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The Veterinary Professional > Consultation Skills > Flashcards

Consultation Skills Flashcards

(64 cards)

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1
Q

What is relationship centered care?

A

involves engaging the client in a shared decision making process, considering their perspective and the human-animal bond, to achieve the best outcomes for the animal

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2
Q

Client benefits of relationship centered care?

A

Improved client satisfaction
Increases trust

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3
Q

Patient benefits of relationship centered care?

A

Improved accuracy of assessment
Better compliance with treatment

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4
Q

Vet benefits of relationship centered care?

A

Improved outcomes
Shorter consultation times

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5
Q

What is the guide we use for consults?

A

Calgary-Cambridge guide

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6
Q

What are the five stages of the calgary-cambridge guide?

A

Initiating the session
Getting Information
Physical examination
Explanation and Planning
Closing the session

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7
Q

What 3 factors does initiating the session include?

A

Preparation
Establish Rapport
Identify reason for consult

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8
Q

What does preparation consist of?

A

Create a professional, safe environment
Check previous patient history

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9
Q

What does ‘Establish rapport’ consist of?

A

Introductions - vet client and patient
‘Chit-chat’ –> how was your journey, summer holiday, weather etc.

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10
Q

What does ‘Identify the reason for consult’ consist of?

A

Open question - e.g. ‘What can we do for Buster today?’
Listen to the answer - The Golden Minute
Follow up question ‘is there anything else you are worried about?’

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11
Q

What 3 factors does ‘Gathering information’ include?

A

Medical/patient perspective
Background information
Client perspective

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12
Q

What does ‘medical/patient’ perspective consist of?

A

Specifics of presenting complaints e.g. duration, frequency, progression
Start with open questions and move to closed questions to fill any information gaps

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13
Q

What does ‘Background information’ consist of?

A

Past medical history, management at home (feeding, exercise)
This step is often just confirming/clarifying information we already have on our records
‘I can see Buster is 6 months old and I believe he was already vaccinated when you got him, is that correct?’

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14
Q

What does ‘client perspective’ consist of?

A

Every client has different ideas/concerns and expectations
Client ultimately will make the decisions, thew more information we have, the better we can help them

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15
Q

What 3 factors does the ‘physical examination’ consist of?

A

Explain the process
Explain each step
Ensure patient and client at ease

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16
Q

What does ‘explaining the process’ consist of?

A

I am now going to examine Buster, starting at his head and working my way back to his tail
… as … may be painful i will leave that to last

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17
Q

What does ‘explaining each step’ consist of?

A

I am now checking Buster’s mouth for signs of dental disease or infection, and I will check his ears and eyes as well

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18
Q

What does ‘ensure patient and client at ease’ consist of?

A

I am going to examine Buster now; is there anywhere in particular he might be more sensitive or worried about me checking?

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19
Q

What 3 factors does ‘Building a relationship’ consist of?

A

Non-verbal communication
Developing rapport
Involving the animal

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20
Q

What does non-verbal communication consist of?

A

eye contact
open body language

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21
Q

What does developing rapport consist of?

A

establish a connection with your client
provide empathy and support

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22
Q

What does involving the animal consist of?

A

greet and interact with the patient

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23
Q

What 2 factors does providing structure consist of?

A

Signposting
Attending to flow

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24
Q

What does signposting consist of?

A

explain to the owner how consult will be structured
Explain to owner how consult will be structured.“I am going to start by asking you some general questions about Buster’s routine, then there will be more specific questions to fill in any gaps. Then I will examine Buster to ensure he is in good health for his vaccination today.”“There are three options for treating Fluffy’scondition, with a range of costs associated with them. I will take you through each option in turn, and you are welcome to ask for more information as we go through them.
THE CLIENT MAY NOT KNOW WHAT TO EXPECT FROM A CONSULT, EXPLAIN THIS TO THEM

