Before Venning (et al 2000) compared efficiency and cost of a cohort of nurse prescribers with doctors in the same geographical area. (Barry et al. Following a consultation model is a key element of consultations in clinical practice, Coffrey and Bowskill ( 2010)recognised that a diagnosis could be made on good quality history taking alone. Is patient involvement possible when decisions involve scarce resources? 0000007586 00000 n This model introduced the concept of eliciting the patient's ideas, concerns and expectations. 0000004860 00000 n Collection. He highlighted some of the changes in general practice that have emerged over recent years, which now make consultations more challenging than ever. Share. 1. Department Health (2003) advocate empowering patients to take more ownership of their health condition. I have not experienced well-organised electronic charts. 0000003100 00000 n 2000). and DRAPER, J., 2005. Refreshments are called refreshments because they refresh the mind, body and spirit. Essay, My Experience in Excite and Execute Dynamic Groups Essay. Questions to check understanding include: 'Could you tell me what you understand the problem to be so I can check I have explained it okay?'. Nurse Educ Today. It follows that such experimentation is likely to be all the greater when medication is used when the benefits are less immediate (eg. 0000008715 00000 n I propose 10 quality indicators that would be simple to measure and could be used to improve clinical consultations. Study for free with our range of nursing lectures! HORROCKS, S., ANDERSON, E. and SAILSBURY, C., 2002. Please enable it to take advantage of the complete set of features! How nurse prescribers influence the role of nursing. How to incorporate consultation models into your 10-minute consultation. This uses the five checkpoints of connecting, summarising, handing over, safety netting and housekeeping alongside an awareness of 'minimal cues' (verbal and non-verbal) to help discover the unspoken agenda. This provides the first step for developing further research on the content of the model, i.e. The Inner Consultation suggests summarising throughout the consultation to clarify that your understanding of the problem is the same as the patient's. If the patient feels hurried by the clinician, they are unlikely to provide a useful history of presenting complaint and will feel that they have not been listened to. It clearly is not a situation which one could have confidence that the patient has a sound knowledge base about his treatment and has a positive attitude towards compliance.Critical Analysis Of A Consultation Model Essay, The point relating to communication failure resulting in poor treatment outcome (primarily in relation to non-adherence to treatment instructions) was explored in depth in an excellent paper by Britten (et al 2000). model for the functional analysis of resistance in clients. If you need this sample, insert an email and we'll deliver it to you. Even if the patient is making good progress the clinician should still re-question the diagnosis. Summarising is a useful tool to clarify your understanding of the problem. Game theorya theory based on assumptions of rational choice and focusing on interactive decision makinghas the potential to provide models of the consultation that can be used to generate empirically testable predictions about the factors that promote quality of care. BMC Public Health. . Would you like email updates of new search results? Summarising the problem is also important and allowing the patient to hear your thoughts is helpful. Critical analysis of a consultation model is assignment will discuss the Me First (2017) model of consultation and communication tool used, in the authors work setting. These battles can use up all of our brain's cognitive capacity, so that there is no brain power left for clinical reasoning. Bookshelf NHS Plan (2010) encourages shared decision making with the patient and family to aid concordance. The https:// ensures that you are connecting to the This is likely to be reflected in greater patient satisfaction, greater compliance with instructions generally and improved outcomes and again, in the words of the authors fewer lawsuits. Choose your writer among 300 professionals! The ability to be a good listener is crucial to the success of anybody working in the hospitality industry, such as veterinary technicians. Roger Neighbour delivered a thought provoking keynote speech at the RCGP annual conference yesterday, which kicked off with a pre-conference session for associates in training (AITs) and GPs in their first five years post qualification (First 5s). The doctor forms rapport with the patient 2. MUNSON, E. and Wilcox, A., 2007. Expert clinicians know that the majority of the information directing towards the correct diagnosis comes from attentive listening to the patient's history of the presenting complaint, set in the context of the patient's life and known medical conditions. If healthcare providers want good patient outcomes and patient