What is the added value of GITT for Social Workers? (word format 23k)

THE ROLE OF THE SOCIAL WORKER INTERDISCIPLINARY GERIATRIC TEAMS 

(Reprinted permission Rose Dobrof, Editor, Journal Gerontological Social Work Journal of Gerontological Social Work, Vol. 30 (3/4) 1998.)

Although not widely practiced, the value of the interdisciplinary team in the health care of patients with multiple health and social care needs has been recognized for several decades. With the advent of managed care and increased understanding of the meshing of physical, psychological and social issues in contributing to patient outcomes, there is renewed interest in the interdisciplinary team. To promote interdisciplinary understanding and skills increases an interdisciplinary team care approach to the health of geriatric patients, the John A. Hartford Foundation of New York launched a national Geriatric Interdisciplinary Team Training (GITT) program in 1997. In that year, nine sites across the country were funded to establish team training programs.

An ever growing experience of gerontological social workers is their interaction with clinicians from other backgrounds in providing for the health care needs of elders. In particular, a resurgence in the effort to provide care through teams of health and social service professionals has placed increased attention on the importance of collaboration and communication between team members, and the importance of the role of the gerontological social worker in this group setting. During the last two years, the Hartford GITT initiative has led to the development of geriatric interdisciplinary teams in a number of universities and health care systems. This initiative has significantly expanded the scope and knowledge base of what constitutes good geriatric interdisciplinary teams and offered new insights as to how teams can be developed, integrated into health care systems of the 1990s, and used as a highly effective method of educating advanced practice professionals in the techniques of interdisciplinary teams.

The Hartford GITT Program has successfully taken the work of the last several decades in interdisciplinary care and melded it with teaching teams how to function at the optimal level, resulting in an outstanding care environment for elders. Each of the nine different Hartford GITT sites, consisting of academic health centers and health care provider organizations, includes advanced practice clinicians in social work, nursing and medicine, with many incorporating the expertise of a wide variety of advanced practice students in other health professions. These teams of trainees receive didactic training as well as an extensive clinical practica in team care for elders. To date, hundreds of trainees and thousands of patients have benefited from this initiative. Each Hartford GITT site is unique in its specific program but all face common issues and challenges. To be a productive and credible member of an interdisciplinary team, each member needs to first understand the role of his/her own discipline, and to be able to articulate this to others. At the GITT program sites, it rapidly became clear that this initial step towards a functioning team was both confusing and elusive.

It has become apparent that many, if not a majority, of the clinicians participating in this educational experience do not have an accurate understanding of the skills, knowledge and specific expertise that their colleagues bring to the team. This is probably most apparent for the gerontological social workers. Although they make up a critical component of the team, nearly all the training programs have remarked that there is minimal understanding of just what constitutes a social worker's training and what specific roles she or he may bring to the group. Even though this problem of limited understanding of roles and skills is not unique to the social workers on the team, in fact it occurs for every discipline, the lack of understanding of the social work role by each of the other professionals in a geriatric health care team training experience appears to be particularly glaring.

A social work interest group was formed with representation from the nine Hartford GITT Programs, in part, as a means of trying to improve the understanding of the nature and expertise of gerontological social workers among other health care professionals. Through a series of several meetings and with inputs from interest group members and other key informants in the field, the members of the social work interest group created a two-part summary of what constitutes the work and critical contributions of social workers in geriatric clinical teams. The work group created a synthesis document of the purpose, focus, and specific activities that a social worker brings to geriatric teams. In fact, this document is appropriate for social workers in all team settings.

The one-page synopsis of what social workers bring to teams is intended as a brief but cogent summary of the specific expertise of social workers. The longer version of this document elaborates upon the specific skills, training, and expertise gerontological social workers bring to teams. Taken together, these documents provide social workers, other clinicians, and geriatric team members, a thorough overview of the social work experience. The social work summary documents are intended to be used in conjunction with summary documents of the role and activities of other health care professionals in orientations, during ongoing training programs, and as summary documents to all health care delivery vehicles. The GITT Social Work Interest Group, consisting of Carol Ashendorf, Joanna Avery, Barbara Bacon, Judy Howe, Kathryn Hyer, David Lindeman, Marilyn Luptak, Marty Mandel, Russ Martineau, Joanna Mellor, Baila Miller, Jim Reinardy, Barrie Robinson, Ann Schneider, Ellen Stevens, Nancy Wadsworth, and Lisa West, is very interested in your feedback and any suggestions that might be generated to improve this document. Feedback, items to improve the description, and methods for circulating the descriptions can be addressed to the New York University GITT Resource Center (212)998-5565, (212)995-4561 fax, or e-mail, gitt.resource@nyu.edu. We look forward to your comments and hope that this effort fosters further understanding of the importance of social workers in gerontological team care.

David Lindeman
Joanna Mellor

Developed by the GITT - Social Work Interest Group of the
John A. Hartford Foundation Geriatric Interdisciplinary Team Training Program

SOURCES:
Council on Social Work Education. Commission on Accreditation Handbook of
Accreditation Standards and Procedures. 1994.

Health Resources and Services Administration. A National Agenda for Geriatric Education:
White Papers. Ed. S. Klein. US DHHS. 1995.

Scharlach A & Robinson, B. Social Work and Gerontological Education.
White Paper developed for the John A. Hartford Foundation. 1997.

West, L., Mellor J., & Robinson, B. Personal Communication. 1998.

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