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25
What does attending to flow consist of?
Structure the consult in a logical sequence e.g. history taking, clinical exam Ensure you keep to time (10/15 mins)
26
What three factors does 'explanation and planning' consist of?
providing the correct amount and type of information shared understanding of patient's illness Shared decision making
27
What does 'providing the correct amount and type of info' consist of?
find out the client's current knowledge base
28
What does 'shared understanding of patient's illness' consist of?
give opportunities for client to ask questions to check understanding Acknowledge the emotional load of information: I realise this is a lot to take in, do you need to process this info, do you need a minute, anything you want to ask me?
29
What does 'shared decision making' consist of?
we are the professionals/expert on knowledge however the client is the expert on their pet client need to be able to make an informed decision for their pet's treatment Client should contribute their thoughts, ideas, suggestions and preferences Give choices, not directives
29
What three factors does closing the session consist of?
summarise forward planning saying goodbye
29
What does summarising consist of?
check client understands agreed plan, 'would you mind repeating our plan back to me so i can check we've covered everything/you understand' check client is happy with outcome of consultation, have i missed anything?
30
What does 'saying goodbye' consist of?
Lead client to consult room door or take to reception to collect medications or book next appointment.*“I’ll see you again in one week but please do contact us sooner if you are worried. If you are happy waiting at the reception desk, one of our team will be out with Fluffy’smedications shortly.”
30
What does forward planning consist of?
When do we want to see the patient again? “Buster seems in great health today, so unless you have any concerns, we will see him back in 6 months for his next health check.”*What to do if agreed plan is not working “If Fluffy seems to be getting worse before your next appointment, please call so we can get her seen earlier
31
clarifying:
is what I've explained clear?
32
What three factors does 'shared decision making' consist of?
understanding the client providing information suitable for the client decision making
33
what does 'understanding the client' consist of?
identify client preferences create a partnership assess client's knowledge
34
what does 'providing information suitable for the client' consist of?
tailor information and use understandable languages use of resources e.g. visual aids establishing mutual understanding
35
what does 'decision making' consist of?
educate clients about their options work together towards a treatment plan (vet recommendations vs. client autonomy)
36
When should we use shared decision making?
behavioural consultations end of life care cardiopulmonaru resuscitation preventativw treatmenta antimicorbials
37
What are the four ways of approaching shared decision making?
paternalistic, empathetic, sympathetic, realistic
38
Describe a paternalistic approach to shared decision making:
acting from a place of authority making decisions for other people
39
Describe a empathetic approach to shared decision making:
identifying with others understanding their point of view
40
Describe a sympathetic approach to shared decision making:
responding with care acknowledging their experience
41
Describe a realistic approach to shared decision making:
acknowledging challenges finding solutions in a practical sense
42
What approach do we use for 'shared decision making'?
SHARE (seek, help, assess, reach and evaluate)
43
Explain the S from share:
Seek client participation 'Now that we've identified the problem, it's time for us to think about what to do next'
44
Explain the H from share:
Help the client explore and compare treatment options 'Here are some choices we could consider'
45
Explain the A from share:
Assess your client and patient values and preferences 'As you think about our options, what's important to you?'
46
Explain the R in share:
Reach a decision with your client Now that we've had a chance to discuss your options, which treatment do you think is right for Buster?
47
Explain the E in share:
Evaluate your client's decision 'Let's plan on reviewing Buster and this treatment plan next week
48
SDM?
Shared decision making
49
Challenges of SDM?
Disconnect between information provided by vet and what is needed by client Veterinary surgeon barriers What would you do if it was your pet?
50
Disconnect between information provided by vet and what is needed by client - what are these challenges of SDM?
Does the vet understand the client's perspective? Is the information suitable for the client? How to decide on options presented?
51
Veterinary surgeon barriers, challenges with SDM?
Time constraints Multiple owners involved Language barriers
52
What three factors make up the client's perspective?
ideas, concerns and expectations
53
What does 'chunking and checking' consist of?
Providing - provide a small amount of information Pausing - to allow time for your client to process this information Checking - confirm your client's understanding before moving on
54
What does ASK-TELL-ASK consist of?
ASK - what do you know about diabetes? do you know what arthritis means? TELL - three pieces of info, resources - handouts/models ASK - do you have any questions? can you tell me what you understand about epilepsy now?
55
What 5 stages does signposting consist of?
setting the agenda differentials pivoting warning shot skilled interruption
56
setting the agenda:
clear plan when starting the consult
57
differentials:
outlining thought process for diagnosis or treatment plans
58
Pivoting:
acknowledging but then moving on from less urgent concerns
59
warning shot:
prepare client for bad news
60
skilled interruption:
when you need to focus discussion 'I'm so sorry, I'm just going to have to interrupt you there...'
61

The Veterinary Professional (2 decks)

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