Thinking Through the Intake Functional Status Summary - Part 1
Although I've been practicing for quite a few years, I haven't acquired the talent of having a magical, crystal ball, inner sense. I've been using FOTO for a year now and I'm finding that I clinically love having the extra information that the Intake Functional Status Summary provides at my fingertips. I'd like to share how the summary is incoporated into my clinical thinking and the conversations I have with patients.
My eyes are immediately driven to one section as soon as my office manager places the report in my hands.
My eyes are immediately drawn to the graph. I assume that is because I am visual and I am readily drawn to information that helps me learn something at a glance.
In this scenario, the patient's functional status measure is 27/100. FOTO has over 5 million outcome assessments. FOTO equates the person in front of me to other patients in the system. In this particular situation, the other patients in the system had a 51/100 at intake.
Without the information FOTO provided, I might not be quite on clinical alert. I also appreciate, I didn't have to spend a ton of time to know that I need a targeted approach to learn what's up. That graph immediately puts me on alert. What is different about my patient?
When I see a patient's score that is quite different than others in the system, my clinical mind begins churning. In no standardized order, the top thoughts or questions that jump in my brain are below:
1) Ensure that I am very focused in my clinical examination: red flags need to be ruled out.
2) Take time to learn about current medications: any new, any interactions?
3) What was the mechanism of injury?
4) Listen closely to the patient's story of what he/she thinks is going on.
5) Double check level of fear.
6) What has the patient been told about his/her current situation?
7) Are cultural influences a factor? Socially, could any personal relationship be influencing the patient's presentation? (spouse/attorney/supervisor)
That one little graph, which took no work on my behalf to receive, begins my clinical thinking journey with that patient.
What kind of thoughts go through your mind when you see something like the graph I shared?