Social Work in Outpatient Neurology at a Safety-Net Hospital: A 200-Hour Profile

Area of Science:

• Social Work in Healthcare
• Neurology Patient Care
• Health Disparities Research

Background:

• Social work is crucial for preventive health and reducing healthcare disparities.
• Limited research exists on social work's role in multi-specialty clinics for marginalized groups.
• Outpatient neurology settings present unique challenges for underserved patients.

Purpose of the Study:

• To characterize the role and interventions of an outpatient neurology social worker.
• To assess the impact of social work on patients in an urban, safety-net hospital's neurology clinic.
• To identify key areas of need and intervention time allocation for neurology social work.

Main Methods:

• Implementation of a dedicated social worker in an urban neurology clinic serving an underserved population.
• Logging and characterization of 200 consecutive hours of patient encounters.
• Classification of social work interventions using a 10-category scheme based on natural language processing algorithms.
• Analysis of 125 patient encounters referred to social work.

Main Results:

• Social worker spent most time on care coordination (40%), housing insecurity (14%), and applications/reporting (11%).
• Time-intensive interventions included housing (129 min/case), applications/reporting (120 min/case), and care coordination (96 min/case).
• Most interventions directly addressed patients' neurological conditions, underscoring the need for specialized social work support.

Conclusions:

• Embedding social workers in neurology clinics is effective for addressing social determinants of health.
• Neurology-specific social work interventions are critical for mitigating health disparities.
• This model can improve patient outcomes and reduce inequities in neurological care.