The past decade has seen significant growth in the complex care field, which aims to better
coordinate care and enhance the outcomes for those with complex social and health needs. With an ever-growing evidential base of best practices and the development of supportive payment models after the passage of the Affordable Care Act, the number of health plans and healthcare systems involved in complex care has dramatically expanded.
The field has recently seen its first randomized controlled trials. It has also begun organizing itself around more standardized basic competencies. Moreover, it has started bridging gaps in quality measurement to assess the individual, community, and program-level impacts accurately.
What is complex care?
As mentioned, complex care aims to enhance the lifestyles, well-being, and health of those with complex health and social needs by reshaping and coordinating care at the individual, community, and program levels.
It seeks to address the root causes of illness via interdisciplinary aid groups and cross-sector alliances, delivering person-focused care around participants’ aims and priorities.
Complex care essentially identifies and records who and where the present approach fails to serve complex patient populations adequately. It also aims to establish interconnected care ecosystems to fulfill the present and long-term requirements of these populations and the community.
Such root causes can extend beyond physical well-being and health to include the social factors of health, including trauma, poverty, food or housing insecurity, and lack of access to healthcare.
Aspiring nurses exploring this field may do so via the UIndy accelerated nursing program. The program’s Complex Transitional Nursing Care course explores professional nursing and its function in healthcare and injury prevention in complex patient populations.
Individuals with complex needs are a subdivision of the US population, comprising a mix of social, mental, and physical health needs. This particular population usually has higher hospitalization and ED use rates than the wider population. Despite frequent service use, those with complex needs experience deteriorating health outcomes.
The importance of complex care
The US care system — including public health, healthcare, social care, housing, education, etc. — primarily approaches a single individual in isolation. They do not work together to take care of multiple needs simultaneously.
For those with increasingly complex social and health needs, limited access to organized behavioral, physical, and social care services leads to poor health outcomes and complex patient populations resorting to expensive services.
The US care system must deliver care more effectively to achieve optimal results. Care should be:
- Cross-sector: Complex care works toward breaking down the barriers separating sectors, fields, and specialties. It also works to shape the ecosystem needed to facilitate person-focused care.
- Person-focused: Individuals’ preferences and values direct all aspects of their care in complex care, prioritizing their life and health goals.
- Inclusive: Complex care acknowledges the structural barriers in the health sector, including institutional, interpersonal, or systemic racism and bias, aside from other discrimination forms, and helps individuals and communities overcome them.
- Data-driven: Complex care regularly shares cross-sector information across partners and team members to distinguish individuals, facilitate adequate support of consumer objectives, and evaluate success.
- Team-oriented: Complex care is provided via non-traditional, interprofessional, and all-inclusive teams of behavioral health, medical care, and social services providers headed by the individual themselves.
By enhancing care for those suffering and encouraging healthcare systems to share power with social organizations, a complex care approach may help achieve health equity in the US.
Types of complex care
To better understand the importance of adequate training in complex care, below are some examples of the types of complex care offered:
- Urinary catheter care: If an individual suffers from spinal cord injury or multiple sclerosis, they may need to wear a catheter. They will need someone to insert the catheter and replace the collection bags.
- Manual handling: Anyone with limited mobility may need someone to ease them from the bed to the wheelchair. They may also require support while using the toilet or showering.
- Tracheostomy care: Individuals with a tracheostomy may need carers experienced with first aid, ventilation, and CPR. Moreover, replacing the tracheostomy dressing can also be complicated. It typically requires two carers to be present to ensure safety.
- Wound management and care: Injured individuals may need someone to dress their wounds or must regularly be moved to avoid bedsores or pressure sores.
- Bowel health care: Although bowel care is a regular part of support work, specific individuals may need a specialist level of support. For instance, they may need a professional to monitor their bowel activity regularly and administer enemas or laxatives when required.