See It in Action
From First Question to Final Outcome — A Real Example
Here’s how FENTON’S WAY–COLLEAGUE works in the real world:
Scenario:
A 77-year-old woman presents with worsening fatigue, shortness of breath, and confusion.
Her chart lists:
Heart failure
COPD
Chronic kidney disease
Anxiety
Diabetes
Malnutrition
Depression
Atrial fibrillation
Pressure injury (sacrum)
Acute hypoxia
Recent hospital discharge
Care is fragmented. Different specialists are involved. No one has the full picture.
FENTON’S WAY Organizes It
Using the Four Questions, we begin building the Medical ISSUE List:
MET 1: Who is she, and who is she becoming?
Baseline: Independent, sharp, lived alone
Goal: Return home, walking, making decisions
Story: Now confused, weak, and not eating
This frames everything else:
We’re not just treating “CHF” or “malnutrition” — we’re trying to restore a person.
MET 2: Why now?
Trigger: Acute drop in function post-discharge
Timeline: 4 days ago she was walking. Today she’s in bed, with oxygen, declining
This changes urgency. We’re not dealing with chronic conditions — we’re dealing with a crisis of decline.
MET 3: Do we know what we’re doing?
Medical ISSUE List (prioritized):
Respiratory Failure / Hypoxia
Diagnostic Plan: Imaging, pulse ox trending, ABG
Treatment Plan: Oxygen, BiPAP, steroids
Success = PaO₂ > 65, breathing without distress
Function Plan: Walking 25 feet without desaturation
QOL Plan: No constant oxygen at home
Delirium / Confusion
Diagnostic: Labs, meds review, imaging
Treatable cause? UTI? Medication effect?
Monitor with CAM scoring
Malnutrition / Functional Decline
Diagnostic: Dietitian, labs, swallowing eval
Treatable: TPN vs PO supplements
Function: Can she eat independently?
... and so on. Each ISSUE has a plan.
Each plan is tied to a goal.
Each goal reflects who she is and where she wants to go.
MET 4: Where are we going, when are we leaving, and who cares?
Goal: Return home independently
Timeline: Target = discharge in 7–10 days
Who Cares: Primary, SW, family, home health
COLLEAGUE Brings It Together
Organizes the ISSUE List
Flags missing diagnostic steps
Tracks whether treatments are working
Highlights disconnects between team members
Shows real-time Benefit/Cost analysis
Outcome
Because the team had structure, clarity, and shared goals:
Oxygen was weaned
Nutrition improved
Delirium resolved
Patient discharged home with services
Time to stabilization: 72 hours
Total cost of stay: 23% lower than prior admission
Patient goal met: Yes
Team satisfaction: Reported “best coordinated care of the year” by nursing lead
This Is FENTON’S WAY–COLLEAGUE in Action
Not theory. Not just software.
A new operating system for care.
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