Remote consulations Flashcards
what is a consultation
Is a meeting to discuss something or get advice with the goal of discovering the best course of action to take.
What are the 4 technological barriers to remote consultation
- Poor digital literacy
- Technology malfunctioning
- Tiring
- multitasking with computer
What are practical challenges to remote consultations
- Your environment (background may be distracting)
- Other person in the call i.e carer
- Information governance
- Filming or recording consultation without consent
- Confidentiality, hard to manage remotely
- Preference, patient may prefer face to face
Emotional barriers to remote consultations
- Patient may feel hesitant about RC if not familiar
- Patient may be frustrated or annoyed because can’t get face to face.
- Harder to manage Pt emotions over RC
- Pt may feel apprehensive appearing on video
Interpersonal barriers to RC
- Less non verbal cues, audio lag, sound overlap
- Challenging to show empathy
- End of consultation is not always clear online or on the phone
- Patient may have pre-existing challenges i.e hearing aid or lip reading
- Exacerbation of language barriers or accents
What is the CONSULT model
It is a model designed to support remote consultations
What does C standard for in CONSULT
Consider
- the type of RC (phone or video)
- Decide whether the consultation should be remote or not i.e patient with dementia, learning disability
- Can use GMC remote consultation flowchart to decide whether appropriate
What does O stand for in CONSULT
Organise
- Check technology is in place, everyone has the equipment necesssary
- Organised a safe/suitable place to conduct RC
What does N stand for in CONSULT
Necessary
- Ensuring all necessary information is to hand i.e patient records and access to records
- Check background is appropriate
- Pt phone number incase video call doesn’t work
What does S stand for in CONSULT
START
- Intiate consultation effectively
- Introduce yourself
- Ensure patient can see and hear you
- Check whether the patient is alone?
- explain that you be talking notes
- how you willl manage interruptions
What does U stand for in CONSULT
Undertake
- Work through the consultation
- establish the other persons agender
- gather/share information
- Formulating a plan
-USE tools such as ICE
What does L stand for in CONSULT
Listen
- Consider the patient’s needs and agree next steps
- Used shared decision making
- Agree on how you will share any further information
- Make written records
What does T stand for in CONSULT
Terminate
- Close consultation appropriately
- Summarise
- Safety net, and how to indentify red flags and who to contact
- Discuss next steps
- Be last person to leave
-Write documentation
What acronym is used to guide you through a patient displaying anger
PACE
What does P stand for in PACE
probe
- Gain attention or raise a concern
- discover what the issue is, “I can hear you are upset, please let me understand what’s wrong”
What does A stand for in PACE
Alert — try to progress if the patient is shouting, “I need you to stop so we can work this out together
What does C stand for in PACE
Challenge — state the terms of the consultation, “If you aren’t going to stop shouting, I will have to end this call and we can speak again later”;
What does E stand for in PACE
Escalate — following through on your statement, “I am now going to end this call to allow you to pause and we can resume later or reschedule for a later date”