experience, they have to ensure and insist that staff take full refreshment breaks not 10 minutes carrying a coffee, answering emails, making referral calls and chasing tests results a proper gossipy break doing nothing else but eat, drink and chat. If a consultation does become difficult you will have different strategies ready to get things back on track. In the best traditions of scientific endeavour, they were subject to a barrage of audits and studies to see how they actually performed. If healthcare providers realised that clinical consultations are the crucial productive process of their business and worked to improve the process of clinical consultation, we could see fewer misdiagnoses with substantial improvements in patient outcomes and experiences, along with happier more fulfilled staff within 2 years from now. The Non Medical Prescriber (NMP) is still developing as a role, which is now fundamental in AP due to increased demands and reduced resources, especially in the role of autonomous practice in primary care and OOH services. COOPER, N., FORREST, K. and CRAMP, P., 2006. A consultation is a private interaction between health professionals and a patient (Kaufman, 2008). Clinical consultations rarely feel like well-prepared business-like meetings. (2001) has shown that compared to a biomedical consultation, patient satisfaction is greater when using a patient-centred approach and their is the preferred method when attending a primary care practitioner. Although, Neighbour (1989) and indeed Calveer can be adapted and be utilised in Children and Young people, consultations, Young people and children are physiology different to adults and therefore the clinical approach to child consultations should be tailored to meet individual needs (barker, Moules. (Legge 1997) the accumulative results of the initial studies showed that nurse prescribing had been proved in terms of safety, efficacy and improved working practices. Author links open overlay panel Veronika Wirtz a, Alan Cribb b, Nick Barber a. Which are you interested in? 2007 Feb;65(2):189-96. doi: 10.1016/j.pec.2006.07.007. Asking the following easy to answer questions gets the patient talking. The clinician will have an expected trajectory of progress in their mind. Counseling Strategies and Consultation Models CEP 863 Spring 2009 . In Sweden, Valdemar Erling and colleagues, have set up ward round rooms which provide greater privacy.2 The consultations that I observed were more like adult conversations between equals than the conversations that happen when the consultant stands towering over the patient in their bed. The aim of this case study is to illustrate how prescribing decisions can be enhanced through the use of systematic consultation, reflection on practice and relevant information seeking. Notes FAQ Contact Us. Many of the ideas and phrases you have picked up in your GP training - 'the golden minute'; 'ideas, concerns and expectations'; 'shared decision-making . Externally, everything should be done to provide an environment conducive to high-level thinking. It can be condensed into a six-stage process: 1. To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the NursingAnswers.net website then please: Our academic writing and marking services can help you! 2003. THOMSON, R., EDWARDS, A. and GREY, J., 2005. This model looks at the process of the consultation from initiating the session, gathering information, providing structure to the consultation, building a relationship, giving information by explanation and planning, and closing the session. Critical analysis of a consultation model is assignment will discuss the Me First (2017) model of consultation and communication tool used, in the authors work setting. 0000003730 00000 n I may experience some challenges in Explore and Examine Dynamic group. It follows that if the clinician elicits a poor history or physical examination, they may well arrive at the incorrect diagnosis. HARPER, C., AJAO, A., 2010. The doctor tries to elucidate the reasons for the patient having attended the surgery 3. For example, there is a wide-ranging set of possible problems that a patient with Parkinson's disease might be experiencing and we could help patients to prepare their information. This area used to be termed compliance which was a reflection of the now outmoded concept of implicit power and authority invested in the prescriber. Resources can be used in the consultation to aid communication when choices need to be made, for example, The Medicine for Children (2018) provides patient friendly leaflets (although it could be argued that they are not necessarily child friendly) when exploring views and negotiating a contract, around the choice of medication, it provides clear explanation of the medication for example, how the medication can be given ie tablet, or liquid? 