The patient vulnerability can appear in different formats and vulnerable patients show their vulnerability in different and sometimes unexpected ways. This is why sometimes healthcare organizations and healthcare personnel wonder; Who Can Be Classified as a Vulnerable Patient? If a patient is scared or anxious does that classify them as a vulnerable patient? Whats the difference between a patient who’s just feeling a bit scared or anxious and a patient who is obviously displaying vulnerability? Are all patients classified as vulnerable? I mean, beaning a patient means that you are sick, at the mercy of doctors and nurses and a lot of times in pain. Does this make you automatically vulnerable? These and much more are the questions researchers seek to answer when they try to classify patient vulnerability and its attending facets.
Ways to Tackle Patient Vulnerability
Therapy at the Door
Therapy is a branch of medicine that we are all familiar with. Therapy helps manage the emotions of individuals and helps them be more in tune with and aware of themselves. Therapy at the front door is a brand of therapy that brings therapists into a hospital to attend to vulnerable patients (and other patients who might need it as well). Therapists access and identify patients who need extra attention as well as patients who can be discharged the same day or after a very short admission. One of the issues that lead to patient vulnerability is being in an unfamiliar environment which in this case is the hospital. Patients feel anxious, lost, and out of control and so being in familiar environments such as their homes could actually speed up recovery. Therapy at the front door enables early care planning and can greatly reduce the length of stays and patient vulnerability.
Therapy at the door works well in a lot of situation. Besides helping tackle the problem of patient vulnerability, therapy at the door also serves as a part of an acute fragility service involving social care and other defined pathways. Some of these other pathways are mental health liaison, dementia specialists, frailty nurses, and geriatrician and they also involve social care.
There are cases where a child is brought into the hospital and the doctor or nurses suspect a case of domestic violence or parental neglect. Or maybe the child has no accompanying guardian. In cases like this patient whether classified as vulnerable or not can greatly benefit from therapy at the door before and after social services intervene.
Implementation of Therapy at the Door
Implementing therapy at the door needs to be carried out in a detailed and intentional way. The process of appointing therapists for this responsibility can take different formats. The format also depends on where the therapists are being sourced from. Are they in-house therapists who also work in the hospitals? In this case, implementation is regarded as an in-house and interdepartmental issue. Therapists can also be sourced from partner organizations. In this case, it becomes a cross-organization issue where top management of both organizations needs to be involved. Some healthcare organizations could also focus on getting private practicing therapists and have them on a contract or retainer basis. This, of course, calls for a different kind of implementation strategy.
Data and Technology
When it comes to the timeframe of implementing therapy at the door for patient vulnerability, there needs to be a detailed and set approach to it. There should be three to six months of prep (depending on need) to allow for planning, staffing, and adjustment of schedules. There needs to be a team set in place to help with the implementation and the transitional period of it. The team could contain heads of service, heads of departments, senior managers, consultants and lead nurses etc all working together to provide the essential leadership and support for change. The early stages of the process should involve information gathering. This will help whatever plans put in place have a solid foundation. In recent times with the emergence of tehcnology and healthcare, there has been a heavy reliance on data and big data and the need to have data inform decisions and processes. An effective competency framework must be in place. Registered therapists should be fully integrated into their roles and the team should use a generic assessment method in the management of their patients and potential patients.
After the information gathering stage comes to the strategy and planning stages. All plans and strategy must be put in place in a way that makes implementation easy. Then there should be a period of testing and adjustment. This is why a flexible plan is also necessary. If a plan is set in place and is fixed with no room for adjustment, it is more likely to fail as when a plan comes in contact with the real world there are bound to be changes and a few bumps along the lines of implementation. This is why a skillful team is needed and not only that, but the team should be a good representation of the organization. There should be members from different departments and different levels of management. In addition, an effective competency framework must be in place to help access the team and their strategic plans and strategy implementation.