The SAGE Program: Social Work Innovation in Palliative Care
Catherine Arnold, MSW, LICSW, medical social worker
Historically, social workers have played a pivotal role in advancing palliative care. Recognizing the need for a holistic approach to caring for patients with life-threatening illnesses, social workers have pioneered an integrative practice that attends to patients’ unique physical, psychosocial and spiritual needs.
In an effort to improve patient experience and outcomes, Partners is sponsoring the innovative, interdisciplinary Speaking About Goals and Expectations (SAGE) program at BWH.
As a social worker with more than 30 years of professional experience, including clinical practice in palliative care, program development and implementation, I serve as a key member of the SAGE team, working with hospitalists trained to use Ariadne Labs’ Serious Illness Conversation Guide to engage those patients longitudinally who have had multiple recent hospital admissions.
The SAGE program’s primary goal is to engage in earlier conversations with patients about their care preferences, helping them articulate and record their priorities and concerns before a medical emergency occurs.
The program prioritizes regular communication between inpatient and outpatient providers, serving as a bridge for sharing goals across different health care settings and the patient’s entire care team. The social worker’s role is pivotal in these important communications.
“Establishing trusting relationships early, before the pressure of in-the-moment decision-making, allows patients an opportunity to explore their values and goals, and share them with their families and interdisciplinary health care teams,” said Josh Lakin, MD, palliative care physician at the Dana-Farber Cancer Institute and member of the SAGE program. “Earlier conversations decrease patients’ anxiety, strengthen the patient-provider relationship and empower patients and their families when those challenging moments arise.”
The interdisciplinary team approach is at the heart of the SAGE program’s success, as well as early “upstream” conversations, which invite patients to explore and articulate their concerns and preferences. In doing so, they gain mastery over their care and lives.
The SAGE program is just one example of social workers’ significant contributions as members of interprofessional care teams.
In March, as part of National Social Work Month, we honor all BWH social workers, who bring compassion and clinical expertise to patients, families and interprofessional teams.