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Consultation Models Roger Neighbour - East Sussex VTS

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									CONSULTATION MODELS
  ROGER NEIGHBOUR




                  Sam Rezk
                      GP ST3
NEIGHBOUR’S CONSULTATION MODEL
5 checkpoints:
1- Connecting
    Building rapport


      Greeting, meeting and joining with the patient-
       not just at the superficial level but at a level
       where real empathy can develop

      Being able to see the world as if through the
       patients’ eyes
2- SUMMARISING
 making sure you’ve understood the patient’s needs and that
 patient and you are on the same track by:

          to and eliciting the patient’s story ( include
 ØListening
 symptoms, ideas, concerns and expectations)

 Øexplaining back to patient what they have told you or
 offering them a summary of what you’ve understood to be the
 problem

 Øallowingfor correction/development of ideas &
 understanding
3.HANDING OVER
 At this point the patient feels well equipped to depart,
      adequately informed and sufficiently confident of
      progress.

 Strategies for handing over:
 1- Negotiating
 2- influencing
 3 gift wrapping ( presenting your plan in an attractive
      package which the patient is pleased to receive)

 This is achieved by:

 Ø   agreeing a management plan, and checking that the
     patient accepts it

 Ø   sharing decision-making & responsibility

 Ø   negotiating and compromising on options
4- SAFETY NETTING
     This checkpoint reminds you to consider, before the
     patient leaves, a few ‘what if?’ questions.

      checking you’ve not missed anything, and making a
      contingency plan

     This includes:

Ø   Thinking ahead to plan for the unexpected- considering
    ‘what if?’

Ø   Acknowledging uncertainty and risk

     “General Practice is the Art of Managing Uncertainty”
5- HOUSE KEEPING ( TAKING CARE OF
YOUR OWN WELL-BEING)
  This checkpoint reminds you to attach no less importance to
   looking after your own physiological and mental health than you
   do to patients.

  During  consultations
  In between patients
  Before and after surgeries
  At intervals during the course of your career


  This includes:
  Øidentifying any left-over feelings or needs after the patient
   leaves
  ØDoing what you need to do (e.g. stretch, relax, having a cup of
   coffee, talking to someone, releasing feelings)
NEIGHBOUR’S ‘INNER CONSULTATION’ MODEL:
‘THE CONSULTATION AS A JOURNEY WITH 5
CHECKPOINTS’
              Take care of your own
              Take care of your own
            physical & mental wellbeing
            physical & mental wellbeing

  5 - HOUSE-KEEPING                       Establish working rapport
                                          Establish working rapport
                                              with the patient
                                              with the patient

                      1 - CONNECT
                                                           Check, by offering a
                                                           Check, by offering a
                                                          summary, that you’ve
                                                          summary, that you’ve
                                                          understood what the
                                                          understood what the
                              2 - SUMMARISE               patient has come for
                                                          patient has come for


                                                         Make sure the patient is
                                                         Make sure the patient is
                              3 - HAND-OVER              happy with the agreed
                                                         happy with the agreed
                                                           management plan
                                                           management plan



                       4 - SAFETY-NET              Anticipate the
                                                   Anticipate the
                                               unexpected and make
                                               unexpected and make
                                                a contingency plan
                                                a contingency plan

								
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