Initial Consultation Flashcards
Before seeing patient do…
- Review referral or curbside with PCP
- Review patient’s EHR before seeing the patient; this helps reduce time needed to collect info and communicates that you already know something about the patient’s health status.
The phases of Initial Consultation
Introduction (1-2 mins) -> bridge to assessment (10-30 secs) –> assessment: symptoms & functioning (10-15 mins) –> bridge to intervention (1-2 mins) –> intervention (5-10 mins)
Pitfalls to avoid
significantly abbreviating the intro phase, “fishing” for problems in the assessment phase, moving too fast from assessment to the intervention phase.
using handouts designed for specialty mental health practice - need more details, limiting interventions to those they have handouts about - beh prescription, and being overly conservative about who can be managed at the primary care level.
having too brief an interval btwn appts and scheduling when it’s unnecessary
taking too much time in feedback to physician or using case presentation style. Theyll start avoiding you if you are wordy and go into unnecessary depths
5 A’s (main, text, intro)
ACCESS: gather info
ADVISE: specific personalized options
AGREE: collaboratively select goals
ASSISST: provide info, teach, problem solve barriers
ARRANGE: specific plans for follow up
*all steps integrated to personal plan for pt.
Structure for initial consultation appt linked with the 5 A’s
1) intro of beh health consultation service (1-2 mins)
2) identifying/clarifying consultations probs (1 min)
3) conducting functional assessment of prob (12-15 min)
4) summarizing your understanding of problem (1–2 mins)
5) listing possible change plan options (1-2 mins)
6) charting a change plan (3-10 mins)
