Better consultation skills

There are various ways you can approach a consultation as a health coach:

A. Rapport

• Set the scene and build rapport. Listen and acknowledge the patient's agenda without interruption and agree a shared agenda for the consultation. Demonstrate respect for the patient's perceptions at all times
• Communicate positively and use appropriate language throughout the consultation, adapting your communication and consultation skills to the individual patient
• Discuss and share information in an open, honest and non-discriminatory way
• Understand that patient behaviour, values and attitudes vary with age, gender, ethnicity and social background.

B. Listen

• Actively listen and focus on the patient's words and their non-verbal behaviour without interrupting. It is important to use questioning techniques that reflect active listening so that you can gather information
• Check for understanding at different points of the consultation and allow the patient time and space to reflect
• Negotiate a shared understanding of the patient's issue and its management. Empower the patient to take control of his or her health. It is essential to respect the patient's reasons for any likely non-adherence to their management plan in a non-judgmental way
• Manage the patient's concerns and emotions in a sensitive manner
• Manage the tools you use to facilitate the consultation in an effective and efficient manner that does not detract focus from the patient.

C. Understand

• Explore the patient's attitude towards their medicines and appreciate their values, expectations and beliefs
• Encourage and provide on-going support for new behaviours and actions in the patient, even if they involve taking risks and a fear of failure
• Identify the extent to which family, friends, carers and other healthcare professionals are involved in decisions pertinent to the patients' health while respecting their right to confidentiality
• Appreciate that a patient's perspectives can change throughout a long-term medical condition. It is important to acknowledge that patients make their own choices on the basis of their own values and not just on clinical evidence
• Close the consultation in an effective manner, making sure that the patient has enough information, providing further explanation where needed and offering the opportunity to ask further questions and summarising and agreeing the plan for their medicines and ongoing care.

Take the right approach

The key to any successful consultation with a patient is how you approach it €“ that is, the 'internal state' that you adopt. Most of us have good days and bad days. Some mornings you may feel really motivated and everything flows perfectly for the rest of the day.

At other times, you might feel a little low and for some reason nothing goes to plan. The state that you find yourself in at any point of the day can influence your behaviour and outcomes. Pharmacy professionals should be acutely aware of and limit self-talk throughout a consultation.

Try not to impose your view where it is not necessary. You may not agree with a patient's view or hold negative beliefs, but it is essential to respect the patient's model of the world. This is the basis of a successful pharmacy consultation.

References and further reading

1. Krug S. 2011. The Empowered Patient, Pharmaceutical Executive. Vol 31, 4, 20-20, 22
2. Greenhill N, Anderson C, Avery A, Pilnick A. 2011. Analysis of pharmacist-patient communication using the Calgary Cambridge guide. Patient Education and Counseling. Vol 83, 3, 423-431
3. CPPE. Consultation Skills for Pharmacy Practice. Resources are available online.
    

The next step is to put these ideas into action. Finish by recording your learning outcomes.