Mizrahi T, Berger C S
School of Social Work, Hunter College, 129 East 79th Street, New York, NY 10021, USA.
Soc Work. 2001 Apr;46(2):170-82. doi: 10.1093/sw/46.2.170.
The health care system is undergoing dramatic change in auspice, structure, and services delivery in response to an emphasis on market-driven, cost-containment strategies. Consequently, many hospital social work directors either have lost some of their administrative responsibilities or have expanded their span of control beyond social work services. This article examines the responses of social work administrators to the breadth of changes occurring throughout their hospitals; the major accomplishments of social work services within their facilities; and the failures, frustrations, and obstacles in the delivery of social work services. As a result of examining the relationship between their actual and anticipated behavior and changes in the hospital and external environment, the authors found that social work leaders in hospitals understand the complexities and challenges of the world around them. Overall, they have exhibited commitment, competence, and confidence in shaping organizational change.
为响应以市场为导向的成本控制策略，医疗保健系统在主办机构、结构和服务提供方面正经历巨大变革。因此，许多医院社会工作主任要么失去了一些行政职责，要么将其控制范围扩大到了社会工作服务之外。本文探讨了社会工作管理人员对其所在医院全面变革的应对措施；其所在机构内社会工作服务的主要成就；以及社会工作服务提供过程中的失败、挫折和障碍。通过研究他们的实际行为与预期行为之间的关系以及医院和外部环境的变化，作者发现医院中的社会工作领导者了解周围世界的复杂性和挑战。总体而言，他们在推动组织变革方面展现出了敬业精神、能力和信心。
