Risk, Uncertainty & Problem Solving Flashcards
What are the aims of a GP consultation?
Initiating session; Gathering information; Providing structure; Building relationship; Explanation and planning; Closing the session
Name a model used in consultation.
Calgary Cambridge Model
What are the tasks of a consultation purely from a doctor’s perspective according to Neighbour?
Connect with patient;
Summarise and verbally check that reasons for attendance are clear;
Hand over and bring consultation to a close;
Ensure that a safety net exists in that no serious possibilities have been missed;
Deal with housekeeping of recovery and reflection.
What is the difference between Neighbour’s model and the Calgary-Cambridge model?
Neighbour’s model starts to include concepts of risk management - minimise the chance of future problems.
CC model is more like a systematic enquiry.
Define risk.
Chance of (bad) consequences, loss, etc. Implies chance - perhaps can be quantified.
Define uncertainty.
State of being not completely confident or sure of something.
Explain individualised care for patients.
Must take into account their health beliefs, educational, social, cultural and economic backgrounds.
Advice and path of treatments will differ for everyone depending on the individual they are.
This minimises risk and uncertainty.
How does resilience come into general practice consultations?
Personal growth and control often result from getting through uncertainty.
There is evidence that medical graduates do not feel prepared for certain situations including dealing with error and safety incidents and lack an understanding of how the clinical environment works.
What is stress?
Imbalance between demands and resources, tends to occur when pressure exceeds one’s perceived ability to cope.
It is important to have strategies to deal with stress.
What can be the result of lack of skills for dealing with uncertainty?
Can lead to burn out and depression.
Describe safety netting.
Critical for minimising risk. If uncertainty remains, this should be conveyed to the patient.
They must know what to look out for and how exactly to seek help and for what clinical features.
Arrange follow up face-face or by phone.
What guidance is available that might help in dealing with risk and uncertainty
National Local Immediate Colleagues Peer group Reflection
Where can national guidelines be found?
SIGN and NICE. They provide peer reviewed guidance for specific conditions.
When is local guidance useful?
When there is clinical uncertainty about which step to take next or who to refer to.
e.g. Scottish referral guidelines for suspected cancer
What is immediate guidance useful for?
This is critically helpful in the management of an acute condition which you may be slightly unfamiliar with.
A protocol to follow is very helpful in highly stressful situations.
