Social Work Practicum Change Process By: Alexis Goodrich, BSW Student

What Is A Change Process? It is an integral part of their Social Work Practice III (Macro Practice) course. It allows students to apply the skills they have learned in a tangible way at their internship agency. Students engage in a “planned change process” at their agency- either one that is already in process or a new change that is needed (Fineran, 2014). Students are graded on the design of their change process. Implementation of the change may or may not occur during the practicum (Fineran, 2014). Macro practice can be viewed as having four major components: Understanding the important components to be affected by the change- problem, population, and arena. Preparing an overall plan designed to get the change accepted. Preparing a detailed plan for intervention. Implementing the intervention and following up to assess its effectiveness (Fineran, 2014)

Coastal Carolina Neuropsychiatric Center Mission: “To establish a practice with a cornerstone of quality, patient-centered, evidence-based mental health care in a warm, caring environment, and where there is respect between the staff, providers and patients.” —Dr. Ash Mikhail, MD, CEO/Medical Director One of the leading mental health outpatient treatment facilities located in eastern NC, providing a wide range of psychiatric services including: Supportive therapy                                           Individual psychotherapy Couples/marital therapy Family therapy Parenting skills education                                 Diagnosis of mental disorders Medication assessment and management           Comprised of a diverse clinical staff with a wide range of educational backgrounds, experience, and interests, and specializations: Psychiatrists Nurse Practitioners Physician Assistants Psychologists Licensed Psych. Assistants Licensed Clinical Social Workers Licensed Professional Counselors Website: www.coastalcarolinapsych.com

- Darynda Jones, NY Times Best-selling author The Need for Change… Change Process Goal– What am I doing? To revise the CCNC new patient paperwork packet. Is there really a need for change? Yes. Patients and staff have both expressed frustrations with the current paperwork including redundant information and time spent completing/processing. Change Agent – What is my role? To coordinate the change process and oversee the assessment, planning, decision- making, implementation, evaluation, and monitoring. Approach – Project, Program, or Policy? Project AND Policy: The change process is a project in that it is short-term and the focus is specific. If implemented, it will also involve a policy approach in terms of changing a procedure for CCNC’s intake process. “Paperwork wouldn’t be be so bad if it weren’t for all the paper. And the work.” - Darynda Jones, NY Times Best-selling author

If It Isn’t Broke, Don’t Fix It…Right? Increased time on paperwork=decreased direct care for patients (Garcia, 2006). Also results in fewer scheduled treatment appointments, no shows, cancellations, and an overall disengagement with their own treatment (Garcia, 2006). Increased documentation and paperwork leads to occupational stress, dissatisfaction, and burnout for mental health workers (Garcia, 2006). The American College of Physicians states that health care providers: “Need to view clinical documentation as a fundamental tool for improving patient care rather than a regulatory burden or gateway for reimbursement” (Sequist, 2015)

Change Process Cost Projected Expenses Amount Personnel $ 0 Rent Supplies Telephone Copying & Printing $ 0 *CCNC already has allocated funding for this expense. Amount spent on paper/toner will be reduced after the patient paperwork revision. Equipment Travel Total Considering the cost of the change is $0, what is the cost of doing nothing? Impact on staff? Impact on patients? Impact on resources?

Old vs. New *Refer to your handouts

What I Learned…

References Garcia, I. (2006). Administrative duties: Weighing up the problem. Mental Health Practice, 9(10), 32-34. doi:10.7748/mhp2006.07.9.10.32.c8074 Fineran, S. (2014). Macro social work change process handbook. Sioux City, IA, Briar Cliff University. Sequist, T. D. (2015). Clinical Documentation to Improve Patient Care. Annals of Internal Medicine Ann Intern Med, 162(4), 315. doi:10.7326/m14-2913

Any questions?