Social Worker

Job Description

The Social Work and Discharge Planning team consists of staff that provide scope of practice social work and discharge planning for all four sites of Halton Healthcare.

The successful candidate will work within a fast-paced environment as a collaborative team member of an interdisciplinary team. Using critical thinking and working with the interdisciplinary team, the Social Worker collaboratively formulates, facilitates and coordinates discharge plans focused on the needs and goals of the patient and their family system. Provides social work support to patients and families across Maternal/Child, Pediatric, Acute Care, and ICU settings. Responsibilities include, but are not limited to, supporting families experiencing fetal loss, addressing newborn protection concerns, and managing a wide range of psychosocial issues within the adult patient population, including homelessness, financial hardship, mental health concerns, substance use, intimate partner violence, and elder abuse.

• Coordination, formulation/development, documentation, and implementation of care plan for hospital discharge and safe transition back to community or institutional setting.
• Identification of both short and long term goals to ensure/enhance continuity of care for patient/family.
• Ensure plan is communicated to all stakeholders and that appropriate referrals have been processed and received.
• Ensure that patient and/or SDM understands the discharge plan and has the relevant contact information for community partners.
• Ensure efficient use of hospital and community resources
• Early identification of patients requiring complex discharge planning case management through high risk screening criteria, consultation with team members and referrals.
• Planning, review and communication of plans and time lines in partnership with the multidisciplinary team, client/SDM, family, and community agencies/facilities.
• Facilitation of safe patient discharge through: case coordination and development of appropriate discharge plan. Included but not limited to: patient/family education; referral and completion of application to community services; coordination of legal/financial capacity or SDM issues including potential PGT involvement.
• Advocate to identify gaps in services, need for individualized program consideration and system level changes required to meet changing needs of patient population.

Qualifications

Halton Healthcare endeavors to hire individuals who are competent in their chosen profession and who exemplify our mission, vision and values of accountability, respect and compassion which guide our individual behaviours and attitudes.

• MSW required
• Member in good standing with the Ontario College of Social Workers and Social Services Workers
• 2-5 year clinical experience in an acute care hospital setting
• Considerable experience in family assessment/treatment within the context of a multi-function mental health and in a psychiatric setting.
• Demonstrated strong multi-discipline team skills required.
• Knowledge and familiarity with psychiatric disorders and treatment thereof would be a decided asset.
• Excellent communication and interpersonal skills
• Presentation skills are required to explain the program to a variety of stakeholders.
• Current knowledge of community resources and initiative to proactively search for new resources
• Experience with legislation that governs Public Hospitals (Public Hospitals Act, Substitute Decisions Act, Consent to Treatment Act, etc.)
• Demonstrated extensive knowledge base of resources in the public and private sector, and medical and clinical language and procedures.
• Extensive knowledge of how to effectively serve diverse populations with complex medical, functional, cognitive and psychosocial needs
• Comprehensive knowledge of the impact of social determinants of health on discharge planning, hospital LOS, Patient Flow and hospital system capacity
• Expert communication, collaboration, organizational and problem solving skills
• Ability to work independently as well as with an interdisciplinary team
• Demonstrated ability to set priorities
• Skilled working with a broad range of client groups and their significant supports
• Satisfactory employment and attendance record

Additional Information

REVISED AND REPOSTED

Hours: Monday to Friday; hour day shifts (Hours are subject to change based on operational needs)

Salary: $ to $ per hour

Date Posted: July 14, 2026

Internal Applicants Due By: July 21, 2026

REF3691M