;.\R:(ilRE^l1^S?®Rl)(jDEiS GIFT OF Pacific Coast Jfrnrnnl nf NiTPfi'iTt^ Handbook of Organizcttion and Method in Hospital Social Service Handbook of Organizdtion and • Method in Hospital So'cidl Sewice An Outline of Policies as practiced at The Johns Hopkins Hospital Baltimore, Md. by MARGARET S. BROGDEN Chief of Social Service The Johns Hopkins Hospital Baltimore, Md. THE NORMAN, REMINGTON CO. PUBLISHERS, BALTIMORE, MD. -RA^ ^t GIFT PAOIFIC COAST JOURNAL OF NUBdING to HYG£1NE- DEPT., Copyright, 1922, by The Norman, Remington Co. Published June, 1922 Printed in the United States of America at the Press of G. A. Peters Co., Baltimore. IN THE HOSPITAL The doctor smiled, and said, "You may go home Tomorrow;" and he looked surprised when I Returned no answering smile. How should he know The sudden shrinking of my tortured flesh From all that ''going Home" implies to me? I am so tired — so tired ! And when I think Of taking up the burdens that I dropped When sickness bought for me a breathing space — The grimy, odorous clothes, so hard to rub To whiteness as I bend above the suds; The food that must be bought, prepared, and cooked; The constant struggle to keep up the rent, So that our poor, cheap sticks of furniture May not be set out in the public street, (Ah, God! that fear looms chief of all my fears!) — Then is it strange that I should weakly cling To this white cot, this atmosphere of rest. Where I may sleep, afar from vendors' cries, And noisy brawlings from the flat next door? I almost hoped this pain would end all pain; But no; the verdict's ''Life!" I must "go home!" — Florence Van Cleve. 7435 1 8 INTRODUCTION Monrovia, California, May 17, 1922. "Miss Margaret S. Brogden, Social Service Department, The Johns Hopkins Hospital, Baltimore, Maryland. My dear Miss Brogden: Your letter was forwarded to me here, where I am spending the summer. I used your Policy Book as reference material for those students in my course in record keeping who were interested particularly in hospital social service, and to that group I feel that it had real value in making clear the relationship of records to hospital administration, and of showing case records in their administrative setting, a thing which the new worker always needs to learn. Of course, it is understood that adaptations would be needed in applying this or any other plan to another institution, but it seems to me that any hospital social service worker would be helped by the suggestions in this book. Sincerely yours (Signed) GEORGIA G. RALPH." (Of the New York School of Social Work). PREFACE With the growth and development of the social service department, the need of a reference book setting forth clearly the routine and policies of the department, accessible to all the workers, became apparent. To meet such need this book was compiled. In addition to our own routine and policies I have incorporated into it helpful material and sugges- tions from the Boston Dispensary and the Massachu- setts General Hospital Social Service Departments, the writings of Miss Mary E. Richmond, Dr. Richard C. Cabot and others, to whom I am much indebted for their co-operation and courtesy. This book was compiled with no idea of publica- tion. It is being published now in response to numer- ous requests from visitors to our department. The original is in the form of a loose-leaf ledger, and has been revised from time to time to meet changes in the social service department or dispensary routine. I regret that at this late date I can not give due recog- nition to those who have generously helped me with their suggestions and material. M. S. B. TABLE OF CONTENTS Page Diagram facing 13 Organization of the Hospital 13 Report of Committee on the Function of Hospi- tal Social Work 18 Approach to Doctors and Nurses 19 Case Analysis 21- Case Work 22 Records: Attitude toward Records 30 The Danger of Becoming Mechanical in Work 30 The Need of Accuracy and Completeness of Information 31 The Need of Getting Results 32 Records Should Show 32 Types of Records 33 Statistical Records 33 Intensive and Short Service Case Records 33 Yellow Sheet 34 Old Histories 34 Letters 35 Making Corrections in Typewritten Work 35 Folders 35 Care of Records 35 Outline for Writing Histories 37 Outline for Yellow Sheet 40 Forms 41 Use of Medical Records 49 Registration of Cases 51 Cards 51 Statistics: Page Monthly Sheets 55 Transferred Cases 55 Closed Cases 55 Forms 56 Confidential Exchange of Information: Principles of Confidential Exchange of Infor- mation 60 Registration of Cases 60 Form 61 Giving Information to Outside Agencies and Individuals 62 Steering Blanks 62 Bills, Orders and Money: Ledger Cards 63 Orders 64 Instalments: Method of Payments 66 Method of Closing Cases 67 Requests for Free Treatment 67 Miscellaneous Forms: Refemng Patients to Social Service :... 68 Discharge Notice to Social Service 68 Form given by Interne to Patients upon Discharge 69 Supplies: General Office 69 Departments 70 Repairs 70 Outside Requisitions 70 Office Rules: Page Volunteer 72 Telephone 72 Telegrams 74 Filing 74 Keys 74 In and Out Board 74 Office Resources 74 Use of the Social Service Ford 75 Clothing required by the Patients entering THE State Tuberculosis ;JSanatorium 76 Key to Abbreviations 77 THE JOHNS HOPKINS HOSPITAL Orfianization of the Social Service Department ORGANIZATION AND METHOD IN SOCIAL SERVICE 13 SOCIAL SERVICE DEPARTMENT ORGANIZATION OF THE HOSPITAL The Johns Hopkins is a general hospital of 625 beds. The service includes: Medicine, with sub-divisions, Surgery, with sub-divisions. Gynecology, with sub-divisions. Obstetrics, Pediatrics, Psychiatry, Pathology, X-Ray, Social Service, Out-Patient Department. There is a daily dispensary service, with nineteen departments, and an average attendance of 475 patients a day. Each hospital service has a chief of service, with resident and visiting staff. 14 ORGANIZATION AND METHOD IN SOCIAL SERVICE There is a Training School for Nurses, with 48 officers and 240 pupils. The course is three years. Social Service is an integral department of the hospital, supported by hospital funds. The staff comprises a department chief and sixteen associates. The department chief is responsible to the trustees through the director of the hospital. Social Service is in operation in the following services: Department of Medicine, Surgery, Pediatrics, Psychiatry, Tuberculosis, Syphology, Ophthalmology, Orthopedics, General. The social workers are assigned to a definite service and cases are referred by the physicians on that ser- vice from both the hospital wards and out-patient department. A weekly staff meeting is held on Thursday, 9-10 A.M. The function of the social worker is to aid in medi- cal treatment and prevention of disease through in- vestigation, reporting to the physician and adjustment of problems, both personal and environmental, that ORGANIZATION AND METHOD IN SOCIAL SERVICE 15 hinder or retard the process of recovery. If I may define our function in the terms of the American Hos- pital Association's Survey : ** Discovery and reporting to the physician facts regarding the patient's personaUty and environment which relate to his physical condition. Overcoming obstacles to successful treatment, such as may exist or arise in his home or work. Assisting the physicians by arranging for supple- mentary care when required. Educating the patient in regard to his physical condition in order that he may co-operate to the best advantage with the doctor's program for the cure of the illness, or the promotion of health." Through the Social Service, interpreters are secured for foreign-speaking patients. Aid in management of clinic is supplied by volunteer staff. Medical infor- mation and advice regarding medical sources is fur- nished outside agencies. Such services as arranging for transportation and escorting patients who are unable to perform these offices for themselves, either because of illness or ignorance, are rendered. All cases are referred by