What Support Workers Can Notice and Report

Request observable information that supports clinical judgement, without taking responsibility for it.

Changes in gait, intake, sleep, skin, mood or function may be observed by the support worker well before a brief consultation.

Without a directed question, the reports may be general or be clinical interpretations. Excessive monitoring can cause workers to be taken outside of scope and the home to become a medical environment.

Why this matters for medical professionals

Clinicians make decisions and implement the interventions in a limited amount of time, and in the home, transport systems, and everyday activities. A small amount of functional and coordination information can explain why an appropriate clinical plan is not working. The intent is not to shift clinical accountability, but to make the back-and-forth and path forward clear.

What better coordination looks like

Clinicians can request a few observable indicators tied to a decision, with a set timeframe and escalation plan.

Ask one useful question

Explain the change or routine to be observed and its importance.

Specify observable detail

Ask who, what, when, how and what happened for the person instead of asking for a diagnosis.

End the monitoring

Once there is enough information for the clinical decision, set a review date and stop at that point.

Make the change last

Useful change is specific enough to practise, small enough to review. Decide who will take the first action, where the decision will be documented, and when the person will be asked if the action was effective. If it is an approach that relies on multiple services, make sure to check agreement on each service individually instead of assuming agreement in a meeting is agreement in action. Distinguish between what is working well and what isn't and eliminate temporary measures that no longer further the desired goal.

Questions for the next review

What would “ask one useful question” look like from the person's point of view?

What is given and what is a hypothesis or an open question?

What will the person and team observe to determine if this approach is working?

Keep the boundary clear

Staff should not perform a clinical evaluation, analyse the results or delay urgent emergency care while gathering data. All reporting is subject to consent and privacy.

A practical example

A GP with a concern for morning dizziness requested one week of notes on timing, position, intake and immediate response. The short pattern enabled clinical review without the need for workers to make a diagnosis.