If patients are not readily available, family members or others sometimes are used as substitute informants when evaluating consumer satisfaction. Little is known, however, about the extent to which responses of patients and proxies are interchangeable. In this study, patients (N = 225) or significant others (N = 115) provided an overall rating of discharge plans, as well as information on psychosocial, health, and post-hospital service related factors, at 3-4 weeks post-discharge. While no difference was found between mean plan ratings for the two groups, substantial differences were found in factors predicting satisfaction for patients and for proxies. Results indicate that care should be taken in using proxy ratings in the place of patient ratings, particularly when developing strategies for enhancing consumer satisfaction. Findings are discussed as they relate to continuity of care initiatives and programs for enhancement of desirable health utilization behaviors, in the context of managed care.

Twenty-seven hospital field work programs in New York City were studied. Questionnaires were administered to program coordinators and 238 graduate social work students participating in study programs. High degrees of program structural complexity and variation were found, indicating a state of art well beyond that described in the general field work literature. High rates of student satisfaction with learning, field instructors, programs, and the overall field work experience found suggest that the complexity of study programs may be more effective than traditional field work models. Statistically nonsignificant study findings indicate areas in which hospital social work departments may develop field work programs consistent with shifting organizational needs, without undue risk to educational effectiveness. Statistically significant findings suggest areas in which inflexibility in program design may be more beneficial in the diagnostic related groups era.

This study of 238 social work students in 27 hospital field work programs examined how student satisfaction with field work affects their willingness to accept employment in host hospitals. Job willingness was positively correlated with five measures of student satisfaction. Factors predictive of each measure were identified. Findings suggest strategies that can be used by hospital social work managers and field work supervisors to enhance student satisfaction with the field work experience, in order to maximize the benefit of providing field work education as a way of recruiting graduating students for employment in hospital settings.

Social workers in hospitals develop discharge plans for in-home patient care with little systematic feedback about postdischarge implementation. A telephone follow-up study of patients discharged from an urban teaching hospital in 1990 was undertaken to determine the extent to which discharge plans for home services were carried out and to identify factors associated with unsuccessful implementation. Overall, 72 percent of the patients received all, 19 percent some, and 9 percent none of the planned home care services. Great variability was found in service delivery: Registered nurse visits were the most successfully delivered type of service; 24-hour companions were the least successfully delivered service. Further, over one-third of patients experienced termination or reduction of services between discharge and the follow-up interview 21 to 28 days after discharge. Such unexpected and varied outcomes suggest the need for development of discharge follow-up programs that move beyond hospital walls to ensure that patients receive needed services.

Hospital field instructors of graduate social work students can experience considerable stress in managing their dual roles as practitioners and teachers. This paper looks at the kinds of supports that field instructors need from hospital social work departments to help them experience field instruction positively. Annual program evaluations completed by field instructors at one hospital over a five year period were analyzed. Findings suggest that ongoing departmental seminars for field instructors can be critical in supporting them in this role well beyond the first year. Implications for retaining field instructors and directions for further research are highlighted.