the physicians with definite recommendations. The Johns Hopkins is a private hospital dependent for support upon its endowment, voluntary contribu- tions and fees from patients. Both private and public ward patients are received. During the year from February 1, 1920, to February 1, 1921 7,793 patients were treated in the hospital wards, and 16 ORGANIZATION AND METHOD IN SOCIAL SERVICE 142,532 visits were made to the out-patient depart- ment. 2,882, or 37.1% of the house patients, re- ceived free treatment, and 2,791, or 35.8%, were treated at a reduced rate. The Johns Hopkins is essentially a teaching hos- pital, closely allied with the Johns Hopkins Univer- sity and Medical School. The members of the Hos- pital Staff hold corresponding positions in the Medical School; for example the Professor of Medicine is the Physician-in-Chief to the hospital and the head of the Medical Service. Courses in psychiatric and medical social service are given in collaboration with the Johns Hopkins University, to a limited number of students who have completed the first year's work in the course in Social Economics at the Johns Hopkins University, or a school of social work of equal requirements. ^ REPORT OF COMMITTEE ON THE FUNCTIONS OF HOSPITAL SOCIAL WORK cx-^ Presented at the Annual Meeting of The American Association of Hospital Social Workers, June, 1921. Permanent Functions 1. Case work; by the method of social case work to care for ward patients and out-patients whose medical and social condition indicate need of adjust- ment in order to render their medical treatment effective and restore them to health and sound social condition. 2. Research; to study social causes of health con- ditions and behavior. 3. Education; a. To co-operate with schools of social work in the training of students for hospital social work. b. To give to students from training school for nurses, medical schools and from schools of socio- logy and psychology insight into the social environ- mental conditions of patients, through lectures, required reading and field work. c. To interpret the hospital to the community by posters, charts, public speaking and other means, and to help to make the resources of the institution available to persons in the community. d. To educate the public by the same means in hygiene and to teach the relation between social conditions and health. 18 ORGANIZATION AND METHOD IN SOCIAL SERVICE e. To co-operate with such outside agencies, institutions and interested individuals as may serve to enlarge the functions of the hospital, and to render its care of patients more effective. Temporary Functions In organizing a department, it may be necessary to undertake, for a time, certain duties that are not essentially the function of hospital social work, such as those of clinical clerk, admitting clerk, financial investigator for the hospital or messenger, which may be performed for a time with the intention of helping the hospital to fulfill its obligations toward the com- munity as well as to the patients. In undertaking these temporary and supplementary duties it is im- portant not to lose sight of the fact that the primary function of hospital social work is social case work, and that the best contribution of such work both to the hospital and the community is to perform this function. "APPROACH TO DOCTORS AND NURSES" "Find out the names of doctors and nurses on duty in the dinic before going to it. "On entering a clinic to take a patient to a doctor, or to make inquiry, be careful each time to give your name and state your connection with the dispensary, to wit: "of the social service department." "DO NOT OMIT the formality unless you are sure that your name and connection are well known, remembering that you are but one of many going on similar errands and that it is not easy for the doctors to place each personality quickly. "In referring a patient to a doctor, only give the symptoms which led you to seek medical advice. Do not make a diagnosis. For example: never say, 'I have brought John to see you about his adenoids, but say, 'As John can not breathe through his nose, I want him to have an examination.' The making of a diagnosis by a layman is very irritating to a physi- cian, and therefore extremely bad etiquette. Doctors themselves in seeking a consultant are very cautious about doing so. "Give the physician sufficient information in regard to your errand to gain his interest, but do so in as few words as possible. "When a doctor refers a patient to a social worker, or makes inquiry of a social worker in regard to a patient, if the particular patient in question is present, or other patients, do not discuss the case in their presence. Make an excuse for seeing the doctor in another room or at another time. 20 ORGANIZATION AND METHOD IN SOCIAL SERVICE "Before leaving the clinic make a definite arrange- ment at the doctor's convenience for securing a report in regard to the examination of the patient. For example, either plan to return to the clinic at a certain time or to see the doctor in the social service depart- ment on his way out of the dispensary. If there is a social worker in the clinic it is best to have all ar- rangements go through her." CASE ANALYSIS "In order to understand a hospital patient's disease we should know: a. Physicallylg^l^f ^^^ functions 1. The individual b. Mentally 2. His environment a. Physically b. Mentally Habits Habits Interests Abilities Fears, worries, etc. Food and clothes Housing Work conditions School conditions Income and outgo Family and friends Workmates Schoolmates Recreation ^Religion" The above quotation is taken from a paper by Dr. Cabot published in the ''Modern Hospital," March, 1916. If we agree with Dr. Cabot (I think few will question his statement) that the physician must know his patient both from the physical and the environ- mental side, and since the physician's time is com- pletely filled with the study of the physical, it is evident that information concerning the environ- mental must be supplied to him through the medium of social service. 22 ORGANIZATION AND METHOD IN SOCIAL SERVICE CASE WORK A. Patients: I. How referred: a. Inside the hospital, (admitting officers, doctors, nurses, social workers.) b. Outside the hospital (social agencies). II. Why referred and methods of handling: a. Home adjustment; visits to home, to relatives, friends, employer and clergyman. b. Work adjustment: investigation of character and place of employment; interview with employer. c. School adjustment: visit to school, interview with teacher, withdrawal from school, or trans- fer to special class. ■ (For special classes see directory, S.S.D. office) d. Hospital care. (1) Pay Patients: (a) Applying for admission to JHH should be referred directly to Admitting officer. (b) If no room in JHH, phone other hospital for admission (see telephone directory). (2) Free Patients: (a) If there is no room in JHH, and patient has resided in Baltimore for one year, phone Plaza 2000, Clerk of the Super- visors of City Charities office, 329 Courtland St.,f or bed in another hospital. ORGANIZATION AND METHOD IN SOCIAL SERVICE 23 Or if patient has chronic disease, a recom- mendation blank may be filled by the doctor's order and the patient sent to above office for admission to Bay View Hospital. (b) Should the patient be too ill to make personal application, a relative or friend may take recommendation and secure admission slip from the Clerk of Super- visors of City Charities. If ambulance case, special permission may be asked to send patient without admission slip. Information can be given by phone to the Clerk who will transmit same to the hospital and secure the use of the City ambulance. The JHH recommenda- tion must be mailed immediately to the Supervisor's office. It is possible to secure use of the JHH ambulance through the admitting officer if the City ambulance is not available. The Social Service Ford may be requi- sitioned in the Social Service office. (c) If