Evaluating Social Work Practice in a Medical Setting: How Do We Meet the Challenges of a Rapidly Changing System?

Social work's response to a rapidly changing health care system requires an empirical approach to practice. However, most empirical studies that evaluate social work services emphasize productivity and efficiency instead of effectiveness. This article examines the following ques tions : (a) What is the nature of contemporary social work practice in a medical setting? (b) What accounts for the effectiveness of social work interventions? (c) Does the currentpractice ofsocial workers meet the demands of a changing health care system? Social workers in a large metropolitan hospital collected data on 60 cases. Descriptive data regarding the types of presenting problems, nsk factors that complicate these problems, interventions, and obstacles to service delivery are presented. Regression analyses showed that the obstacles were the strongest predictors of the overall outcome of the cases. The authors discuss the implications of the rapidly changing medical system on social workers' activities.