The Role of Documentation in Social Work Practice- Ensuring Accountability and Quality Care

The Role of Documentation in Social Work Practice- Ensuring Accountability and Quality Care

In social work, documentation is the writing skill for all social workers. Communication between a social worker and other people working with the client, like courts, healthcare professionals, therapists, or teachers. It is important to cite where the information came from to limit the opinion and bias of the social worker. Concise and clear documentation is critical. Social workers have to document everything because anything that is not documented is assumed not to have happened.  Documentation lets the professionals know what has happened, what has been done, and what plans are for the patient (Wohltmann, 2017). Good documentation ensures that there is evidence of all the services provided to a client in the future. It also establishes accountability. Skilled documentation ensures quality care for a client if the primary social worker is not available because of disability, employment termination, or sickness. Thorough documentation can protect social workers when faced with a lawsuit or any complaints on ethics.

Evidence is the facts on something that can be useful in concluding. An opinion is the judgment or view formed by someone about something. In the video, the social worker is professional and also friendly to the young boy. I have learned that as a social worker, before getting to conclude anything like a child is being abused or neglected, there is a need to hear the facts. The facts for evidence for every social worker start from before the adverse incidences happened. It can be a day, hours, or a week before (A social worker interviewed a victim of physical abuse, 2021). It also includes what happened, such as a fight, how it happened, and when and how. The final part of the evidence is what happened after the incident.  A social worker should be open-minded and not biased when collecting evidence. No opinion or personal perspective should be added to the report.

References

A social worker interviewed a victim of physical abuse. (2021).

. Retrieved 30 November 2021, from https://www.oercommons.org/courses/writing-good-case-notes-differentiate-fact-evidence-from-assessment-opinion/view.

Wohltmann, T. (2017). Intro to Case Notes for New Social Workers [Ebook] (p. single page). Retrieved 30 November 2021, from https://www.oercommons.org/authoring/8157-intro-to-case-notes-for-new-social-workers/view.

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After reviewing the readings/video (found in the readings), please consider the following:

What is the importance of documentation in Social Work?

The Role of Documentation in Social Work Practice- Ensuring Accountability and Quality Care

Please share your thoughts on the video and what you have learned about separating fact and evidence from assessment and opinion.