Topic: How to have realistic conversations

Realistic Conversations: Shared Decision Making Conversations for Physiotherapists

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A free online webinar for NHS Greater Glasgow & Clyde Physiotherapists who may be involved in Shared Decision Making Conversations.

This online session allows participants to watch a real time interactive demonstration led by EC4H tutors. Participants will have the opportunity throughout the demonstration to contribute suggestions and feedback to the tutor team via the chat box.

Workshop overview

Scenario: Scenario: Sarah Buchanan is a 57 year old lady who is attending her first appointment in a MSK Physiotherapy out patient department.  She has osteoarthritis of her right knee.  Our healthcare professional is meeting with Mrs Buchanan to discuss treatment options using a shared decision-making approach.

Shared Decision Making, as defined by NICE in their 2021 guideline, is a collaborative process that involves a person and their healthcare professional working together to reach a joint decision about care. It could be care the person needs straightaway or care in the future, for example, through advance care planning. It involves choosing tests and treatments based both on evidence and on the person’s individual preferences, beliefs and values. It means making sure the person understands the risks, benefits and possible consequences of different options through discussion and information sharing. This joint process empowers people to make decisions about the care that is right for them at that time (with the options of choosing to have no treatment or not changing what they are currently doing always included).

In this scenario we demonstrate the use of the ‘DECIDE’ approach to structure the conversation, demonstrating the value of the clinician and the patient exploring options together.

Learning outcomes

Workshop participants will:

Review their current practice in communication about treatment related decision-making and consent

Working together, they will practice more effective ways to:

  • Communicate information about risk clearly and effectively with a wide range of patients and families.
  • Communicate the benefits and limitations of treatment in a balanced way.
  • Manage patients and families who have unrealistic expectations of treatment and outcomes.
  • Use decision aids to support effective communication and complex shared decision-making
  • Respond to complaints about clinical decision-making and consent

 

 

EC4H Realistic Conversations: Skills to support TEP conversations

A free webinar for NHS Greater Glasgow and Clyde staff involved in TEPS discussions.  This online session allows participants to watch a real time interactive demonstration led by EC4H tutors.  Participants will have the opportunity throughout the demonstration to contribute suggestions and feedback to the tutor team via the chat box.

Workshop overview

Susan Henry is a 72-year-old widow living alone at home. She came in overnight by ambulance with a 2-day history of productive cough and worsening breathless. Susan has community acquired pneumonia and oxygen, IV antibiotics and fluids for acute kidney injury were started. PMH Stage 4 heart failure on treatment with diuretics and ACE inhibitors, and breast cancer with multiple rib and vertebral metastases on hormone therapy. Susan has been seeing GP due to cognitive decline over past few months. Susan has improved slightly since admission but remains unstable and at risk of further deterioration.

A Doctor from the ward calls Susan’s daughter to discuss the Treatment Escalation Plan

This session will demonstrate:

Treatment Escalation Plans“A Treatment Escalation Plan (TEP) is a communication tool which is helpful in hospital when a person with serious illness has the potential for acute deterioration or may be coming towards the end of their life. Sometimes doing everything possible may actually lead to harm – to more suffering and distress rather than less – and without any particular gain. What can be done and what should be done may not necessarily be the same thing. Treatment Escalation Plans should be discussed and made based on personalised realistic goals rather than ‘one size fits all’ treatment.

Crucially, a TEP provides on-call hospital staff with immediately accessible guidance about how to respond to an individual in times of crisis, especially out of hours and at weekends. A TEP becomes particularly important when there is agreement that interventions or referrals for more intensive care that are contrary to a person’s wishes or are futile or burdensome should not be undertaken. Equally in many patients who may have an agreed DNACPR, a TEP clarifies all the treatments and care that should continue.”

In severe illness quality of care becomes more important than ever but the goals of treatment are different for different people. Hospital care is becoming more and more complex and both patients and their families are particularly vulnerable to the impact of errors, harms and poor communication. It is especially important for hospital staff to understand and respect the values and preferences of the people they are looking after and to discuss with them a plan for emergencies.

