Medical Social Work Skills Checklist

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GENERAL KNOWLEDGE/SKILLS EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
National Patient Safety Goals123
CMS: Centers for Medicare and Medicaid Services123
Awareness of HCAHPS scores123
Knowledge of Advance Directives123
HIPAA: Health Insurance Portability and Accountability Act123
Disability Management123
Worker’s Compensation123
Discharge planning123
The Joint Commission123
Universal Precautions123
Cardiac Arrest/CPR/AED123
Rapid Response Teams123
KNOWLEDGE OF ASSESSMENT EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Health History, review of physical examination, review of systems123
Psychosocial Assessment (social history, support systems, emotional, caregiver support, ability to deal w/loss)123
Financial Assessment (income, ability to manage needs)123
Emotional Assessment (response to illness, treatment, support)123
Spiritual Assessment (religion, beliefs, practices and relationship to care)123
Terminal Care Assessment (5 stages of grief, hospice, palliative care, crisis)123
Development of problem list123
Perform Initial Evaluation123
Develop and revision of care plan123
Assess outcome to treatment123
Establish and revision of goals123
DOCUMENTATION SKILLS:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Initial assessment and treatment plan123
Skilled visit notes123
Follow Physician orders123
Documents according to POC123
Documents key information to physician, supervisor and case manager123
Discharge Summary123
PLAN OF CARE AND COORDINATION:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Follows Plan of Care123
Review POC prior to care123
Communicate and Coordinates with interdisciplinary team members123
Knowledge of criteria for participation in Medical/State Regulations123
Knowledge of skilled reimbursable visit123
Effective Case Coordination123
Knowledge of available community resources123
Community Resource Planning123
Attends case conferences as required123
INFECTION CONTROL:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Hand washing123
Exposure plan123
Utilizes Personal Protective Equipment PPE123
PATIENT EDUCATION:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Determine learning needs123
Set goals/objectives123
Develop and implement care plan123
Evaluate effectiveness of teaching123
Ability to revise care plan123
WORK SETTING EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Hospital123
Hospice123
Military base or Veteran Affair Clinic123
Long Term Care123
LTAC123
Schools123
Community Mental Health Agency123
Correctional Facility123
Private Practice123
Substance Abuse Clinic123
State/Local Government (Dept HHS, Child Welfare, Jobs and Family Services)123
AGE-SPECIFIC EXPERIENCE:

Rank each of the following sections on a scale of 1 to 3:

1) Limited or no experience
2) Experienced, but may need review or supervision
3) Able to function independently *
Newborn/Neonate (birth to 30 days)123
Infant (31 days to 12 months)123
Toddler/Preschool (13 months to 5 years)123
School Age Child/adolescent (6 years to 18 years)123
Young Adults/Middle Adult (19 years to 64 years)123
Older Adults/Elderly (65+ years)123

Attestation

ATTESTATION: *