Realistic Medicine Flashcards
What are the six topics of Realistic Medicine (2015)?
Build a personalised approach to care
Change our style to shared decision-making
Reduce unnecessary variation in practice and outcomes
Reduce harm and waste
Manage risk better
Become improvers and innovators
What is a citizens panal?
A Citizens’ Panel is a large, demographically representative group of citizens regularly used to assess public preferences and opinions.
The Our Voice Citizens’ Panel has 1,258 Panel members from across all 32 Local Authority areas in Scotland. They performed a survey in 2017. What were their findings?
A good consultation:
What makes a ‘good doctor’?
Knowledge/qualifications
Good listener
Friendly
Approachable
What are the most important elements of a ‘good consultation’ with a doctor?
Feeling listened to/not rushed
Clear communication
Resolution/diagnosis/outcome
Making decisions together:
How comfortable are you asking a doctor…
… what are my treatment options? (92% feel comfortable)
… what are the risks/benefits of treatment options? (91% feel comfortable)
… how likely are these to happen to me? (87% feel comfortable)
With increasing quality of evidence, what have we been able to produce?
What are guidelines based on?
However what is the pitfall of these guidelines?
Guidelines
These are often based on the scenario of a patient having a single disease.
They are a very helpful starting point, but in the modern world, where patients often suffer multimorbidity, the use of single disease guidelines may need to be reappraised.
Who have been the driving force to monitoring quality of work?
For example, the Scottish Intensive Care Society Audit Group system, what is this?
For several years, doctors have been the driving force behind quality monitoring work
A system that is now being used to inform and design ways that routine data like these can be used to design routine quality monitoring and improvement systems across the country.
What do surgeons do?
Surgeons and other clinicians have participated in the thousands of surgical safety “pauses” that take place across the country every week – collectively contributing to reductions in surgical mortality.
What did the results show from Our Voice Citizens’ with how people would feel about decision making?
Why was this and what does it suggest?
The results showed that while 92% of people said they would feel comfortable asking their doctor about their treatment and care options, only 67% had actually spoken to their doctor about them.
When asked to expand on their answers, a number of people commented that the attitude of their doctor had an impact on their inclination to ask questions. This would suggest that taking the time to listen and have a truly shared conversation is invaluable.
Choosing Wisely UK devised 5 Questions to help prompt better conversations between clinicians and patients, what were these?
Asking the right question matters:
To help ensure you have all the information you need to make the right decisions about your care, please ask your doctor or nurse:
- Is this test, treatment or procedure really needed?
- What are the potential benefits and risks?
- What are the possible side effects?
- Are there simpler, safer or alternative treatment options?
- What would happen if I did nothing?
Following on from the Citizens Panel what do patients desire?
Looking back to the Citizens Panel report earlier, patients (people) desire a friendly, knowledgeable doctor who is able to communicate accurate information well and with whom they are comfortable sharing decision making.