there is no room in the JHH, and patients reside in Maryland but not in Baltimore, phone to the Secretary, State Board Aids and Charities, 405-6 Union Trust Bldg. (Plaza 2680), for care in a hospital providing beds for state pat- tients, or communicate with the com- missioners of the county from which they come. 24 ORGANIZATION AND METHOD IN SOCIAL SERVICE (d) Should the patient Hve out of Maryland and be too ill to travel, phone office of the Supervisor of City Charities (see paragraph (a) ), stating details of the case, and ask advice or assistance. In some instances it is possible for the Supervisor to provide temporary care at the BVH pending arrangements to send the patient home. (3) A U. S. sailor may be referred to United States Public Health Service, Custom House, Gay & Lombard Streets (phone. Plaza 4220). A foreign sailor may be re- ferred to the consul representing his country. (4) Contagious disease diagnosed by a member of the JHH staff or by a doctor sent by the Health Department, is handled by the latter office. If the patient has advanced pulmonary tuberculosis and has been a resident of Baltimore for one year, effort should be m.ade to secure immediate admission to the Municipal Tuberculosis Hospital. If this is impossible, the patient is sent home and the Tuberculosis Division of the Health Department is notified. By this means the patient is placed on the waiting list for the MTH or sanatorium, and is given nursing care pending admis- sion. ORGANIZATION AND METHOD IN SOCIAL SERVICE 25 e. Institutional Care. (1) A man or woman, white or black, without home or funds and not in need of hospital care, can be sent to The Friendly Inn, 309-11 S. Sharp Street (phone. Plaza 278). (2) Un-co-operative patients living in the city, in the primary or secondary stages of syphilis or gonorrhoea, may be referred to the Health Department (Plaza 320) to enforce treatments. Un-co-operative pa- tients living in Maryland outside of Balti- more may be referred to the State Board of Health, 16 W. Saratoga St. (Plaza 4810). Soldiers and sailors are sent to the United States Public Health Service. (3) Should it seem likely that the patient will need care for an indefinite period, the Bay View Hospital commitment can be ar- ranged through the Clerk of the Super- visors of City Charities, provided the patient has been a resident of Baltimore for one year. Out-of-city patients with- out home or funds can be sent to The Friendly Inn pending investigation of the patient's statement as to his social situa- tion. (4) Patients with mental disorder who are residents of Maiyland, after being certi- fied by two physicians who are residents of Maryland and have practiced for 5 years, should be referred to the Secretary of the Supervisors of City Charities, Court 26 ORGANIZATION AND METHOD IN SOCIAL SERVICE House (phone, Plaza 2000); blank certi- ficates can be secured from the HPPC. Arrangement must be made with the Sec- retary of the Supervisors of City Charities by the nearest relative. Non-residents v/ith- out resources may be referred to the Sec- retary of the Supervisors of City Charities pending return to their own state. f. Medical attention, nursing and convalescent care. (1) If a patient residing in the City needs medical attention at home and is unable to pay for same, notify the Instinctive Visiting Nurse Association, 1123 Madison Ave. (phone, Vernon 469). (2) Patients over three years of age, residents of the City, in need of nursing care can be provided with it as follows: (a) If the patient has non-contagious disease notify the Instructive Visiting Nurse Association. (b) If the patient has contagious disease, notify the Nurses Division of Health Department, 311 Courtland St. (phone. Plaza 230). (c) If the patient has pulmonary tubercu- losis, notify the Nurses Division of the Health Department, 311 Courtland St. (phone. Plaza 230) (d) Infectious venereal cases receiving treat- ment at the dispensary are reported to the City Health Department if they can not be induced to come regularly for treatment. ORGANIZATION AND METHOD IN SOCIAL SERVICE 27 (3) Patients three years of age and under, residents of the City, in need of nursing care can be provided with it as follows: (a) If the patient has non-contagious dis- ease, notify the Babies Milk Fund As- sociation, 130 S. Calvert St. (phone. Plaza 3271). (b) See paragraph (2) (b). (c) See paragraph (2) (c). (d) Children needing surgical dressings should be referred to the Instructive Visiting Nurse Association (phone, Ver- non 469). (4) Mothers of children needing country care during the summer can be sent to The Fresh Air Farm, through the Children's Fresh Air Society, 35 Knickerbocker Bldg., Lexington and North Sts., (phone. Plaza 1268). g. Surgical Appliance dental plates, diet and material relief: (1) Patients residing in Baltimore who claim inability to provide any of the above, can be referred to the Family Welfare Associa- tion's district office (see phone book for addresses). (2) Hebrew patients should be referred to the Hebrew Benevolent Society, 411 W. Fay- ette St. (phone, Calvert 3280.) (3) Roman Catholic patients should be refer- red to the St. Vincent de Paul Society, 222 St. Paul Street, (phone, Plaza 4216). 28 ORGANIZATION AND METHOD IN SOCIAL SERVICE (4) Abdominal binders recommended in the JHH dispensary will be furnished at re- duced prices by Miss Foard, maker, 711 N. Carey St. (phone, Madison 81). Miss Foard is in the dispensary on Tuesdays 11 a. m.-12 m. to take orders and measure patients. (5) Should the patient live out of the city, effort should be made with the patient's permission to secure assistance from the relatives, friends, church, employer or relief-giving agency in his place of resi- dence. h. Free treatment, lunch and car-tickets. (1) 24-hour pass can be given without investi- gation, permanent free treatment should be given only after investigation. See form on page 67. (2) Lunch can be provided, when the patient is unable to pay for it and must remain for afternoon clinic. (3) Car-tickets can be given for emergency use. (Money for lunches and car-tickets may be obtained from the secretaiy. Social Service ofhce.) See form on page 65. i. Steering. (1) To another clinic for examination. (2) To admitting office at front. (3) Out-^of-towm patients to a boarding-house, j. Emergency or accident cases. (1) To accompany patient home. ORGANIZATION AND METHOD IN SOCIAL SERVICE 29 (2) To call an automobile to take the patient home. The Stewart taxi-Service Co., 7 W. Eager St., for white and colored patients. Patients not ambulance cases may be sent home or called for in the social service Ford car if necessary; write requisi- tion in the register in central office. (3) To notify patient's relatives, friends or employer of illness either in person or by telephone. k. Return visits. Efforts should be made by letter or visit to secure return of patients to the clinic, if further treatment is advised. 1. Reports. Diagnosis and recommendation as to treat- ment may be given to other medical or social agencies or to responsible individuals, (i. e., friend, relative or employer.) See page 62. 