Knowing how the plans should be sensitively discussed and used is important and this session provides a framework for such conversation

Learning outcomes

Workshop participants will:

Review their current practice in communication about treatment related decision-making and consent

Working together, they will practice more effective ways to:

  • Communicate information about risk clearly and effectively with a wide range of patients and families.
  • Communicate the benefits and limitations of treatment in a balanced way.
  • Manage patients and families who have unrealistic expectations of treatment and outcomes.
  • Use decision aids to support effective communication and complex shared decision-making
  • Respond to complaints about clinical decision-making and consent

 

Realistic Conversations: Shared Decision Making Polypharmacy for Primary Care Staff

A free online webinar for Primary Care staff  working in NHS Greater Glasgow and Clyde who may be involved in shared decision making conversations .  This online session allows participants to watch a real time interactive demonstration led by EC4H tutors.   Participants will have the opportunity throughout the demonstration to contribute suggestions and feedback to the tutor team via the chat box.

Workshop overview

Scenario: Meg Shaw is an 88 year old lady who lives alone.  She has a diagnosis of mixed type dementia, hypertension and over the past 9 months, Meg has experienced three falls.  The most recent fall led to a brief hospital admission.  Today her daughter, Ruth Shaw, has a telephone call with the GP for a medication review.

Shared Decision Making, as defined by NICE in their 2021 guideline, is a collaborative process that involves a person and their healthcare professional working together to reach a joint decision about care. It could be care the person needs straightaway or care in the future, for example, through advance care planning. It involves choosing tests and treatments based both on evidence and on the person’s individual preferences, beliefs and values. It means making sure the person understands the risks, benefits and possible consequences of different options through discussion and information sharing. This joint process empowers people to make decisions about the care that is right for them at that time (with the options of choosing to have no treatment or not changing what they are currently doing always included).

In this scenario we demonstrate the use of the ‘DECIDE’ approach to structure the conversation, demonstrating the value of the clinician and the patient exploring options together.

Learning outcomes

Workshop participants will:

Review their current practice in communication about treatment related decision-making and consent

Working together, they will practice more effective ways to:

  • Communicate information about risk clearly and effectively with a wide range of patients and families.
  • Communicate the benefits and limitations of treatment in a balanced way.
  • Manage patients and families who have unrealistic expectations of treatment and outcomes.
  • Use decision aids to support effective communication and complex shared decision-making
  • Respond to complaints about clinical decision-making and consent

 

 

Realistic Conversations: Future Planning/ACP Conversations – advanced renal disease/increasing frailty

A free online webinar for NHS Greater Glasgow & Clyde who may be involved in future planning/anticipatory care planning conversations, with patients who have advanced renal disease/increasing frailty.

This online session allows participants to watch a real time interactive demonstration led by EC4H tutors. Participants will have the opportunity throughout the demonstration to contribute suggestions and feedback to the tutor team via the chat box.

Scenario

Patricia Taylor is an 85-year-old lady who currently attends hospital haemo-dialysis 3 times a week. She has had several recent admissions having missed HD sessions and fluid overloaded.

Our health care professional is meeting with Mrs Taylor to explore future planning/ACP.

Learning outcomes

In this advanced clinical communication workshop participants will:

· Communicate sensitively and effectively with people and those close to them about serious illness, deteriorating health, goals of care and CPR.

· Talk about Anticipatory Care Planning informed by an understanding of ‘what matters’ to people and their families.

· Discuss treatment and care options and outcomes within a person-centred model of shared decision-making and Realistic Medicine.

· Respond to anger, distress, collusion and other complex emotions.

· Discuss the benefits and limitations of treatment in a balanced way.

· Address communication challenges that arise when the person has impaired decision-making capacity

Realistic Conversations: Shared Decision Making Conversations for Primary Care Pharmacists (February)

A free online webinar for Primary Care Pharmacists who may be involved in shared decision making conversations .  This online session allows participants to watch a real time interactive demonstration led by EC4H tutors.   Participants will have the opportunity throughout the demonstration to contribute suggestions and feedback to the tutor team via the chat box.

