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  • Introduction
  • 1. Advance Care Planning
  • 2. Communicating Bad News
  • 3. Whole Patient Assessment
  • 4. Pain Management
  • 5. Assisted Suicide Debate
  • 6. Anxiety, Delirium
  • 7. Goals of Care
  • 8. Sudden Illness
  • 9. Medical Futility
  • 10. Common Symptoms
  • 11. Withholding Treatment
  • 12. Last Hours of Living
  • 13. Cultural Issues
  • 14. Religion, Spirituality
  • 15. Legal Issues
  • 16. Social and Psychological
  • More About:

  • Hospice Care
  • Clergy and Faith Communities
  • Additional Links
    Site Index
    Back to Module 2: Communicating Bad News
    A Six Step Protocol

    Step 6. Planning, Follow-up... Using the Six Step Protocol in Other Situations

    Step 6. Planning, Follow-up...

    Establish a Plan

    Establish a plan for the next steps, which may include:

    • Gathering additional information
    • Performing further tests
    • Treating current symptoms
    • Helping parents to tell their child about their illness and what treatment will be like for them.
    • Arranging for appropriate referrals
    • Explaining plans for additional treatment

    Assess Support

    Discuss potential sources of emotional and practical support, including:

    • Family
    • Significant others
    • Friends
    • Social worker
    • Spiritual counselor
    • Peer support group
    • Professional therapist
    • Hospice
    • Home health agency
    • Sources of support for an ill child’s siblings

    Provide Reassurance

    • Reassure the patient and family that they are not being abandoned
    • Emphasize that the physician will be actively engaged in an ongoing plan to help
    • Indicate how the patient and family can reach the physician to answer additional questions
    • Establish a time for a follow-up appointment

    Ensure Patient Safety

    In order to ensure that the patient will be safe when he or she leaves, ask yourself...

    • Is the patient able to drive home alone?
    • Is the patient distraught, feeling desperate or suicidal?
    • Is there someone at home to provide support?

    Future Visits

    • At future visits, elements of this protocol may need to be revisited
    • Many patients and families require repetition of the news to gain a complete understanding of their situation
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