30 ORGANIZATION AND METHOD IN SOCIAL SERVICE RECORDS ATTITUDE TOWARD RECORDS. "There is a certain natural tendency in most of us to exalt the record as an end in itself, a tendency to feel that something has actually been accomplished in the disposition of a case when a statement appears in black and white. We are a little too inclined to feel, perhaps, that the aim of asking questions of the persons we are interviewing is to get material to fill the blank spaces on a yellow card. A record, how- ever, is only a tool to be made keen and kept avail- able for use. Only that should go into a record which will help the agency whose tool it is, in the working out of the problem which this particular case presents or which will aid in the interpretation of other cases. There may possibly be material introduced, which, though of no available use at the time there cord is made, may furnish data for a special inquiry of one kind or another. The record should not be used to stand for the justification of the worker — for instance that she lost a great amount of time in trying to establish a telephone connection. The record stands for the establishment of definite human relationships. It grows and takes new force as, because of these re- lationships, things happen." THE DANGER OF BECOMING MECHANICAL IN WORK "It is always easy to do a thing in the same way we have done it a hundred times before; it saves the trouble of thinking. In social work, because of its ORGANIZATION AND METHOD IN SOCIAL SERVICE 31 nature, action merely mechanical is fatal to real ac- complishment. We must ask our questions, not because we believe that such questions always are asked, but because we want to find out certain things. When we visit a home we notice the surroundings of the house, the hallways, the light, the cleanliness, the ventilation, the sleeping arrangements, the toilet conveniences, etc., not because a complete report is expected of us, but because the man or woman whose problem we are trying to understand and help solve is vitally affected by these things. They bear a direct relation to his past, his present and his future. "The method we employ in a given case should not necessarily be the one that happens to occur to us first; it should be chosen because we have reason to think it will bring the best results. It represents a conscious taking of heed in the matter." THE NEED OF ACCURACY AND COMPLETENESS OF INFORMATION ''Inaccurate information is practically valueless or positively harmful as a social history. So often one stops short just a step too soon. Go on and you get a clear view of the situation; stay where you are and there is nothing but haziness about you. You must follow up your clues. A woman tells you that she has had a great deal of sickness. You do not find out how long ago the illness occurred, how and by whom she was treated, what hospital care, if any, she re- ceived. You expect to be able to make a plan for her future treatment without any idea as to how she re- acted to treatment in the past. Or she gives you the name and address of an attendant physician and you get it almost right, but find later that your informa- tion will not identify. 32 ORGANIZATION AND METHOD IN SOCIAL SERVICE "Before you are prepared to make any plan in a given case you must have both complete and accurate information. With your deep realization of this comes a very real change in attitude as investigator- You lose the feeling that you are intruding, in your interest in a human situation. "Carefully prepared histories should furnish valu- able data for research work." THE NEED OF GETTING RESULTS "In most cases, our getting results is dependent upon a great amount of questioning and record- writing, on use of the telephone and the postman, and it is fairly easy to confound effort made with results obtained. "Whether the two are even closely related depends upon the competency of the worker. Has she the skill to get a complete statement of the situation, the wisdom to interpret it, and the power to act according to a well-conceived plan, then there will probably be little wasted energy. She will be saved the only too common experience of filling her days full of comings and goings which, because they do not lead to an ac- complished goal, are meaningless." RECORDS SHOULD SHOW 1. Cause as well as effect. 2. Results: a. What has been accomplished. b. Failures as well as successes. 3. What other agencies are needed in the com- munity. ORGANIZATION AND METHOD IN SOCIAL SERVICE 33 4. How far problems of disease are affected by environment. 5. Where relief is necessary is it adequately given? 6. Definite status at time case is closed. TYPES OF RECORDS There shall be six types of case records: i.e. (A) page 41, statistical records; (B) pages 42, 44, 45, inten- sive case records; (C) pages 43 to 45, special case records; (D) Same as (A), short service records; (E) page 46, social service records for dispensary his- tories; (F) page 47, steering blank records. STATISTICAL RECORDS Statistical records, see sample (A) on page 41, of all new cases after being filled in by long hand should be put in wire basket No. 1 in the record room. The secretary will number, make index cards if intensive case and duplicate card for permanent record if short service case, and return the original card to wire basket No. 2. A statistical card in the index file indicates no social service record except the yellow sheet filed with the medical record. INTENSIVE AND SHORT SERVICE CASE RECORDS Samples ((B) and (C) on pages 42 to 45) are kept in addition to the statistical record when inten- sive case work is undertaken. Should a case be started as a short service case and develop into an intensive case, a (B) or (C) record is made and it is 34 ORGANIZATION AND METHOD IN SOCIAL SERVICE indexed and handled as in the intensive cases. Date of birth, not age, should be given. Present tense is used in history writing. Notes are entered chrono- logically. An intensive history has one family face sheet (B No. 1, page 42 or C No. 1, page 43). It has as many individual face sheets (B and C No. 2, page 44) as there are patients in the family treated by social service. In speaking of a doctor, mention his name and position on the staff or in the clinic. In speaking of a patient, be sure to mention him by name, prefixed "In re" in red type. In mentioning other persons state name and rela- tion to the patient. In mentioning co-operating agencies state the name and official position of the worker interested in the case. Always use official title of agencies and institutions. Social Service Records For Dispensary History (yellow sheet) A social service history (E), page 46, filed with dis- pensary records is made with each case treated by social service. (N. B. A note may be made on the medical history instead of making up the yellow sheet in cases referred for return visit or immediate hospital care.) OLD HISTORIES Make up a No. 2 sheet for a re-instated patient, if such a sheet is lacking. Confirm household as it appears; add new names if any; confirm the ADDRESS. ORGANIZATION AND METHOD IN SOCIAL SERVICE 35 When histories are re-instated, a memorandum of change of address, deaths, births, etc., should be attached to the history, so the necessary note, cor- rections, or additions may be made on the file cards. In the case of the death of a patient, write in red ink "Died" (and give date) after the name on No. 1 and No. 2; of the death of a member of the family, write in red ink ''Dead" after name. LETTERS Copies of letters, either in whole or in abstract, are embodied in histories, with note ''See letter No. — " Letters are then marked with S. S. number and number of letter and put into file drawer. MAKING CORRECTIONS IN TYPEWRITTEN WORK A small cross mark (x) opposite the line will call attention to any error in typing; any change in phraseology is indicated by writing in margin. Do NOT UNDERSCORE WHEN A CHANGE IS DESIRED. FOLDERS Surname, father's and mother's Christian names are typed in the extreme left-hand corner, social ser- vice number in right-hand corner. care of records Folders are never taken from the drawer EXCEPT: 1. When histories are closed at the end of the month. 2. When cases are re-instated. 3. When closed histories are pasted in the folder. 36 ORGANIZATION AND METHOD IN SOCIAL SERVICE In the first instance a note "closed" is attached to the folder; in the second, a note *Ve-instated/' (ab- breviated R.