EC4H Realistic Conversations: Skills to support TEP conversations

10 Feb 16:00 - 17:15 Online attendance Free

Workshop overview

Mr Clark, aged 78, has prostate cancer with extensive bone metastases. He was admitted to the ward for assessment due to deteriorating health. Mr Clark fell overnight. The consultant phones Mr Clark’s son to inform him and discuss further treatment plans

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

 

Online

EC4H Realistic Conversations: Skills to support TEP conversations

Date: 10 Feb
Time: 16:00 - 17:15

Tutor team

Dr Kirsty Boyd

EC4H Lead Tutor

Dr Kirsty Boyd was trained as a clinical communication tutor by Professor Peter Maguire in 1995 and has been organising postgraduate communication courses for over 20 years.  She was Clinical Communication Programme Theme Head for the University of Edinburgh Medical School from 2002-2015 and she is an honorary clinical senior lecturer at the University of Edinburgh. Kirsty holds a Masters in Clinical Education from Nottingham University.  She is retired from her clinical role is as consultant in palliative medicine at the Royal Infirmary of Edinburgh. GMC Number: 2846907

Claire O’Neill

EC4H Lead Tutor

Claire O’Neill is Lead Nurse and Clinical Service Manager for Acute Palliative Care Services in Greater Glasgow and Clyde. Claire has been involved in delivering communication skills training since 2003. More recently working with EC4H and NHSGGC Lead for Realistic Medicine to deliver Realistic Conversations virtual sessions.

Dr Alastair Ireland

EC4H Tutor

Alastair Ireland is Clinical Lead for Realistic Medicine for NHS GGC and consultant in Emergency Medicine at Glasgow Royal Infirmary. He led on the programme to implemented a unified Treatment Escalation Plan for NHS GGC and has assisted in the delivery of the new GGC online ‘Realistic Conversations’ webinars on Treatment Escalation Plans and Shared Decision Making.