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Soc Work Health Care. 1999;30(2):1-26.

The impact of hospital restructuring on social work services: a case study of a large, university-affiliated hospital in Canada.

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  • 1Department of Sociology, Trent University, Ottawa, ON, Canada.


The study investigates the impact of organizational restructuring on social work practice at a large, university-affiliated hospital. The article first reviews relevant literature on the patient-focused care model and presents an overview of the study setting. Several hypotheses are then presented that informed the research process. Workload measurement, interview, and questionnaire data are analyzed to test these hypotheses. The results indicate that the shift to program management has had some intended effects, particularly regarding increases in direct services supporting patients. Social workers reported somewhat lower levels of job satisfaction than expected, which partly reflects the dismantling of the professional infrastructure. Finally, the authors discuss implications for the future of the social work profession under the program management model.

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