-I.) with the worker's initials and the department, is attached to the folder, and it is put in the file drawer. Closed histories are pasted in the folder by the Secretary. All histories are filed in the central office except those active in HPPC, or HLH. Active his- tories are filed alphabetically; no histories are to be kept out of the files over night. Whenever a history is taken from its folder a note (see form below) must be left in its place. No 1 Size 5" by 3'' HISTORY NO NAME . HELD IN DEPARTMENT . ORGANIZATION AND METHOD IN SOCIAL SERVICE 37 When a pasted history is taken from the drawer a temporary folder is put in its place, containing note stating department held in, date, and by whom taken. A blank for the purpose will be found on top of the filing cases. (See page 36). When a history is reinstated inHPP C orHLH the original folder is put into the file drawer with proper note (as above) and a temporary folder is made in the branch office. OUTLINE FOR WRITING HISTORIES Date: Worker's name, department, stenographer's initials. IN RE: Patient's Name. I. Referred by: Co-operating agency, doctor, student, personal application, etc. II. Why referred: Concise statement of reason for referring. III. Medical Data: 1. Name and rank of doctor who gives the follow- ing information : stated in medical terms and in descriptive terms intelligible to lay persons, and, if more than one disease is present, which is the more important for treatment. Summarize special findings, e.g., tests and re- actions. 2. DIAGNOSIS. 38 ORGANIZATION AND METHOD IN SOCIAL SERVICE 3. PROGNOSIS. When will pt. probably be restored to normal condition. Disability -permanent handicap-work, when will pt. be able-kind-amount-social condi- tions that may affect prognosis. 4. TREATMENT. Where to be obtained — P D-other hospitals- medicine-dressings-prescription and instructions- date to return. 5. PREVIOUS MEDICAL FACTS. When significant. Treatment — where obtained. IV. Personal Appearance. When significant. V. Home Conditions. From whom and by whom obtained; from home visit whenever possible. Number of rooms, flights, location, sun and air, yard, piazza, plumbing, modern improvements, approach to house, frame or brick, street. Order. Cleanliness. VI. Family Background or History. Social status. Length of time in United States and at different addresses. Reasons for coming to Baltimore. Date and place of marriage. Significant events in family life. Religious con- nections. VII. Personal History: a. Education: Ability to read and write. Grade reached in school. ORGANIZATION AND METHOD IN SOCIAL SERVICE 39 Trade or evening school. If at school, grade and teacher. Distance from school, walk or ride. b. Industry: Name of industry, foreman and work number. Hours of work, sitting or standing. Female, distance from home, walk or ride. Time in present position, frequent change and reasons. Earnings. c. Social connections and recreation. Kind of recreation — out-of-doors. Companions. d. Habits. Disposition, attitude towards home and relationships within family. e. Personal hygiene. Diet. VIII. Analysis of members of family and household. a. Health. b. Work. c. Attitude toward patient and treatment. IX. Financial Data. Total earnings of all wage earners (gross income). Amount given to family budget (net income.) Itemized list of expenditures; rent, union, dues. X. Relatives. Significant facts — relationship, number of child- ren, health, finances. XL Patient's Statement of Difficulty and Plan. XII. Personal Impression. When significant. 40 ORGANIZATION AND METHOD IN SOCIAL SERVICE XIII. Reports from relatives, doctors, ministers, other agencies. (Paragraphed separately). XIV. Tentative social plan. (Including statement of emergency action.) Next steps — medically, socially. XV. Action taken. Chronological. In re: patient's name, whenever note refers to different patient. XVI. Summary. (Very brief, when case is closed). 1. Action taken. 2. Present status of case. Outline for Yellow Sheet Outline for Yellow Sheet: Referred by: Diagnosis: Why Referred: Social Situation: Action Taken: status at time of closing. ORGANIZATION AND METHOD IN SOCIAL SERVICE 41 FORMS: A Size 5'' by 3" THE JOHNS HOPKINS HOSPITAL SOCIAL SERVICE DEPARTMENT NAME WORKER ADD. OCCU. D. OF B. W. B. M. F. S.M.W.D. DEPT. DISP. NO. S. S. NO. DIAG. REF. BY OP. CLOS. TRANS. DIED NEW REIN. INTBN. SHORT SER. NOT REG REL. CO-OP. AG. Reverse Side of A 42 ORGANIZATION AND METHOD IN SOCIAL SERVICE Bl Size 6i^" by 9 v<" THE JOHNS HOPKINS HOSPITAL SOCIAL SERVICE DEPARTMENT DATE S. S. NO. SURNAME RACE C. E. OF I. CROSS REF. DATE ADDRESS HOUSE ROOMS FLOOR RENT PER WK. DATE PREVIOUS ADDRESS HOUSE ROOMS FLOOR RENT PER WK. NO. HOUSEHOLD RELATION D. OF B. BIRTHPLACE OCCUPATION DISP. NO. 1 2 3 4 5 6 7 RELATIVES ADDRESS RELATIONSHIP AGENCIES AND INDIVIDUALS INTERESTED IN ORGANIZATION AND METHOD IN SOCIAL SERVICE 43 CI Size 6^/^" by 9}4'' THE JOHNS HOPKINS HOSPITAL SOCIAL SERVICE DEPARTMENT DATE S. S NO. SURNAME RACE C. E. OF . CROSS REF DATE ADDRESS HOUSE ROOMS FLOOR RENT PER WK. DATE PREVIOUS ADDRESS HOUSE ROOMS FLOOR RENT PER WK. NO. HOUSEHOLD D. OF B. RESULT OF EXAM. DISP. NO OCCUPATION DATE INT. RELATIVES ADDRESS RELATIONSHIP DATE INT. AGENCIES AND INDIVIDUALS INTERESTED IN 44 ORGANIZATION AND METHOD IN SOCIAL SERVICE B&C2 Size 6y2" by 9>^" THE JOHNS HOPKINS HOSPITAL SOCIAL SERVICE DEPARTMENT s. s. NO. NAMB ADDRESS BIRTHPLACE FAITH DATE DIAGNOSIS OTHER DEPT S. TREATED IN PREVIOUSLY TREATED AT ENTERED INSTITUTION DATE AGE M. OR F. S.M.W.D. HOW LONG IN U. S. HOW LONG IN BALTO. CITIZEN DIAGNOSIS DATE OCCUPATION OB SCHOOL PROCESS OR GRADE WKLY. WAGE DATE EMPLOYEE OR PRINCIPAL FOREMAN OR TEACHER ADDRESS BENEFIT SOCIETIES TRADE UNION INSURANCE WKLY. PREMIUM ORGANIZATION AND METHOD IN SOCIAL SERVICE 45 B&C3 Size 6X'' by 9^'' JOHNS HOPKINS DISPENSARY SOCIAL SERVICE DEPARTMENT NARRATIVE 46 ORGANIZATION AND METHOD IN SOCIAL SERVICE E Size 6j<^" by 9^'' (Stiff buff card) THE JOHNS HOPKINS HOSPITAL DISPENSARY, NO. SEX DATE SSS SEX i BIRTHPLACE OCCUPATION SOCIAL SERVICE DEPARTMENT No. ORGANIZATION AND METHOD IN SOCIAL SERVICE 47 F Size BVs'' by 9)4'' JOHNS HOPKINS DISPENSARY SOCIAL SERVICE DEPARTMENT Referred by Date . . . . Fees to be omitted. Yes. No. Name Date of birth . Address Church Birthplace . . How long in the United States ; in Baltimore? . If a child, names of parents Significant facts in family and personal history, physical and social Significant facts about environment . EMPLOYMENT Nature Hours . Place Wages . School Grade . . . PREVIOUS MEDICAL ATTENTION Places: Date . Reason for referring. (The blanks below are to be filled in by physician for information of Social Service Department) Diagnosis: Recommendations: 48 ORGANIZATION AND METHOD IN SOCIAL SERVICE Size ^Vs" by Ws" (Yellow Sheet) c z m a < a h w H s| 1 b: a Q K o ^ H S. H a o o g < > as O J -> < m u a 9 H "^ f- B b. a. < u B S a. H Qi < Ci. < 2 c L ORGANIZATION AND METHOD IN SOCIAL SERVICE 49 Sheet used by volunteers in writing up case visits. USE OF MEDICAL RECORDS Histories of discharged house patients may be secured from the clerk in the history room (third floor of surgical building) upon presentation of blank (see below), after being signed by the chief of S. S. or a member of the staff authorized by her. DATE. PLEASE ALLOW Miaa TO SEE THE HISTORY OP SOCUL SERVICE DEPARTMENT Dispensary records may be secured from the clerk at the desk by signing the book kept on the desk for that purpose. 