This document discusses best practices for breaking bad news to patients. It recommends using the SPIKES model, which involves six steps: 1) setting by ensuring privacy and comfort, 2) assessing the patient's perception, 3) inviting questions, 4) providing knowledge of the medical situation, 5) addressing emotions, and 6) creating a strategy and summary. The goal is to communicate information clearly and support the patient's emotional response, while building trust so patients will "never forget us."

1. by
Salwa M. Elwasif, MD.
Communication Skills:
Breaking Bad News

2. YOU ARE US

5. “If we do it badly, the patients or family
members may never forgive us; if we do it well,
they may never forget us.”
(Buckman, 1992)
The task of breaking bad news

6. ‫تجارة‬
‫الناس‬ ‫مع‬
Patient
satisfaction
Self
satisfaction
‫هللا‬ ‫مع‬

7. Information that negatively alters the
patient’s view of the future
(Buckman, 1992)
What is bad news?

8. • Situations where there is a feeling either no
hope or the choices convey patient life
• Not welcomed
• Not comfortable

10. “Nothing travels faster than the speed of light
with the possible exception of bad news, which
obeys its own special laws.”
Douglas Adams
Quote

11. Quote
The bad news is that only the bad people reach
the news because they are noisier.
Javier Bardem
https://www.brainyquote.com/quotes/quotes/j/javierbard458964.html

17. • Setting
• Perception
• Invitation
• Knowledge
• Emotions
• Strategy & Summary
SPIKES MODEL: THE SIX STEPS

18. • Provide privacy
• Introduce self
• Determine who else should be present
• Ensure no interruptions
• Provide comfortable space
• Create welcoming environment
Setting the environment

19. • Prepare before speaking
• Ask about patient’s perception of what is
going on
Perception

20. Ask questions to invite the patient into conversation
Ask how much information the patient wants to
hear
Invitation

21. Deliver the message
Use plain language
Be mindful of body language
Get to the point
Give information in small chunks
Pause
Wait for reaction, Use “teach back”
Knowledge

22. Be prepared for patient’s and family’s
emotional response
Anticipate fear, anger, sadness, denial, guilt
Be mindful of your own response
Comfort the patient
Emotions

25. • Assess patients readiness for planning
• Negotiate next steps
• Acknowledge and answer questions
Summarize plan
• Use “teach back” technique
• Follow up.
Strategy and summery

30. • Medical term
• Probably
• May be
• Language barrier
• Mask face
• Patient own
language
• Clear words
• Body language
Not clear Clear
ENSURE PATIENT ID

33. Thank you