Step What you do

1. Setting

Find a quiet location, private if possible

Invite the important people to be present

Have tissues available

Have enough chairs

Turn off the ringer on your phone/pager

2. Perception – what the patient knows already

“Tell me what you understand about your illness.”

“What have the other doctors told you about your illness?”

Look for knowledge and emotional information while the patient responds

3. Invitation – information sharing preferences

“Would it be okay for me to discuss the results of your tests with you now?”

“How do you prefer to discuss medical information in your family?”

“Some people prefer a global picture of what is happening and others like all the details, what do you prefer?”

4. Knowledge – give the information

Give a warning… “I have something serious we need to discuss”
Avoid medical jargon.

Say it simply and stop. (e.g.“Your cancer has spread to your liver. It is getting worse despite our treatments.”)

5. Empathy – respond to emotion

Wait quietly for the patient.

“I know this is not what you expected to hear today.” “This is very difficult news.”

6. Summary – discuss next steps and follow up plan

“We’ve talked about a lot of things today, can you please tell me what you understand.”

“Let’s set up a follow-up appointment.”

Copyright VitalTalk 2017