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Objective: To examine the associations of patients' characteristics, hospitalization factors, and the patients' or family assessment of the discharge planning process, with their evaluation of adequacy of the discharge plan. Method: A prospective study. Social workers from 11 acute care hospitals in Israel provided data on 1426 discharged patients. At 2-week postdischarge, 407 patients and 659 family members evaluated the discharge planning process (information received, involvement, influence) and adequacy. Results: More family (77%) than patients (62%) assessed the discharge planning to be adequate. Discharge process variables contributed more than patient or hospitalization characteristics to evaluation of adequacy but had a negligible mediation effect. Factors significantly associated with higher adequacy of plans were: hospital ward, receiving information, high family involvement, and discharge destination among patients; receiving of information and high patient and family involvement among family respondents. Conclusions: Social workers should actively involve patients and family in discharge planning. (Contains 4 tables and 1 figure.)

This study aimed to examine the implementation, adequacy, and outcomes of discharge planning. The authors carried out a prospective study of 1,426 adult patients discharged from 11 acute care hospitals in Israel. Social workers provided detailed discharge plans on each patient. Telephone interviews were conducted two weeks post-discharge. Findings showed 40 percent of patients were referred to institutional care and 60 percent were sent home with plans to receive community services. At follow-up, the rates of implementation varied by planned services. Among patients referred to institutional care, 46 percent of those referred to nursing homes and 70 percent of those referred to rehabilitation facilities received the planned care. Of those discharged home, 65 percent received planned home attendant services and 59 percent received planned home health care. Implementation of institutional care was related to the patient's functional status and population group. Implementation of community and home services was related to age, gender, population group, and hospital department. These gaps in implementation of planned services have important policy implications. Discussion of the findings with the participating hospitals and national authorities resulted in plans to improve continuum of care.

This paper is a report of an innovative program in social work education to enrich field supervisors and students with the latest theories and practices related to social work practice in health care settings. This program consists of a study day organized jointly by academic faculty, field supervisors, and students, conducted once a year between 1997 and 2001 in two universities in Israel. Each study day focused on a subject relevant to social work practice in health care settings, such as laws regarding patients' rights, short-term therapy, case management, and quality of life. To examine participants' feedback about the program, an evaluation was conducted after each study day with 104 students studying for their BA in Social Work and 49 field supervisors. A questionnaire was distributed to all the participants at the end of the study day. Most of the participants indicated that the program contributed to the integration of social work theory and practice. Students in the second and third years of study reported the greatest benefit. This innovative program can complement the traditional fieldwork program in social work education.

This study of 60 mothers of young children with physical disabilities in Israel failed to support hypothesis that mothers with "internally" focused locus of control would demonstrate greater utilization of their support system. Analysis indicated that mother's age, child's level of functioning, and existence of additional members of family with disability were intervening variables. (Author/DB)

Parenting twins is typically portrayed as more stressful than is parenting single children and, therefore, more of a strain on the marital relationship. With this in mind, the present study examined the contribution of infant characteristics and mothers internal resources (attachment style) and external resources (maternal and paternal grandmothers' perceived support) to their marital adaptation during the first month following delivery, comparing mothers of twins (n = 88) with mothers of singletons (n = 82). The findings indicate that both internal and external resources contribute to the marital adaptation of the two groups, even beyond the contribution of specific circumstances. Thus, it seems that the birth of twins and the birth of a single child are normative life events that have more in common than previously acknowledged. The implications for the focus of social work interventions, particularly in the case of the birth of twins, are discussed. KEY WORDS: marital relationship; motherhood; twins, Social workers in medical settings are often called on to function in response to unique circumstances, such as life-threatening disease, the consequences of an accident, death, and dying. Even in [...]

Patient-reported outcomes measure patients' views of their health-related quality of life. With the increasing interest and usage of PRO's in the world, Sheba Medical Center is the pioneer in the field in Israel looking at the potential value in PRO implementation in routine practice as a quality improvement tool together with the opportunity to help drive changes in healthcare delivery. The PRO implementation process involves the multi-disciplinary ward or clinic staff in order to engage them and transform the process into a work routine. The collection methods and usage differ from one clinical area to another and require cultural adaptation in each area. Adjusted reporting and usage during patient encounter assist to improve patient enrolment and provide better and more accurate outcomes for the patient and the medical center.