Acute Medicine | Palliative care | Agreeing a plan of management and care

Agreeing a plan of management and care
Session overview
Description
Once the patient's symptoms have been assessed a working diagnosis can be made. The clinician can then propose a plan for improving symptoms, discussing any advantages, disadvantages and practicalities with the patient.

This session examines some of the different factors involved in agreeing a plan of management and care.

This session was reviewed by Richard Kitchen and last updated in May 2021.

Learning objectives
By the end of this session you will be able to:

• identify some of the responsibilities of the clinician in proposing a plan of management
• recognise the advantages of informed and collaborative decision-making between the clinician and the patient
• describe the role of family members in agreeing the plan of management and care
• give examples of situations in which it may not be appropriate to involve the patient in agreeing a management plan
• state some of the reasons why a patient facing the end of life may refuse or withdraw from the plan

Prerequisites

• Before commencing this session you should complete:
• General approach to assessment of symptoms (215-0401)

The session - Symptom management/General Approach to the Assessment of Symptoms - showed how diagnosing (identifying) a condition from its symptoms involves careful questioning, examination and relevant investigations.

Having a working diagnosis allows the patient to put a name to their condition, and may give them an explanation for the symptoms they have experienced. This may come as a relief for the patient, but they may also feel anxious, scared or uncertain about what will happen next and what can be done about their condition or symptoms. A plan of management is needed in order to act on symptoms to improve or reverse them.

This session explains some of the responsibilities of the clinician in providing this information, including establishing whether or not the patient wishes to hear such information, and how involved the patient wishes to be in the decision-making process.