Several members of the Blood Cancer (formerly BMT) Special Interest Group (SIG) have been busy participating in the System Capacity Initiative (SCI), led by the National Marrow Donor Program® (NMDP) /Be The Match®. The SCI is a collaborative effort across a broad group of stakeholders in the field of blood and marrow transplantation. Its goal is to determine how our health care system is going to adapt and grow to support the ever-growing number of patients in need of blood and marrow transplant (BMT). In 2009 and 2010, workforce groups (WGs) were convened for physicians, advanced practice professionals, nurses and pharmacists (Denzen et al., 2012).
Clinical social workers are core members of the BMT team. They provide key expertise in psychosocial care for patients, caregivers and families throughout the transplant continuum. At the urging of the other SCI workforce-working groups, the SCI Social Work Working Group (SWWG) was established in August 2013. The aims of this group include:
- Identify workforce challenges among clinical social workers (CSWs) that impact the capacity to meet the growing demand for BMT,
- Recommend innovative solutions to meet the unique psychosocial care needs of BMT patients and families, and
- Provide recommendations on how to best utilize the clinical social worker in delivering patient/family-centered psychosocial care to optimize patient outcomes and serve an increasing number of patients presenting for BMT.
Our SWWG administered a 34-item, web-based survey between October and November, 2013. BMT CSWs from U.S. transplant centers and two professional associations were invited to participate; a response rate of 57% (n = 91) was achieved and results represent 66 transplant centers. Survey domains included:
- BMT CSW care models,
- Role of CSWs on the BMT care team,
- Career satisfaction, and
- Challenges in meeting patient needs
Key findings from the survey:
- Care management or social work departments rather than BMT more often employed CSWs.
- While more than 80% reported satisfaction with their job, only 60% agreed their expertise was utilized to its fullest potential and nearly one-third spent less than 50% of their daily effort on clinical psychosocial care.
- Prioritizing competing patient needs, care coordination for uninsured or underinsured patients, and caring for patients in multiple service lines (e.g., hematology, oncology, emergency room, and child abuse reporting) were common challenges.
These findings show there is an opportunity to build capacity by structuring care delivery models to fully utilize the specialized skill set of CSWs. Thanks to the collaboration of our group (Table 1) and the support of the NMDP, the results of this survey were presented at the multidisciplinary System Capacity Initiative – Workforce Summit in November, 2013.
Members of our SWWG attended the annual American Society of Blood & Marrow Transplant/Center for International Blood & Marrow Transplant Research (ASBMT/CIBMTR) Tandem Meetings in February, 2014. At this meeting the BMT administrator group identified a need to better understand the role of the CSW in order to advocate for the role. In response, the SWWG created a document describing the role of the BMT Clinical Social Worker. The role description document went through multiple revisions and when completed was endorsed by the NMDP, Association of Oncology Social Work and Association of Pediatric Oncology Social Workers.
The ASBMT has posted a copy of the BMT Clinical Social Worker role description on its website. We are in the process of requesting that it be located on the AOSW and APOSW websites as well.
Future initiatives of the SWWG include development of a training curriculum for clinical social workers who are new to the field of BMT and for other health care social workers who interface with BMT patients and families. Several training module topics have been identified and are under development. Stay tuned for more exciting updates!
We are forever grateful to the NMDP for inviting BMT social workers to participate in the System Capacity Initiative, for recognizing and validating the importance of our role as core members of the BMT team, and for providing the forum to advocate for improved comprehensive psychosocial care for patients and families undergoing BMT.
Table 1. System Capacity Initiative—Social Work Workforce Working Group Roster
| Co-Chairs: Jane Dabney, LISW-S, OSW-C (Co-Chair, AOSW Blood Cancers SIG) Marion Kalbacker, MSW, LCSW (Representative, Association of Pediatric Oncology Social Workers) |
| Working Group Members | Organizations |
| Nancy Barbach, LCSW | Cohen Children's Medical Center of New York |
| Nancy Boyle, MSW, LCSW | Oregon Health & Science University |
| Carrie Breitwieser, LISW-S, ACHP-SW | Cincinnati Children’s Hospital Medical Center |
| Eleanor Bruin, LCSW | University of Colorado Hospital |
| Erica Bryan-Wegner, LICSW | Mayo Clinic Rochester |
| Tiffany J. Courtnage, LICSW | Seattle Cancer Care Alliance |
| Mary Crooks, MSW, LCSW | Yale University/ Yale New Haven Hospital |
| Eleanor Leary, LICSW | University of Minnesota Medical Center, Fairview |
| Kathy Roundtree, LCSW | University of North Carolina Hospitals |
| Andrea Starkschall, LCSW, OSW-C | The University of Texas M. D. Anderson Cancer Center |
| Anita Vargas, MSW, LSW | Hackensack University Medical Center, John Theurer Cancer Center |
| Elyse Wells, LSW, MSW, OSW-C | The Jewish Hospital/Mercy Health Partners |
| NMDP, Be The Match Ex-officio Staff | |
| Jeffrey Chell, MD | Chief Executive Officer, National Marrow Donor Program/Be The Match; Executive Director, Center for International Blood and Marrow Transplantation |
| Elizabeth Murphy, EdD, RN | Vice President, Patient and Health Professional Services; Education and Training |
| NMDP, Be The Match Lead Staff | |
| Nicole Heino | Education and Outreach Coordinator, Patient and Health Professional Services |
| Jill Randall, MSW, LICSW | Patient Services Coordinator, Team Lead, Patient and Health Professional Services |
| Stacy Stickney Ferguson, MSW, LICSW | Manager, Education and Outreach, Patient and Health Professional Services |
Former SWWG members: Jeanette Lavecchia, MSW, LCSW, St. Jude Children's Research Hospital; and Sunmee Joo, MSW, MPH, LMSW, CHES
Reference
Denzen, E., Majhail, N., Stickney, F., Anasetti, C., Bracey, A., Burns, L., Murphy, E. (2013). Hematopoietic cell transplantation in 2020: Summary of year 2. Recommendations of the National Marrow Donor Program’s System Capacity Initiative. Biology of Blood and Marrow Transplantation, 19, 4-11. http://www.sciencedirect.com/science/article/pii/S1083879112004211.