Restoring Dignity for Vulnerable Populations: Changing the System for Complex Patients

Lauran Hardin
Case Example
January 2016

This resource describes the author’s changed understanding of the role of the health system in helping people with complex needs, sparked by an encounter with a vulnerable patient. The author, a nurse at Mercy Health Saint Mary’s in Michigan, leads the Complex Care Center there.

  • The emergency department (ED) is also a social trauma center. Sometimes vulnerable individuals visit the ED simply because they are seeking a safe place and have nowhere else to go.

  • The Complex Care Center addresses drivers of instability like housing status, transportation, grief, and loss, and builds partnerships with other entities in the community, even competitors.

  • Consistency in care and reduction of fragmentation is critical to restoring dignity to vulnerable populations.

  • A year after implementation, the first population of 165 patients served by the center had a 68 percent reduction in inpatient admissions and a 48 percent reduction in ED visits. Direct expenses decreased by 56 percent.

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