needs who were at risk of long stay, and to determine the economic value of this model relative to the decision makers’ willingness to pay for bed days released.DesignA prospective, matched cohort study with historical controls.SettingA large, tertiary teaching and referral hospital in metropolitan Southeast Queensland, Australia.MethodsLength of hospital stay for a cohort of patients seen under the specialist social worker-led model of care was compared with a matched control group of patients admitted to the hospital prior to the introduction of the new model of care using a multistate model with the social worker model of care as an intermediate event. Costs associated with the model of care were calculated and an estimate of the ‘cost per bed day’ was produced.ResultsThe model of care reduced mean length of stay by 33 days. This translated to 9999 bed days released over 12 months. The cost to achieve this was estimated to be $A229 000 over 12 months. The cost per bed day released was $23, which is below estimates of hospital decision makers’ willingness to pay for a bed day to be released for an alternate use.ConclusionsThe specialist social worker-led model of care was associated with a reduced length of stay at a relatively low cost. This is likely to represent a cost-effective use of hospital resources. The limitations of our historic control cohort selection mean that results should be interpreted with caution. Further research is needed to confirm these findings.

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This article presents the findings of a study that arose out of the desire by the Allied Health Professionals (AHP) at the Mater Hospital, Brisbane, to better understand the needs of their clients in order to be able to offer a more effective and appropriate service. A questionnaire designed specifically to explore the needs of patients and their families for AHP services was administered to consecutive patients (n = 62) attending the Mater out-patient oncology clinic during one month. The findings provide a wealth of practical information for AHPs to use in planning for the effective utilisation of their services, as well as fresh insights into a number of theoretical issues that need further research.

This paper reports on a pilot project conducted at a Brisbane hospital to develop a social work assistant (SWA) role designed to support clinical social workers in an acute adult hospital setting. In the context of increasing workload demands, constricting health budgets, and organisational expectations, it details the development of the SWA role and outlines the increased scope and quality of practice afforded social workers through the new model of care. The paper demonstrates that the SWA model has positive outcomes for hospital social workers by allowing them to reclaim their core business in an increasingly bureaucratised and deprofessionalised work environment.