What you report, as a hospice social worker, during IDT meetings

The interdisciplinary team meeting is not the ideal forum for advocating for patient needs. Ideally, it would be, but in reality, it isn’t.

The IDT meeting is about checking boxes to maintain compliance. The reason the IDT meeting is mandated is to ensure quality conversations among team members about patients are taking place. Unfortunately, the full expression of your social advocacy voice will not always be well received by all of your colleagues. Only share your candor with those with whom you share a trusting rapport.

You want to help the team check the IDT meeting boxes. And if the team wants that to happen fast, help by keeping it brief. Use your social worker’s intuition and contribute to the extent that gaps in the nurse-led discussion may be gently filled.

For new patients, be prepared to report briefly on the basics:

DNR status

Does the patient have a valid DNR, and does the office have a copy? If not, does the patient want one?

MPOA status

Who’s the legal proxy? Is the patient cognitively functioning enough to call his/her own shots, even though there’s a proxy for when the patient isn’t considering options or communicating well?

Funeral home

Has a choice been made? If not, what is the plan to facilitate a choice?

Psychosocial challenges detected so far

What do you think your focus and goals will be with this patient? What will your plan be–to include frequency of visits–to achieve these goals?

Make full reports for new patients – abbreviated reports for everyone else

For patients who are recertifying, touch base on the status of any of these that needs attention.

For all other patients, report to the team only on major issues. If there are no major issues: “Patient and family needs met by current plan of care.”

Are there exceptions? Sure.

But not really. For example, what if a social worker has great rapport with everyone in the room?

Michael Giles is a hospice social worker and psychotherapist who works in Austin and Cedar Park, Texas. Also by Michael: The secret to effective boundaries

A social worker can be popular enough in a team that her insights are well-received, and she feels free to express herself to the full extent that it can benefit the patient. And then the team can change. It isn’t unusual for nurses to change jobs frequently. And a new nurse, or a new director of nursing can wonder why a social worker has such a significant voice in the meetings. And this may be the beginning of the end of the social worker’s employment there. 

So instead of impressing anyone with how much you have to say, or how powerful an advocate you are for your patients, instead impress the team with your ability to keep track of what they see as your role. And how efficiently you report that information so that the whole team can quickly get back out to the field.

And when you are out in the field, do your job as you know in your heart you are called to do it.