Report & Feedback from the Swansea bay / CTM workshop:

 Serious illness conversations and PAC-planning.

 

Princess of Wales Multiprofessional education centre, 28th June 2019

Format

The day was supported by WG End of life board funding – as applied for by the welsh managed paediatric palliative care network. A team of SB/CTM professionals devised the content for the day, based on the ABMU 2018 format. The team included a palliative care consultant, 2 x general paediatrician with interest in PPC and 2 CNS pall care.

 

15 facilitators, pulled from paediatric palliative care within SB, CTM and managed clinical network / Paediatric consultants from SB/ Hospice and Clinical nurse specialists in paediatric palliative care, supported on the day. Administration and registration was supported by Amanda Young ( ty Hafan).

 

Outside speakers :    

  • Dr Alan Wardaugh Cardiff Critical care

  • Mr Alun Davies & Mrs Geralyn Meehan ( parents)

  • Rhiannon Thomas (WAS)

  • Mike Tobin ( SNOD)

  • With assistance from Mark Jermin management for actors.

 

The day was held in POW postgraduate centre on the POW campus: Utilising the lecture theatre and 6 additional break out rooms.  A total of  74 people attended, 44 delegates booked + 28 additional faciitators / speakers / actors

 

 

Delegates by professional group

 

 

DOCTORS (17)

- 8 senior paediatricians

- 9 Trainees (1 neonatal) from FP2 to ST8

 

NURSING (23)

- 5 ward / acute areas

- 4 specialist (including 2 nurse educators)

- 1 Neonatal

-  3 Community team 

-  10 Students

 

AHP (4)

1 Physio

1 Play therapists

1 Specialist HV

1 ward clerk

 

 

Delegates were asked to rate the following on a scale of 1 (disappointing) to 5 ( exceptional):

• Day overall – 100% thought it was very good (26%) or excellent (74%).

 

• PAC plan plenary- 100% thought it was very good (31%) or excellent (69%) :

 

• Small group pac-plan work: 100% thought it was very good (39%) or excellent (61%)

 

• ‘This is the end’ Lecture 100 % thought it was very good (28%) or excellent (72%)

 

• The afternoon communication skills groups:

                   94% thought it was very good (29%) or excellent (65%) :

                    2 (6%) felt it was disappointing.

 

2 commented  that they would have preferred to see examples of excellent communication in the form of videos or scenarios.

• Session on Parent’s personal views: 100% thought it was very good (13%) or excellent (87%)

100% of respondents felt the facilitators were friendly, knowledgeable & professional.  

 

96%  (24/25) indicated that they would be interested in a bundle of teaching materials developed to support small group teaching on PAC planning / difficult conversations.

 

 100% (26/26) indicated that they would recommend this workshop to a friend?   Reasons why included:- 

 " Awareness of PACs make them more likely to succeed”, “ Very useful, learnt a lot”, “ explored various issues needing advanced care planning” “ It is a good opportunity to learn and strengthen your key skills”,“friendly opportunity to learn some generic skills in communication, useful in everyday work”,“ Crucial skills”, “developing communication skills”, “very informative”, “ Parents perspective was excellent”, Enjoyed the panel of professionals and the difficult conversations role play with actors”, “ Interactive sessions, useful feedbackand advice”. Very beneficial to our training / role as nurses”, “Because doctors and staff should be moreknowledgable on discussions and PAC plans”, “ Very informative day”, “ Really important for us to get this right and not be scared of difficult conversations”. “ very interesting day, learnt a lot about handling difficult situations”,” To improve communication skills”, “ Very informative, highlights the importance of effective communication, “very helpful & informative”, “ Better understanding of PAC planning”, “ Very informative”, “ Informative, very useful”.

 

 When asked “Was there anything you hoped we would cover, that was not included today?

2 delegates answered yes:

- Bereavement, involving siblings, supporting family unit.

- some communication tools that we could use

 When asked: “What did you find the most useful part of the day?”  The key themes emerging were :

- communication sessions / workshops/ actors – (16 mentions, with 10 highlighting work with actors and 5 mentioning the opportunity to learn by watching others)

- parent views (8 mentions)

 - learning about the Pac plan, Panel this morning, hearing from police and ambulance, expectation of own department. (5 mentions

- Is this the end talk about PICU ( 4 mentions)

- whole day (3 mentions)

- Discussions in small groups – (2 mentions)

The take home messages ( as expressed by delegates) were:-

- Show parents how much you value them by careful listening

- Be more careful at paying attention to cues.

-Knowing what a pac plan is and how it empowers care for patients.

- Be honest and don’t be afraid to ask questions.

- Parents views are very important

- Be open and honest . Give time.

-Pac plan  is about the discussion, not just a tick box exercise.

- Respect the wishes of patient and family.

-Pac plans are vital to prepare parents / children.

- To encourage conversations and not be afraid to have them.

- Communication is key in delivering quality care.

- Not to judge people. Always make sure parents understand what is going on.

- Communication & Multidisciplinary team working.

- Parents views

-Give families time and don’t be afraid to ask questions.

- Listen to the family and ask open questions.

- To be less judgemental

- That planning and effective communication is vital.

- Not legally binding, open honest relationship between child, family & professionals.

- How people are predominantly kind, good, helpful.

 

Additional comments and suggestions:-

- Information sessions to highlight PACS in the workplace, lasting ½ - 1hr sessions would be great 

- consider longer communication scenarios but paired up, eg Dr & nurse

- Thankyou . Good food.

- Lunch fab.

- Thankyou

- Hoping to work in palliative care in the future as a student nurse I found this workshop excellent. Wish all the students at the university were able to take part in a workshop like this. Brilliant experience! Best workshop I have attended!

- It was useful to gain different perspectives from a variety of health professionals and parents . Good way to highlight available support.

- Excellent, facilitators were fab. Food could be better.

- Regarding communication, I feel I would have benefitted more if I had witnessed the ‘correct’ way to deal with the situations, e.g like a video.

- Brief intro at start of pac plan group to say who we all were. A chance to mix up groups Drs & nurse.

- I found the communication skills groups less educational than hoped. Videos of how different specialities and professionals would deal with situations would probably be more beneficial.

- Good opportunity to reflect on past experiences.

- Would have liked communication stations to have been longer – 10 minutes seemed too short to really get into it and receive feedback.