Readiness Screening Tool

[Joyce]

I am a hemodialysis social worker looking to assist patients in returning to work. Are you aware of any inventories/surveys I can use to screen one's readiness or preparedness to return to work?

[Beth Witten MSW ACSW]

I recently heard from Dr. Nancy Kutner, a rehabilitation researcher, that she found in a study of new patients that the physical function scale on the SF-36 (this is only two items on the SF-12) was the strongest predictor of continued employment for after starting dialysis.

If you're talking about assessing patients that are not currently working, I think you need to listen to what the patient says. You might want to use the transtheoretical model of change as a guide (www.med.usf.edu/~kmbrown/Stages_of_Change_Overview.htm). I'd suggest devoting less of your time to those in the precontemplation stages than those who are already working and want to continue and those in the higher stages where they're talking about getting a job, getting training, or have started making an effort to do one of the other.

The fastest payoff you'll get is from keeping patients working, especially those with employer group insurance coverage. If you can track the work status of your patients and report to administrators how many patients continue to maintain their jobs and their health insurance this is money in the bank for your clinic since EGHPs often pay 2-3 times what Medicare pays for dialysis alone. Having more commercial pay patients in a clinic makes it possible to offer newer technologies (including rehabilitation programming) and higher qualify of care to all clinic patients.