Workshop overview

Scenario: Caroline Murray is a 28 year old lady, she has called to request a dose increase in her Sertraline during a period of acute emotional stress.  The Practice Pharmacist calls Mrs Murray to discuss this request

Shared Decision Making, as defined by NICE in their 2021 guideline, is a collaborative process that involves a person and their healthcare professional working together to reach a joint decision about care. It could be care the person needs straightaway or care in the future, for example, through advance care planning. It involves choosing tests and treatments based both on evidence and on the person’s individual preferences, beliefs and values. It means making sure the person understands the risks, benefits and possible consequences of different options through discussion and information sharing. This joint process empowers people to make decisions about the care that is right for them at that time (with the options of choosing to have no treatment or not changing what they are currently doing always included).

In this scenario we demonstrate the use of the ‘DECIDE’ approach to structure the conversation, demonstrating the value of the clinician and the patient exploring options together.

Learning outcomes

Workshop participants will:

Review their current practice in communication about treatment related decision-making and consent

Working together, they will practice more effective ways to:

  • Communicate information about risk clearly and effectively with a wide range of patients and families.
  • Communicate the benefits and limitations of treatment in a balanced way.
  • Manage patients and families who have unrealistic expectations of treatment and outcomes.
  • Use decision aids to support effective communication and complex shared decision-making
  • Respond to complaints about clinical decision-making and consent

 

 

Realistic Conversations: Unrealistic Expectations (Shared Decision Making in Practice)

A free online webinar for NHS Greater Glasgow & Clyde staff involved in shared decision making conversations.  This online session allows participants to watch a real time interactive demonstration led by EC4H tutors.   Participants will have the opportunity throughout the demonstration to contribute suggestions and feedback to the tutor team via the chat box.

This session will focus on shared decision making in practice when patients and families have unrealistic expectations of treatment and outcomes.

Workshop overview

Meg Stuart has been admitted from home following a stroke, she has been assessed as having an unsafe swallow. Meg has a background of dementia, hypertension and osteoporosis. Megs’ daughter wishes to speak with a member of staff as she is worried her mum isn’t getting fed.

Shared Decision Making, as defined by NICE in their 2021 guideline, is a collaborative process that involves a person and their healthcare professional working together to reach a joint decision about care. It could be care the person needs straightaway or care in the future, for example, through advance care planning. It involves choosing tests and treatments based both on evidence and on the person’s individual preferences, beliefs and values. It means making sure the person understands the risks, benefits and possible consequences of different options through discussion and information sharing. This joint process empowers people to make decisions about the care that is right for them at that time (with the options of choosing to have no treatment or not changing what they are currently doing always included).

You can read more here: https://www.nhsggc.org.uk/patients-and-visitors/realistic-medicine/info-resources-for-staff/shared-decision-making-yes-i-think-i-do-that-but-could-you-explain-a-bit-about-it/ and the NICE guideline is here https://www.nice.org.uk/guidance/ng197/chapter/recommendations#shared-decision-making

In this scenario we demonstrate the use of the ‘DECIDE’ approach to structure the conversation, demonstrating the value of the clinician and the patient exploring options together.

Learning outcomes

Workshop participants will:

Review their current practice in communication about treatment related decision-making and consent

Working together, they will practice more effective ways to:

  • Communicate information about risk clearly and effectively with a wide range of patients and families.
  • Communicate the benefits and limitations of treatment in a balanced way.
  • Manage patients and families who have unrealistic expectations of treatment and outcomes.
  • Use decision aids to support effective communication and complex shared decision-making
  • Respond to complaints about clinical decision-making and consent

 

 

Realistic Conversations: Future Planning/ACP Conversations – advanced renal disease

A free online webinar for NHS Greater Glasgow & Clyde who may be involved in future planning/anticipatory care planning conversations, with patients who have advanced renal disease.

This online session allows participants to watch a real time interactive demonstration led by EC4H tutors. Participants will have the opportunity throughout the demonstration to contribute suggestions and feedback to the tutor team via the chat box.

Scenario

Peter Taylor is an 85 year old gentleman who currently attends hospital haemo-dialysis 3 times a week.  He has had several recent admissions having missed HD sessions and fluid overloaded.  Our health care professional is meeting with Mr Taylor to explore future planning/ACP.

Learning outcomes

In this advanced clinical communication workshop participants will:

· Communicate sensitively and effectively with people and those close to them about serious illness, deteriorating health, goals of care and CPR.

· Talk about Anticipatory Care Planning informed by an understanding of ‘what matters’ to people and their families.

