So, that's preparation for the meeting
and then, you know, you're going to actually,
you know, have the meeting, start the meeting.
It's important for everyone to introduce themselves.
So, everybody that's in the room that's participating
in the meeting should say who they are,
how they are connected to the patient,
if it's family members, saying what the relationship is.
If it's team members saying
what their role on the team is.
It's always important for whoever's leading the meeting or,
you know, the other supporting members of the team
to set a tone that is non-threatening, show that they
appreciate everyone for participating in the meeting,
for coming to the meeting and really try to be,
you know, friendly and cordial in starting the meeting.
You want to, whoever the lead person is going to be, to explain the agenda
of the meeting, see if that requires modification.
So, as I said, the pre-meeting from the healthcare team,
they might have set certain agenda
or things that they want to accomplish
but you need to check in with the patient
and the family, are there other things that
need to be addressed during the meeting?
Is there something going on
clinically with the patient
that you need to attend to first before
you can get to your meeting agenda?
So, there's always an opportunity for modification
of the agenda based on those initial interactions.
And then, it's also important, especially
if it's family members that you haven't met before,
you need to determine how
information is to be handled.
Is there going to be some amount of information
that some family members shouldn't hear?
Does the respect for patient mean that
they want to keep some information private?
So, you need to be clear, maybe that's happening
on a pre-meeting with the patient
or, you know, the family member that
you've been communicating with,
how you're going to handle information during the meeting.
You want to start with the patient perspective.
So, what does the patient or their family
member understand about what's going on?
So, the questions are really the ask-tell-ask framework
where you're asking them what they're understanding.
Why you're having the meeting, what's going on
clinically, what the treatment decisions need to be,
you know, what's their knowledge base
so that you can then fill in details, provide clarifications,
and then, go on to the rest of the agenda.
Part of, you know, setting the tone is setting expectations.
So, you want to, over the course of the meeting,
talk about what are the hopes of the patient,
what are their fears, you know, the patient and/or their family.
What do they view as important?
So, you want to do that both in the
ongoing discussion during the meeting
but also, at the outset of the reason
we're having this meeting is to find out
what's important to you as we
make treatment decisions.
It's always important to, you know,
check in with the team members
and make sure they're clear that we need to give adequate time
for the patient and/or their family to speak.
It shouldn't be a, you know,
monologue by team members.
It should be a dialogue between all
participants and making sure the patient
and their family have the opportunity
to share their viewpoint.
Periodically, over the course of the meeting, there
should be this, you know, throwing back to them
what questions do you have,
what more information do you need?
It shouldn't be, "Do you have questions, yes or no?"
But, "What questions do you have?"
That sort of, unconsciously, gives the viewpoint
of they should have questions.
They should be asking you and you want them to ask those.