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

Lauran Hardin
Case Study
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.

Posted to The Playbook on
Population Addressed
People with Behavioral Health and Social Needs
Key Questions Answered
  • How can health systems better address the psychosocial needs of vulnerable populations?

  • What’s an example of a program that is effectively doing so?

  • What outcomes has this program achieved?

Level of Evidence
Expert Opinion
What does this mean?


Very moving case study. 

Posted by cmather on Feb 01, 2018