· Discuss treatment and care options and outcomes within a person-centred model of shared decision-making and Realistic Medicine.

· Respond to anger, distress, collusion and other complex emotions.

· Discuss the benefits and limitations of treatment in a balanced way.

· Address communication challenges that arise when the person has impaired decision-making capacity

Realistic Conversations: Shared Decision Making for Primary Care Pharmacists

A free online webinar for Primary Care Pharmacists who may be involved in shared decision making conversations .  This online session allows participants to watch a real time interactive demonstration led by EC4H tutors.   Participants will have the opportunity throughout the demonstration to contribute suggestions and feedback to the tutor team via the chat box.

Workshop overview

Scenario: Caroline Murray is a 28 year old lady, she has called to request a dose increase in her Sertraline during a period of acute emotional stress.  The Practice Pharmacist calls Mrs Murray to discuss this request

Shared Decision Making, as defined by NICE in their 2021 guideline, is a collaborative process that involves a person and their healthcare professional working together to reach a joint decision about care. It could be care the person needs straightaway or care in the future, for example, through advance care planning. It involves choosing tests and treatments based both on evidence and on the person’s individual preferences, beliefs and values. It means making sure the person understands the risks, benefits and possible consequences of different options through discussion and information sharing. This joint process empowers people to make decisions about the care that is right for them at that time (with the options of choosing to have no treatment or not changing what they are currently doing always included).

In this scenario we demonstrate the use of the ‘DECIDE’ approach to structure the conversation, demonstrating the value of the clinician and the patient exploring options together.

Learning outcomes

Workshop participants will:

Review their current practice in communication about treatment related decision-making and consent

Working together, they will practice more effective ways to:

  • Communicate information about risk clearly and effectively with a wide range of patients and families.
  • Communicate the benefits and limitations of treatment in a balanced way.
  • Manage patients and families who have unrealistic expectations of treatment and outcomes.
  • Use decision aids to support effective communication and complex shared decision-making
  • Respond to complaints about clinical decision-making and consent

 

 

EC4H Realistic Conversations: Skills to support staff involved in Shared Decision Making Conversations

A free online webinar for NHS Greater Glasgow & Clyde staff involved in shared decision making conversations.  This online session allows participants to watch a real time interactive demonstration led by EC4H tutors.   Participants will have the opportunity throughout the demonstration to contribute suggestions and feedback to the tutor team via the chat box.

Workshop overview

Katie Stuart (46) developed a severe headache at 10am after cycling to work.  A work colleague took her to ED  and she was sent for a CT scan which was reported as normal. Katie is feeling much better.  Local guideline after negative CT is for admission under medicine for lumbar puncture. The senior doctor has asked to speak to Katie as she is keen to leave hospital after the scan and is a bit disgruntled

Shared Decision Making, as defined by NICE in their 2021 guideline, is a collaborative process that involves a person and their healthcare professional working together to reach a joint decision about care. It could be care the person needs straightaway or care in the future, for example, through advance care planning. It involves choosing tests and treatments based both on evidence and on the person’s individual preferences, beliefs and values. It means making sure the person understands the risks, benefits and possible consequences of different options through discussion and information sharing. This joint process empowers people to make decisions about the care that is right for them at that time (with the options of choosing to have no treatment or not changing what they are currently doing always included).

You can read more here: https://www.nhsggc.org.uk/patients-and-visitors/realistic-medicine/info-resources-for-staff/shared-decision-making-yes-i-think-i-do-that-but-could-you-explain-a-bit-about-it/ and the NICE guideline is here https://www.nice.org.uk/guidance/ng197/chapter/recommendations#shared-decision-making

In this scenario we demonstrate the use of the ‘DECIDE’ approach to structure the conversation, demonstrating the value of the clinician and the patient exploring options together.

Learning outcomes

Workshop participants will:

Review their current practice in communication about treatment related decision-making and consent

Working together, they will practice more effective ways to:

  • Communicate information about risk clearly and effectively with a wide range of patients and families.
  • Communicate the benefits and limitations of treatment in a balanced way.
  • Manage patients and families who have unrealistic expectations of treatment and outcomes.
  • Use decision aids to support effective communication and complex shared decision-making
  • Respond to complaints about clinical decision-making and consent