Topic: How to have realistic conversations

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

 

 

Realistic Medicine: Discussing Risk, Benefit and Uncertainty

All clinicians in Scotland are asked to practice “Realistic Medicine” including talking about risks, benefits and limitations of treatment and care options.

This half day interactive workshop for consultants, senior surgical trainees, advanced nurse practitioners and senior clinicians (Band 7+) supports participants to have realistic conversations about care. Helping patients to feel empowered to discuss their treatment options fully and be at the centre of decisions about their care.

Participants will work in a small peer group to address the challenges around shared decision making and will practise more effective ways

Learning Outcomes

In this advanced clinical communication workshop, participants will:

• Review their current practice in communicating with patients, families and other professionals about deteriorating health and care planning
• Identify personal learning objectives and develop strategies for addressing these within a supported peer learning group
• Critique and apply relevant literature/theory on effective communication
• Identify ways of increasing communication effectiveness in their own practice

To book a place email: meded.seniors@lanarkshire.scot.nhs.uk

Difficult Conversations: Managing Unrealistic Expectations webinar

Free online taster session which 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 difficult conversations when patients and families have unrealistic expectations of treatment outcomes. Emphasis will be on setting realistic goals for patients at the time of rehabilitation and supporting patients to do more self-management.

This webinar if open to all EC4H partner boards and organisations

Overview

Carol Smith, aged 67, was admitted to hospital following a left total anterior circulation stroke (NIHSS stroke severity scale score 21). The patient was discharged home 13 weeks of therapy in the stroke unit and has had 10 weeks of rehab at home. The patient’s aim throughout the therapy is to walk again independently. No progress has been made with mobility and it remains extremely effortful and unsafe. The patient and family’s expectations of a full recovery remain, and they are still hopeful that she will walk again. They are angry at the withdrawal of therapists despite several months of therapy input. The clinician meets with the patient to discuss their treatment plan.