What are the aims of a GP consultation?
Explanation and planning
What model do consultations use?
Calgary Cambridge Model
What are the steps of the Calgary Cambridge Model?
1) Initiating the session
2) Gathering information
3) Providing structure
4) Building relationship
5) Explanation and planning
6) Closing the session
What does using a model allow?
Time to gether information with a structure
What is a model consultations can use other than the Calgary Cambridge Model?
Roger Neighbour's model
What are the steps of Roger Neighbour's model?
1) Connect with the patient
2) Summarise and verbally check that the reasons for attendance are clear
3) Hand over and bring the consultation to a close
4) Ensure that a safety net exists in that no serious possibility has been missed
5) Deal with housekeeping of recovery and reflection
What does Roger Neighbour's model start to introduce?
Concept of risk management
What is risk?
Chance of consequences
What does uncertain mean?
Not able to be relied on, not known or definite
What is uncertainty?
State of being not completely confident or sure of something
How does risk within health compare to other areas?
How do different people perceive risk?
Risk and uncertainty differs for the same problem depending on the situation, what does this lead to?
What are key points of individualising care?
Different patients have different risks
Dependent on health beliefs, education, social, cultural and economic backgrounds
Risk cannot always be eliminated, but it can be minimalised
What can be said about getting rid of risk?
It cannot always be eliminated, but it can be minimalised
What is risk depending on?
What do doctors need to be due to working with risk?
Resilient as they may regularly find themselves asking "have I done the right thing"
What does an inability to be resistant lead to?
What positive thing often results due to uncertainty?
When does stress occur?
Imbalance between demands and recources or pressure that exceeds one's perceived ability to cope
How do doctors deal with stress?
Have coping mechanisms in place like speaking to colleagues
What is a way of minimising risk?
What is safety netting?
Uncertainty should be communicated to the patient
They must know what to look out for and told to seek help if they see this
Maybe arrange a follow up
What are some different categories of sources of guidance to help with risk and uncertainty?
What are some national sources of guidance to deal with risk and uncertainty?
National Evidence Based Guidance
SIGN guidance in Scotland
What does SIGN guidance provide?
Peer reviewed guidelines for specific conditions
What are some local sources of guidance to help with risk and uncertainty?
Scottish Referral Guidelines for Suspected Cancer
What should be noted about local sources of guidance for risk and uncertainty compared to national?
They can be different
What is an example of immediate guidance for risk and uncertainty?
Place of work has guidance for life threatening or complex scenarios
Such as emergency management of anaphylaxis
What is immediate guidance for risk and uncertainty helpful for?
Management of acute conditions