Programme no. 511-WS
Professional Development
First aid consultation kit: five cards and a package
Jan-Helge Larsen*1, Charlotte Hedberg*2
1Kalymnos-kurser.dk,2900 Hellerup,Denmark;Kalymnos kurser,Kalymnos-kurser.dk,2900 Hellerup,Denmark, 2Department of general practice,Karolinska Instituttet,Stockholm,Sweden
* = Presenting author
Workshop
Objectives: To share our experiences of an easy way to identify, train and teach the essential dimensions of patient/personcentred care. We invite participants to test the presented consultation kit.
Background: Since 1980s a tradition regarding the patients’ ideas, concerns and expectations (ICE) has been developed within a patient-centred care framework. The aim has been to get the patients’ whole agenda in consultations. Currently, the outcome of patient-centred care is assessed in terms of clarifying and answering the patient’s questions, whether the patient get sufficient knowledge enabling her/him to make shared decisions.

Our point of departure is that ICE is a precondition for a shared understanding and shared decision-making. Our hypothesis is that patients who attend a doctor using the suggested first-aid-consultation-kit will assess the consultation afterwards as good.

Content: We present the consultation divided into three parts: the Patient´s, the Doctor´s and the Shared part. Five cards are used for the Patient part and a package for the Shared part.

While letting the patient tell his narrative, you will have to imagine you have got two cards:

  1. The receipt card. Of this card you can give as many as you can and the patient will feel listened to and stimulated to go on.
  2. Summary card. Every time you summarize what the patient has told you, he will listen to you. That gives you the opportunity to control the conversation and play one of the following cards.

The patient has got three ‘thought’ cards:

  1. The idea card. This card you must give at least one time.
  2. The concern card. Also this card you must give at least one time
  3. The expectation card. Give it at least one time, because it will clarify what you have to do in the consultation.

The Package focus on assuring that the doctor has:

I) Recognised the patient’s agenda regarding ideas, concerns and expectations understood as the patient’s questions

II) Answering the patient’s questions and presenting the doctor’s explanations or hypothesis according to her/his clinical reasoning

III) Checked shared understanding

IV) Made shared decision-making.

Method: We will give a short presentation, role-play ourselves and then ask participants to role-play in pairs of three. Some of the plays will be video-recorded and revised. Finally we will have a plenary discussion.
Other considerations: 30-40 participants (depending on facilities for small group work)

Reference: Larsen J-H, Neighbour R. Five Cards – a simple guide to beginning the consultation. Br J Gen Pract 2014; 64: 150-51.

Coulter A. Patient-centred care in Swedish Health system. Vårdanalys 2013.