Development, Implementation, and Evaluation of a Social Work Needs Assessment Tool: An Innovative Approach When the Palliative Care Request Is Unclear.

Determining the specific needs and greatest distress of a patient requires thoughtful purposeful assessment. The objective of this article is to present a palliative care needs assessment tool utilized in an inpatient palliative care service, and to discuss the process of implementation and evaluation of outcomes. The tool is specifically designed to identify palliative care needs when there is no initial clarity on the appropriate palliative care intervention. It will support practitioners in understanding the lived experience of the patient, assess readiness to discuss future planning, and offer specific language as a guide. A team of social workers evaluated 50 completed needs assessments to determine if the tool successfully identified a palliative care intervention, elicited values, and treatment preferences, and assisted in the completion and documentation of advance directives. After analysis, the four outcomes were consistently met, demonstrating that this tool has value in the hospital setting with certain referral types. These four outcomes identified are valuable in capturing where a patient currently is in their disease trajectory, while also providing a potential framework for future decision making. Recommendations for future exploration were presented along with feedback from the social work team.