50 ORGANIZATION AND METHOD IN SOCIAL SERVICE When a number of dispensary histories are needed in making reports, etc., give the dispensary clerk a Hst containing the dispensary numbers arranged numerically, between the hours of 11 A.M. — 12 M.or 3-4 P. M. See sample below. Size Ayi" by 11" (or shorter) SOCIAL SERVICE DEPARTMENT REQUIRED FOR SOCIAL SERVICE INVESTIGATION HISTORY NtJMBEai: DATE RETURNED: DATE DEPARTMENT Histories requisitioned before 9.30 can be gotten by 12 o'clock. Those re- quisitioned before 2 P. M. by 4 P. M. More than 15 histories cannot be taken from the files at one time. or(;a>:ization and method in social service 51 registration of cases Cases are registered consecutively by assistant secretary without regard to the cHnic from which they are referred; the social service number is given to the family. New statistical records are placed by the worker, on the date the case is refeiTed,in the wire basket kept in the central office. Before registering a case the assistant secretary will look through the card file to ascertain if the patient or his family has been known to social service; if so, the original number is given to the case historj^ A slip of paper is attached to the history, naming the clinic in which the family is known, and the history is given to the worker. Statistical histories will be kept by the worker until the end of the year when if closed they will be de- stroyed. One patient may have a statistical record in several clinics. The workers are expected to look through the active history drawer at the end of each month and see that all quiescent histories are closed. CARDS White catalogue cards are used when there is any histoiy of the case in the social service files (see No. 1, page 37), short service cards when there is only a statistical history (see A, page 41). ''Steering blank" is written in red, top line of v/hite card lo indicate steering case. If two or more clinics are carrying statistical records on'y of the same patient, subsequent clinics with the dates should be entered on the same card, under '^Remarks." 52 ORGANIZATION AND METHOD IN SOCIAL SERVICE The family card No. 3 (page 54) is practically self- explanatory, except that under ''Relatives" may be , listed without addresses, only those relatives having [the same surname, including married sons of the family with which yoU are dealing. Give year of birth, not age. If the history gives the names of both parents, and one is dead, after the Christian name write ''dead" (in red; if one parent is dead, and the Christian name ,is not given, write "dead" after M or W in black. ( If a woman has been mamed more than once, and has had children by the f oiTner marriage or marriages, their names, giving surnames, are listed and under- neath is written in black, "Ws" by marriage; lif there are children by the present union, their - Christian names follow. In a similar way are indi- j jDated children by the former marriages of the man. A relative (buff) card (see No. 4, page 54) is made .)Up for the children by the former marriages of the 1 wife, names arranged in alphabetical order, the same form being used as with relatives cards. Patient's card (see A, page 41) bears name, ad- dress, "See" (surname, parents' Christian names) in red, and diagnosis, on left-hand side, and S.S. num- ber, date (of coming to S.S.D.), department in which treated, and dispensary, house or service number on the right-hand side. Patient's card bears the * in the extreme left-hand corner to indicate that there is no family card. ^ '"'When deaths occuf write after the names on the 'family card "dead" in red. If the deceased were ' patients, make a similar notation on the index cards. Add births to family cards. ORGANIZATION AND METHOD IN SOCIAL SERVICE 53- Relatives' cards (buff) are made up for married daughters and for all other relatives of different sur- names, and below in red beginning at the extreme left, "See (surname, patient's Christian name)", and to the extreme right, S.S. number of the family with which you are dealing. Occasionally it will be found necessary to make up cards for persons other than relative. For instance in the case of an unmarried mother, a card should be made for the man in the case if his name is known. (The buff card is used.) If there is a B No. 1 or C No. 1 (pages 42 and 43) sheet, the girl's name and the name of the child appear on the family card. If the child is known by the same name as the man, both the child's name and the man's name should appear in alphabetical order on a relative card. Black capital ''C", center top line, indicates a colored patient and appears on patient's and rela- tives' cards. When the family goes by two or more names, cross- reference cards are made out for the other names. Attention is called to the fact that B No. 1 and C No. 1 sheet show "Household," while the cards are called "Family Cards." 54 ORGANIZATION AND METHOD IN SOCIAL SERVICE No. 3 Size 5" X 3" SURNAME U w DATE RACE S. S. NO. ADDRESS CHILDREN NAME D. OF BIRTH CHILDREN NAME D. OF BIRTH RELATIVES No. 4 Size 5" X 3" ORGANIZATION AND METHOD IN SOCIAL SERVICE 55 STATISTICS MONTHLY SHEETS Each worker shall keep a monthly statistical sheet ;see J, pages 57 to 59). The first time a patient is referred to the social worker he is **new," whether or not the family is known to the department. His social service number is that given to the family. He is' ''new/' if he has been knovm to another clinic. He is "old," if carried forward in that clinic from the preceding month for attention. He is "reinstated," if he has been previously referred from that clin'c, has been ''closed/' and is again made "active." TRANSFERRED CASES Cases may be transferred from one JHH clinic to another or to an outside agency. CLOSED A case that is quiescent in the social service de- partment. At the end of each month, data called for shall be entered on the monthly sheets. (See J-2 and J-3, pages 58 and 59) from the statistical records carried during the month. On or before the fifth day of each month all clinic monthly sheets (see J-1, page 57) are returned to the supervisor who will have the totals entered on the department sheet (see H, page 49), which includes statistics for the entire department. Within one week, all department sheets shall be returned to the worker in charge of the department (wire basket No. 2 for registered histories). 56 ORGANIZATION AND METHOD IN SOCIAL SERVICE J-1 -Sizel2K''x8: c '■% 01 * Oh Average per mo. b 1 1 o Eh 'S B Br Average per month B a Q o u "> b. Vi % ! a I £ c a c > o O 0. — — >-3 01 c s 1-9 0) o o ■ * O tn M s •< E _> B c 0^ o W 4) 2 •o O B '3 oi o Total cases carried CASES CLOSED Closed 1 c Q Total Closed Visits to patients SPECIAL GROUPS ORGANIZATION AND METHOD IN SOCIAL SERVICE 57 J-2 Size 13K" X 9}i" DATE: DEPARTMENT PROBLEMS ADJUSTMENTS 1 1 2 X O o < P3 a £ PERSONAL FAMILY COMMUNITY c 1 o K o o o i 0) 0) s 0) > CO s o a 'S 0! o .2 s 1 3 c .2 ta .2 'S s •c a; B < •3 a c E 58 ORGANIZATION AND METHOD IN SOCIAL SERVICE J-3 Size W^" X 103^'' DEPARTMENT: SUMMARY NEW CASES CLOSED CASES INTENSIVE SHORT SERVICE , TOTAL INTENSIVE SHORT SERVICE. TOTAL ADULT CHILD MALE FEMALK WHITE BLACK REFERRED FROM DISPENSARY ADMITTING ROOM OTH^iR SOURCES PERSONAL PROBLEMS FAMILY PROBLEMS COMMUNITY PROBLEMS BAD NOT VISITED .UjUsJTMlSNTt ORGANIZATION AND METHOD IN SOCIAL SERVICE 59 H Size W X 8}^" (blue sheet) « o ^l ^ Qi O n --^ DO E- Q 60 ORGANIZATION AND METHOD IN SOCIAL SERVICE CONFIDENTIAL EXCHANGE OF INFORMATION *'The confidential exchange is a fundamental prin- ciple in efficient co-operation between social agen- cies. PRINCIPLES OF C. E. OF I. "Prevents d\iplication and strengthens co-opera- tion between agencies. Protects the patient from unnecessary investigation and mental confusion arising from conflicting advice. A means of settling identification. Supplies valuable information." REGISTRATION CF CASES All new and reinstated cases are registered with the C. E. of I. by the secretary in the central office. Forms are supplied upon request by the Confidential Exchange of Information, Calvert and Pratt St. (phone Plaza 3271). See page 59. ORGANIZATION AND METHOD IN SOCIAL SERVICE 61 Size 4" X 6" SURNAME NO. 1 MAN'S FIRST NAME woman's maiden name 2 woman's FIRST NAME 1 BORN MAN RACE NATIONALITY OCCUPATION 2 BOBN WOMAN RACE NATIONALITY OCCUPATION ALIAS m PREVIOUS MARRIAGE M w W address DATE CHILDREN BORN ADDRESS IF DIFFERENT 3 4 5 6 7 8 9 10 RELATIVES ADDRESS RELATION 62 ORGANIZATION AND METHOD IN SOCIAL SERVICE Information returned by the C. E. of I. is attached by the secretary to the history, if the case is active in the S.S.D. and placed on the worker's desk. If the case is closed the information is entered on the face sheet by the secretary. GIVING INFORMATION TO OUTSIDE AGENCIES AND INDIVIDUALS Extreme caution should be exercised in giving in- formation about