Report & Feedback from the Swansea bay / CTM workshop:
Serious illness conversations and PAC-planning.
Princess of Wales Multiprofessional education centre, 28th June 2019
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
- 8 senior paediatricians
- 9 Trainees (1 neonatal) from FP2 to ST8
- 5 ward / acute areas
- 4 specialist (including 2 nurse educators)
- 1 Neonatal
- 3 Community team
- 10 Students
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.
- 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.