4. This means the patient does not know in advance what the consultation is about and cannot even prepare an account of their symptoms or concerns. However Alderson & Montgomery (1986) emphasise that children themselves can have different levels of cognitive ability and this needs to be taken into account when decisions are made. If an incorrect diagnosis is made, a good outcome can only arise by good luck eg if the clinician believes that the diagnosis is a urine infection but is actually pneumonia, by good luck the antibiotic might treat the pneumonia. One of the six blueprint areas tested in the CSA is a person-centred approach using recognised communication techniques that enhance understanding of a patient's illness and promote a shared approach to managing problems. Knowing the person means asking about the person's job, interests, family and enjoyments. Patient participation in Dutch ethics support: practice, ideals, challenges and recommendations-a national survey. This model sees the consultation entirely from the patient's perspective using a series of questions such as: 'what has happened?' 0000003927 00000 n The impact of general practitioners patient-centredness on patients post-consulatation satisfaction and enablement. Consultations are a vital part of assessment and diagnosis during the patients journey, it is imperative for the practitioner to carry this out in a holistic and systematic manner in order to promote wellbeing and therefore creating a safe and evidence based management plan tailored to each patient (Nutall and Rutt-Howard 2015). It is even easy to overlook checking the chest X-ray. We need a lot of information readily available to make the correct diagnosis in the patient's context. I believe the patient should have a copy of the referral letter and should be actively encouraged to provide information useful for the consultation. However, the benefits of a closed unit model have not been extensively compared to those of a mandatory critical care consultation model. Behavioral Consultation Model Behavioral consultation is a problem-solving process that includes four stages, problem This essay should not be treated as an authoritative source of information when forming medical opinions as information may be inaccurate or out-of-date. Clipboard, Search History, and several other advanced features are temporarily unavailable. It is important not to neglect the importance of the role of reflective practice in this area (Gibbs 1998). CONSULTATION MODELS Consultation models are established lists of questions or areas to be explored, and provide a framework for a consultation. and 'What were you hoping to get out of today?'. Meaning what does happen and what should happen during a consultation. We live in a dynamic medical world where technology is rapidly evolving, new treatments continue to come to market and approaches to disease management are often revised. By continuing, well assume you agree with our Cookies policy. I read the current admission notes (or hear the junior doctor present the case) and look up test results etc before going to see the patient. The Me First (2017) consultation and communication tool is widely used as part of a paediatric consultation whether this be consultant or nurse-led. Top sports performers are trained in these sorts of techniques to block out the spectators, but I have not heard of similar training for clinicians. A review consultation is as important. At the same time, we have to battle either with illegible paper notes (charts) or hugely inefficient software purporting to be electronic patient records. 0000006162 00000 n 0 We also know that a substantial proportion of the medication that is currently prescribed is not taken or, worse still, inappropriately utilised. As in any new project there were inevitable protagonists and detractors and the initial results of the first eight studies were extremely positive. Any opinions, findings, conclusions, or recommendations expressed in this essay are those of the author and do not necessarily reflect the views of NursingAnswers.net. When I ask patients to tell medical students What makes for a good doctor? by far and away the commonest answer is A doctor who listens. A seemingly hurried clinician cannot appear to be listening. The Clinical Skills Assessment (CSA) demands good communication skills. sharing sensitive information, make sure youre on a federal Physical examination adds some further useful information and tests are used to confirm or refute possibilities. Even having to write notes takes up more of the brain's attention. The Consultation, Assessment and Improvement Structure for Nurses (CAIIN) is considered a useful tool which can be used for ongoing assessment and development of consultation skills in nursing practice (Hastings and Redsell, 2006). (1984) model would be appropriate for use in OOH as it is a useful way of building a relationship with the patient, involving them in care and decisions during the short time the practitioner will meet them. In any new project there were inevitable protagonists and detractors and the initial results of the changes in practice. Family to aid concordance copy of the brain 's cognitive capacity, that! 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