patients. No diagnoses are given out by the social service department except in connection with their own pa- tients, and to agencies or individuals known to the worker and who need our assistance in making a plan for the patient's welfare. Before giving information to be used in Court or for other legal purposes con- cerning a house patient, after being approved by the Chief of S. S., consult the admitting officer, or the director of the dispensary if a dispensary case. Reports of patients shall be given dut only by the workers actively interested in them. If several members Of the social service department in different clinics are interested in various members of a family, and a co-operating agency asks a report, each social worker shall give her own report. If patient is not known to S. S., information in reference to house cases must be secured through the admitting officer, dispensary cases through the director of the dispensary. STEERING BLANKS Blank forms ((F) page 47) are furnished on request to outside agencies. They are required to send them to the social service office by patients for whom they are asking information and advice. ORGANIZATION AND METHOD IN SOCIAL SERVICE 63 Pertinent information from the agency should be given to the doctor before he sees the patient. The patient is directed to return to the social ser- vice department after examination. The doctor is seen by the social worker after the examination. The agency responsible should have the report the day the doctor's recommendation is made. By using the blank form the agency is certain of receiving a report, the social service department has the necessary information to enable the doctor to make a recommendation, the patient is spared un- necessary questioning and a uniform spelling of foreign names is assured. The information is sent to the outside agency by letter. If not previously known to the social ser- vice department the steering blank is the only record of the case necessary and is treated as other histories. BILLS, ORDERS AND MONEY LEDGER CARDS Ledger cards, see below, are filed for all money re- ceived or advanced, or bills contracted, containing in addition to the printed form the name of the firm from whom the purchase is made. If installment payments, state amount, and if made monthly, weekly, etc.; if the patient cannot pay for an ap- pliance, state whether the Social Service Department or what outside agency is responsible. Entry is made by the worker on the ledger cards of first pay- ment on the day the debt is contracted, or if subse- quent payments are made to her on small manilla envelopes, and handed to the secretary. Payments 64 ORGANIZATION AND METHOD IN SOCIAL SERVICE for appliances ordered from The Johns Hopkins Hospital Brace Shop are made directly to the nurse in charge of the Orthopedic Clinic, except when an outside agency has assumed responsibility for the appliance, then payment is made through the Social Service Department and, after being entered on the ledger card, the money is turned over by the secre- tary to the nurse. Size 5" X 3" 1 3 5 NAME 11 13 15 17 19 21 23 25 27 29 31 NO ADDRESS WORKER DATE AMOUNT REMARKS PAID DATE AMOUNT JOHNS HOPKINS HOSPITAL ORDERS For appliances ordered from the Charles Willms Surgical Instrument Company use firm's order book; for other orders use outside requisition blank (see page 70). All orders should be signed by the chief of social service. Nothing is to be charged to the social ser- vice department without a written order, a copy of which is to be on file. Checks should be made payable to The Johns Hopkins Hospital Social Service Department, and the checks should state for whom and what remittance is made. ORGANIZATION AND METHOD IN SOCIAL SERVICE 65 Receipts should be given in the name of the "Chief of Social Service" per worker's initials. Orders on the cash drawer should be approved by the chief of social service before being presented for payment. Form, see below, may be secured from the secretary. Size 5" X 3" APPROVED. Carfare for patients is paid by the Social Service Department. Tickets may be secured from the secretary. Lunches for patients are paid for by the Social Service Department. Carfares for workers, and incidental expenses are paid by The Johns Hopkins Hospital. A statement is presented monthly on *Tay-Day" at ''the bank," after being approved by the Chief of Social Service. A cash statement, and all bills contracted by the Social Service Department, after being approved by the Chief of Social Service, are sent to the Controller of The Johns Hopkins Trust Estate, 1210 Fidelity Building, on the twelfth day of the month. Bills due the Social Service Department are sent out by the secretary on the first day of the month. 66 ORGANIZATION AND METHOD IN SOCIAL SERVICE INSTALMENTS "The first point to be considered when a patient asks to be allowed to pay for apparatus of any kind on installments, is whether the patient is able to pay or whether a charitable agency should be asked to bear the responsibility. Having determined this question and decided to make it an installment case, the second point is whether the patient should pay full price or be given the benefit of a reduction. This must be determined by the social worker and based upon the patient's circumstances." Ortho- pedic appliances and glasses may be given free or at cost by the social service department. METHOD OF PAYMENTS Patients must fill out the following blank, promis- ing to pay a definite amount, stating terms, i.e., whether weekly, monthly, etc. Size 5" X SVs" THE JOHNS HOPKINS HOSPITAL I PROMISE TO PAY TO THE SOCAL SERVICE DEPARTMENT ON OR before: ON THE FOLLOWING TERMS: .19. ORGANIZATION AND METHOD IN SOCIAL SERVICE 67 METHOD OF CLOSING CASES If it becomes evident that a patient who is paying for apparatus on installments cannot keep up the payments, he should be transferred to the free list and the worker on the case should notify the book- keeper. REQUESTS FOR FREE TREATMENT Twenty-four hour passes may be given without in- vestigation. For longer periods requests for free treatment must be made on form below after case has been investigated, and are not to exceed 30 days, but may be renewed at expiration if necessary. Size 4:3yi" X 3K'' THE JOHNS HOPKINS HOSPITAL DATE BEARER DISP. NO IS RECOMMENDED FOR ADMISSION AT THE REDUCED RATE OF PER VISIT FOR FROM DATE. ( TO APPLY ) THIS RATE (NOT TO APPLY) TO MEDICINES. approved: SOCIAL WORKER ASSISTANT DIRECTOR 68 ORGANIZATION AND METHOD IN SOCIAL SERVICE MISCELLANEOUS FORMS Form used in referring patients to Social Service. Size 4^" X 23^" THE JOHNS HOPKINS HOSPITAL DISPENSARY REFERRED TO SOCIAL SERVICE DEPARTMENT PATIENT S NAME. REASON REFERRED . Discharge Notice — filled in by interne in charge of case. Size 6" X 4" THE JOHNS HOPKINS HOSPITAL SEND TO S. S. D. AT LEAST 24 HOURS BEFORE DISCHARGE NAME ADM. . . . ADDRESS DISCH. . . AGE M. F. W. B., S.M.W.D WARD. . DIAGNOSIS RESUI.T . TO RETURN 1. NOT NECESSARY DATE 2. TO WARD; OBSERVATION DATE 3. TO DISPENSARY — OBSERVATION — DRESSING RECOMMENDATION : ORGANIZATION AND METHOD IN SOCIAL SERVICE 69 Form given by interne to patient upon discharge. Size 5" X 3" NAME PLEASE COME TO THE JOHNS HOPKINS HOSPITAL DISPENSARY, MONUMENT STREET AND RUTLAND AVE., MORNING AT 9 O'CLOCK, AFTERNOON AT 2 O'CLOCK FOR TREATMENT IN THE DEPARTMENT. BRING THIS CARD WITH YOU. SUPPLIES GENERAL OFFICE Supplies may be ordered any Thursday before twelve noon. The main supply should be ordered the first Thursday of each month. Requisition (see form No. 2, page 71) is made in duplicate; after being signed by department chief, one is taken to the office of the assistant director. Stationery supplies are delivered at the social ser- vice office on Saturday, A M. with the exception of stamps for which the secretary has to go to the bank on Saturday A. M. A duplicate requisition is filed in the social service office after checking up the supplies. Separate requisitions are made for: Henry Phipps Psychiatric Clinic Phipps Tuberculosis Clinic Orthopedic Clinic Harriet Lane Home Johns Hopkins Colored Orphan Asylum. 