Complex care accounts for a substantial portion of all healthcare spending, according to the Commonwealth Fund. Therefore, a fraction of the population uses many of the available healthcare resource dollars. In addition, people with complicated needs often receive fragmented care with many communication barriers. A patient-centered complex care approach aims to build a more robust, coordinated, patient-first method for individuals whose health conditions are complicated and layered.
Nurses can help create a complex care experience that respects, involves and empowers patients to help close the health equity gap. Southern Utah University’s online Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) program prepares graduates to address these inequities and offer quality care to all patients, no matter the complexity of their conditions.
What Is Complex Care?
Complex care has varying definitions depending on the field or situation. A primary care provider may define complex care as care involving many comorbidities, such as diabetes, hypertension, hyperlipidemia and arthritis. Pharmacists might define complex care as care for patients with multiple prescription and over-the-counter medications (polypharmacy). Social workers might consider limited resources as constituting complex care. A nurse might determine patient complexity by the number of consultants, equipment or monitoring devices required to provide care. The use of interdisciplinary care teams and cross-sector partnerships may be part of a facility’s definition of complexity. All these various definitions have truth: complex care is holistic care.
The National Center for Complex Health and Social Needs defines complex care as an approach to care that “seeks to improve health and well-being for people with complex health and social needs by coordinating and reshaping care delivery at the individual, community, and system levels.” Complex care models help individuals and work at a systemic level to address the root causes of poor health.
What Are the Goals of Complex Care?
Complex care is “a growing field to improve health and well-being for people with an array of health and social needs.” The goal is to bring patients, their caregivers, the community and the healthcare system together toward a common goal of improving the person’s health and well-being and removing barriers to care.
Some of the beneficial outcomes of a coordinated complex care approach include the following:
- Decreased healthcare costs to the patient and the system
- Avoided duplication and delay of care
- Increase in shared decision-making between the care team and patient
- Improved access to community or ancillary services
- Decreased caregiver burden
- Facilitation of better communication and collaboration
- Increased patient and provider satisfaction
- Elimination of health disparities
- Increased efficiencies
What Is the Nurse’s Role in Complex Care?
Nursing practice focuses on patients’ holistic needs by considering the impact of medical, mental, social or behavioral problems. A whole-person approach is the backbone of nursing practice, naturally following the eight principles for complex care:
- Listen first, second and third. Learn about the patient’s culture and understand how they see their care and what is important to them.
- Believe the patient’s stories. Realize the patient’s story is their perception and understanding and that having their voice heard is important.
- Work to build trust and open dialogue, as many complex patients may have experienced mistrust or trauma.
- Teach and empower. Build the care plan with the patient in the center to help them feel in charge of their own decisions.
- Follow up. Understand that patients with complex needs may get the “royal run-around,” feeling like no one cares about the “big picture” as they see specialist after specialist.
- Ask open-ended questions about unfamiliar areas. Check your assumptions and biases.
- Recognize that the patient’s goals may be far from what you recommend. Meet patients where they are, as their priorities or plans may change over time.
- Keep good relations with the surrounding communities. Learn to work with a diverse group of care stakeholders for a collaborative approach across sectors.
How Can Nurses Begin to Support Complex Care?
An easy way for nurses to start a culture of complex care toward health equity care is to use people-first, destigmatizing language. For example, use the term “patient with complex needs” instead of “complex patient” or “individual with obesity” instead of “obese patient.” Individuals with complex medical, behavioral health and social needs can improve their health and well-being when the healthcare team has a complete view of them and addresses barriers to inclusive language and environments.
Southern Utah University’s online RN to BSN program equips students to provide complex care to patients with multiple comorbidities throughout their lifespan. The Management of the Complex Patient for the RN to BSN course focuses on the nurse’s role in caring for individuals with multiple complex health problems. Graduates of the program will be equipped to advocate for patients’ needs no matter their complexity.
Learn more about the Southern Utah University online RN to BSN program.