Agency Assessment: Nephrology Clinic Children’s Hospital-

Central CA

Paj Tshiab Vang SWRK180

California State University, Fresno

Who are we? A non-profit children’s hospital w/a medical staff

of more than 450 physicians. Children’s Hospital is the premier pediatric

medical center in California. The Nephrology program at Children’s is the only

dedicated pediatric peritoneal dialysis program in the Valley.

The clinic provides comprehensive and continuous inpatient and outpatient care for Nephrology patients.

Mission & Goals:

HOSPITAL MISSION:SOCIAL WORK DEPT MISSION:

The mission of Children's Hospital Central California is to provide high quality, comprehensive health care services to children, regardless of their ability to pay.

“With caring and compassion, we guide our patients and families through the entire health care process. As guides, we want our patients and families to feel secure and supported through out their health care experiences…”

Core Values: There are six core values that

Children’s Hospital use to guide their practice:• Excellence• Compassionate care• Integrity• Innovation• Collaboration• Stewardship

Organizational Structure:

The Nephrology clinic at Children’s Hospital works collaboratively w/the social worker, doctors, nurses, medical assistants, dietician and dialysis specialist.

Their primary goal is to provide the best care and support possible for the patient and the families.

Organizational Structure continued:

Board of Trustees:• Chair• Vice-Chair• Treasurer• Secretary• (12) other board

members totaling 16 members.

Executive Leadership:• President & Chief Officer• Vice-President & Chief

Operating Officer• Vice-President Medical Affairs &

Chief Medical Officer• Vice-President & Chief Nursing

Officer• Vice-President & Chief Financial

Officer• Vice-President Human

Resources • Vice-President Facilities and

Support Services• Vice-President Revenue Cycle

Management• Vice-President Corporate

Development

Organizational Structure Continued:

Medical Staff Officers:• Chief of Staff• Vice Chief of Staff• Secretary-Treasurer

Department Chairs:• Dept of Anesthesiology

& Critical care• Dept of Cardiology &

Cardiothoracic Surgery• Dept of Emergency

Medicine• Dept of Medical

Imaging• Dept of Medicine• Dept of Pathology &

Laboratory Medicine• Dept of Surgery

Organizational Structure continued:

Board of Directors:• President• Chairman• Vice-Chairman• Secretary• Treasurer• Past Chairman• (29) more members, totaling 35.

Agency Practices: The services provided by the Nephrology clinic

and the hospital per Social Worker as a whole go beyond medical care, they also include:• Psychosocial support and assessment• Crisis intervention• Counseling• Support Groups• Mediation of family conflicts and disputes• Coordination and facilitation of community resources• Aftercare follow-up

etc…

Community Context: Children’s Hospital provides services to

patients all throughout the Central Valley. The Hispanic population makes up a large

percentage of the patients at Children’s Hospital.

In the Nephrology clinic, about 70% of the patients seen by the Social Worker are CCS patients (California Children Services).• *CCS is a secondary medical program funded by

the state of California to help low-income families pay their child’s medical bills.

Populations At Risk Served: The Nephrology clinic serves many populations

at risk:• Undocumented immigrants• Low income families who are at a high risk due to lack

of transportation and other barriers that could possibly stand in the care of the child’s medical condition

• Families who do not speak English, this in return causes language barriers

• Families w/poor adherence which at times causes difficulty in clear communication.

• Child Protective Services families Ex: domestic violence, drug abuse, child abuse, medical

negligence

Significance of Agency to Social Justice, Human Rights, and

Social Work Values: Social Justice:

• Children’s Hospital provides medical services to patient’s regardless of their inability to pay

• The Social Workers encourage patients to work toward citizenship if they are undocumented so that they can receive some sort of medical assistance when they turn 21.

• Promote cultural & ethnic diversity: The hospital and staff are culturally sensitive of their

patients and interpretation services are available in various ways (i.e. phone & person).

They also provide spiritual services and chaplain services as requested by the patient’s family.

Significance of Agency to Social Justice, Human

Rights, and Social Work Values cont.

Human Rights:• Importance of human relationships:

The staff at Children’s Hospital understands the importance of building a strong relationship with the patient and their families to gain their trust.

• Dignity and worth of the person: Children’s Hospital is respectful and caring

toward patients and their families.

Significance of Agency to Social Justice, Human Rights, and Social Work Values cont.:

Social Work Values:• Termination of Services:

Prior to terminating a patient, they are given 3 weeks to find a new physician and are given a list of physician references to choose from if they’d like to.

The Social Worker also provides the patient with a letter of termination. • Confidentiality:

Medical records can not be released without the consent of the patient. To access medical records the individual must have valid reason(s) to

do so. HIPPA (Health Insurance Portability and Accountability Act) protects the

confidentiality of patients• Consent:

Children’s Hospital does not make medical decisions without the patient’s or their family’s consent.

Social Workers do not speak to children alone without the consent of their guardian(s).

Conclusion: To date, Children’s

Hospital with its physician continues to be the pre-eminent provider of pediatric services for Central California and the Western United States. The continue to be an indisputable resource for healthcare solutions, information, and advocacy for children in an expanding pediatric market place.

The department of Social Services at Children’s consists of Master’s level and Licensed Social Workers who continue to promote physical, emotional and psychological well-being in their patients and their families.

References: www.childrenscentralcal.org 2010-2011 Undergraduate Field

Education Manual