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Risk, Escalation and Information Sharing With Support Teams
Risk, Escalation and Information Sharing With Support Teams
Support workers have more frequent contact with patients than any other member of the team. That makes them valuable, and makes information sharing a live question, since they're not clinicians, the information is sensitive and the patient has opinions about who knows what.
Most arrangements work to one of two extremes: workers are told nothing and miss what they're looking at, or workers are told everything and they have to deal with history that the patient has not agreed to share.
The standard worth applying
Information travels only if it changes what the worker does. Practice-level facts, in, with handling instructions attached. Diagnostic history, formulation and past incidents that don't change the shift, out.
Where there is truly sensitive information that needs to be sent because it impacts practice, it is accompanied by handling instructions, who else has access, and who does not.
What a worker needs for risk
The changes that can be observed in this person, in the language of everyday observation.
What to expect while waiting, and when the response is an ambulance.
A number that answers, and an after-hours line.
Permission to escalate something that turns out to be nothing. That last one decides whether the system works. Once a worker calls and feels foolish, they stop calling, and you lose the review that could have started two days sooner.
Consent
Real consent is conditional and revocable. The patient knows what goes to the worker and can narrow it. If capacity is impaired, it runs through the appropriate substitute decision-maker, not whoever is available.
Keep the boundary clear
Workers don't evaluate risk. They monitor for agreed indicators and escalate. Any framing that pushes them to judge how serious it is puts them and the patient at risk.
How this plays out in practice
Imagine one worker handed the complete history, and another given four observational indicators, an instruction sheet and a number. The second worker makes good decisions by week two. The first is still holding information she can't use.
Next steps
For one patient this week, write the four indicators, the holding instruction and the number. That is all the protocol actually is.
Connect Your Patient With Consistent Support. Workers hired through Support Network can start with your watch list and escalation line from the first shift.
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