70 ORGANIZATION AND METHOD IN SOCIAL SERVICE DEPARTMENTS Each worker makes out a requisition for supplies Wednesday of each week, before 5 P. M. The sup- phes are put on the worker's desk by the assistant secretary. All requisitions are approved by the department chief, REPAIRS Repairs are requisitioned in the same manner as supplies. OUTSIDE REQUISITIONS For ordering office furniture use requisition form No. 1, (see below). Three copies are made, after being approved by the department chief; two copies are taken to the office of the assistant director. One copy is kept on file in the S.S. office. No. 1 Size 8^'' X eVs'' THE JOHNS HOPKINS HOSPITAL DEIPASTMENT DATE PLEASE FURNISH THE FOLLOWING SUPPLIES: DESCRIPTION SUPERINTENDENT. ORGANIZATION AND METHOD IN SOCIAL SERVICE 71 No. 2 Size 4K'' X ly^" THE JOHNS HOPKINS HOSPITAL REQUISITION FOR SUPPLIES AND REPAIRS TO THE superintendent: REQUIRED FOR DEPARTMENT, SiGNATimE 19. 72 ORGANIZATION AND METHOD IN SOCIAL SERVICE OFFICE RULES Members of the staff are expected to notify the supervisor of any change of address or telephone number. When anyone is absent on account of illness or other reason the supervisor should be notified, also when unduly delayed in reaching the hospital. When there is an inquiry for a worker who has left or is absent be sure to put the one who inquires in touch with the one who is taking her place. If no one has been appointed, refer the inquirer to the supervisor. VOLUNTEERS All names and addresses, telephone numbers, hours and days with clinics they are serving, should be in the index file under ''Volunteers." Volunteers are expected to register daily in the general office, and to notify the supervisor of anticipated absences or when delayed in reaching the hospital. TELEPHONE Messages taken over the telephone or from a visitor in the office should be written in the following form and put in the letter box if the mail has not been collected or on the desk if it has. FOR WHOM FROM WHOM . BY WHOM TAKEN . TIME TAKEN (DATE. HOUR) ORGANIZATION AND METHOD IN SOCIAL SERVICE 73 Telephone calls are received by the clerk and turned into the worker's office by a bell system. Each worker has her own number of rings posted on the telephone and is expected to listen for her signal. When expecting a telephone call, notify the sec- retary where you may be, otherwise much valuable time is lost. In answering the telephone always state at once who you are and your connection with the social service department. Ascertain the name of the person speaking. When calling another agency find out to whom you are speaking. Be careful of the telephone you use on those cases when you do not wish to be overheard. Remember that patients sitting in the office or near- by, may easily misinterpret what has been said over the telephone or feel that their confidences are likely to be betrayed. Do not use the telephone as a form of communica- tion for cases in which there have already been diffi- culties or misunderstandings. And, again, if during a telephone conversation a misunderstanding has been created, do not continue, but arrange a conference in which to talk the matter over. In ending a telephone conversation, reiterate what- ever arrangement has been made; in this way there will be no lack of definiteness. At this time if you are talking with someone whom you do not know, your name may be again emphasized so that further communications on the same case will be made to the worker interested. 74 ORGANIZATION AND METHOD IN SOCIAL SERVICE TELEGRAMS Telegrams if charged to the hospital must be ap- proved by a member of the Administrative Staff and be sent from front office. If prepaid, they may be sent from the pay telephone booth in the adminis- tration building. FILING All filing is done by the assistant secretary. KEYS Keys to the clothes room, library and supply closet, are in possession of the assistant secretary. In the supply closet, boxes labeled to indicate contents are arranged in order. IN AND OUT BOARD The workers are to push their names in and out whenever entering or leaving the hospital. OFFICE RESOURCES LIBRARY For the use of the staff: Books on social work. Reports and reprints. Periodicals: The Survey. The Family. Hospital Social Service. The Public Health Nurse. For the use of the staff and patients: Fiction. ORGANIZATION AND METHOD IN SOCIAL SERVICE 75 When a book, a report, a reprint, a magazine, etc., is taken from the Hbrary, the worker indicates on a card the title of the volume and issue, the author's name, the date on which taken, signs her name, and hands same to the assistant secretary. Books may be kept for two weeks. Books, reports, etc., are returned through the as- sistant secretary, so that the card previously signed may be destroyed. Fiction may be taken without filing card. The social workers have access to the main library in the administration building. Directory: Institutions, Co-operating agencies, Boarding houses, Interpreters, Special schools, Foreign Consuls. USE OF SOCIAL SERVICE FORD The Social Service Ford is used to bring patients back and forth to the dispensary who are not able to come by trolley and cannot afford to pay for a taxi. We are dependent upon volunteer chauffeur service. Workers wishing to requisition the Ford, should make entry in register in central office as follows: DATE NAME OF PATIENT. . FBOM TO HOUR worker's initials. Entries should be made as far ahead as possible to prevent duplication. 76 ORGANIZATION AND METHOD IN SOCIAL SERVICE CLOTHING REQUIRED BY PATIENTS EN- TERING THE STATE TUBERCULOSIS SANATORIUM IN WINTER Horse blanket Rubbers Shoes Bathrobe Bedroom sHppers or bed socks 3 pair hose 2 sets underwear (Hght or heavy, according to sea- son) 2 flannelette night gowns, or 2 sets of pajamas. Cap (also muffler, if convenient) Mittens Overcoat Laundry bag Hot water bottle Sweater. All clothing should bear patient's name written in indelible ink. Supplies on hand (i. e. sputum cup and liners) may be taken to the Sanatorium. These policies have been gradually compiled as a guide to the individual worker. The true aim toward which social service is working has been masterfully expressed in the words of our Physician-in-Chief, Dr. G. Canby Robinson: "It should be the outspoken ideal of every hospital and all connected with it to endeavor to have every patient who enters its doors leave the institution a better man, woman, or child, not only physically, but also intellectually and spirit- ually in the period of transition when the doctor more ORGANIZATION AND METHOD IN SOCIAL SERVICE 77 or less withdraws, the social worker should take his place, and the transition should be accomplished with intimate co-operation, in that gradually the patient is transferred from the medical to the social service, rather than being discharged from the hospital." * KEY TO ABBREVIATIONS B V H Bay View Hospital (City Hospital and Alms House). C E of I Confidential Exchange of Information. H L H Harriet Lane Home (Department of Pediatrics). HPPC Henry Phipps Psychiatric Clinic J H H Johns Hopkins Hospital M Man. M T H Municipal Tuberculosis Hospital, sec Supervisors of City Charities. S S D Social Service Department. W Woman. ♦"Influence of Social Service in The Hospital."— G. Canby Robinson, M.D., Physician- in-Chief. The Johns Hopkins Hospital. (Pub. in HOSPITAL SOCIAL SERVICE, April 1922— Vol. v.— No. 4.) THIS BOOK IS DUE ON THE LAST DATE STAMPED BELOW AN INITIAL FINE OF 25 CENTS WILL BE ASSESSED FOR FAILURE TO RETURN THIS BOOK ON THE DATE DUE. THE PENALTY WILL INCREASE TO 50 CENTS ON THE FOURTH DAY AND TO $1.00 ON THE SEVENTH DAY OVERDUE. um MU ILiliiiiiuiAiuuu -§Ee — Me48- MAY 1 6 lybl MAY 14 1951 JAN 2 1 1957 "Hm JAN 919 iMOV 19 19581^ Due end of SPRING Quar APR 2 1 1972 lEC. PUDl. •^V92- ■'> > ^1 ^. 5 'O W -f^r Ji- LD 21-100m-12,'43 (8796s) PUSUO U.C. BERKELEY LIBRARIES CDETaiDlbT