Interprofessional Education, Social Work, and Discharge Planning: A Focus on Health Equity

Overview: The purpose of this study is to examine the role of health equity as part of an interprofessional learning simulation focused on hospital discharge planning. Implications for social work education are offered as well as strategies for interprofessional education to promote health equity across disciplines.Proposal text: Background
Interprofessional teamwork is a core feature of social work practice, especially in healthcare settings that serve older adults and their family members. However, research suggests that the workforce providing care to older adults is often fragmented, with varying levels of training that hinder interprofessional teamwork (Shapmire et al., 2018). This raises concerns about the complex task of discharge planning for older persons which involves multiple disciplines, including hospital social workers. A comprehensive discharge plan is critical to ensure continuity of care for the patient as they return to the community (An, 2014; Eaton, 2018) and prevent hospital readmissions. However, little is known about issues related to health equity, aging, and discharge planning, particularly as it relates to interprofessional social work education. The purpose of this study is to examine the role of health equity as part of an interprofessional learning simulation focused on hospital discharge planning.

Methods
As part of a virtual, interprofessional skills simulation, social work students participated in an interdisciplinary team meeting for discharge planning for a hospitalized older adult with cognitive impairment. Students in medicine nursing, social work, and allied health professions met in small teams with a standardized family member (i.e. person trained to perform after hours of rehearsal) in order to ascertain and prioritize options for residential placement of an older patient with Alzheimer’s disease following her discharge from the hospital. Following the simulation, social work students were required to complete a written case note to document the patient’s background, household, support system, health insurance coverage, summary of the interdisciplinary team meeting, and barriers identified to discharge.

Two social work researchers conducted a qualitative study of the case notes using directed content analysis. Directed content analysis was chosen as the analytic method in order to explore a phenomenon of interest (i.e. health equity and discharge planning) using a theory as a guide (Hseih & Shannon, 2005). The researchers used the Health Equity Framework (Peterson et al., 2021) to examine the content of the student case notes.

Results: As part of a required assignment, social work graduate students (N = 107) participated in an IPE simulation across two courses (Family Caregiving and Aging; Special Topics in Health Equity). All students were in their advanced year of their MSW program located at a large, public university in North Texas. Using the Health Equity Framework, findings suggested that students identified: 1) systems of power including health insurance and payor type; 2) relationships and networks related to health equity including the patient’s family members as well as the family members’ involvement in care; 3) individual factors of health equity including the home environment and socioeconomic status; and 4) physiological pathways related to health equity including the patient’s functional and cognitive ability.

Discussion:
Findings underscore the importance of interdisciplinary teamwork and bolster support for the role of social workers in promoting health equity as part of discharge planning. Implications for social work education are offered as well as strategies for interprofessional education to promote health equity across disciplines.