PC 10 Step Management Plan

Question 1

Step 1

Answer 1

State the diagnosis

If diagnosis not possible, state/describe the symptoms/what is going on for the patient

Question 2

Step 2

Answer 2

Ask patient what their understanding of their diagnosis is, and if they know anything about it

Question 3

Step 3

Answer 3

Ask the patient to describe how they feel about the diagnosis, based on what they know

Question 4

Step 4

Answer 4

Acknowledge the patient’s understanding, and correct any incorrect beliefs
Address any fears / misconceptions / concerns

Supplement information given with hand-outs, diagrams, or using patent’s own test/investigation results (where appropriate)

Question 5

Step 5

Answer 5

Develop a clear, concise management plan, that includes the following management steps:

Immediate management (even if ‘immediate management’ is to do nothing)

Long-term management (i.e. for chronic, long-term or recurrent illnesses)

Preventative: What can be done to prevent worsening of condition / exacerbations of conditions / recurrence of condition

Encourage patient to participate in decision making regarding management. This increases compliance.

Question 6

Step 6

Answer 6

Explore other preventative opportunities:
E.g. Immunisation, screening status, pap smears

While I have you here, I might just check in on when you last had a few routine health checks done: when did you last have a pap smear? when was your last STI check? Have you ever had a bowel screen?

Question 7

Step 7

Answer 7

Reinforce the information given: the diagnosis, what it means, and the management that has beena agreed upon between the doctor and patient

Give hand-out of management plan

Question 8

Step 8

Answer 8

Provide take away information - include resources / help-lines etc.

Question 9

Step 9

Answer 9

Evaluate the consultation - encourage feedback

Ask patient: “have we sufficiently addressed everything you wanted to talk about?” “Do you have any further concerns or questions, before we finish our consultation” “Are you happy with the outcome we have come to, regarding you (e.g. COPD) today?”

Question 10

Step 10

Answer 10

Arrange follow-up

Provide CLEAR instructions on when follow-up will be necessary.

If follow-up isn’t necessary, this might be an opportunity to remind patient of any important screening tests / check-ups / immunisations they may need in the near future

Otherwise clearly state - I would like to see you again in 8 weeks time, to see how you’re going with the management of your hypertension. Then we can reassess your management and check that everything is going well… etc.