Abstract for: Modelling the Effect of the Allocation of Social Worker Duties on Delayed Discharges using System Dynamics in the UK
Delayed discharges have become a common problem within hospital, predominately within elderly care. Patients become ‘blocked’ unnecessarily along the patient pathway. Historically allocation system policies were needed acting as coping mechanisms when there was a lack of social workers to carry out patient assessments and set up services. These allocation policies helped to reduce delayed discharging of elderly patients when resources were scarce. This paper examines the formal priority and informal proportional staff allocation system used by Social Services managers to allocate patient assessments and set up of post hospital services to social workers. The priority system involves social workers prioritising one duty over another and is an alternative to the standard policy of allocating social worker duties proportionally among patients waiting for social workers along the patient process. System dynamics is used to test the effect of these allocation systems on delayed discharges and the effect of an alternative integrated information system policy. Priority policies are routinely used by Social Services. Research has shown that they are disruptive to work schedules, as social workers change priorities to cope with a situation of diminishing capacity. Proportional policies are a less disruptive way of coping with situations of low capacity.