Managing the patient using Stott and davies model

When managing a patient, it is important to consider the Stott and Davis model of consultation, which outlines four key areas to explore:

1. Manage presenting problem: The patient's main problem, their ideas, concerns, and expectations, and the physical, emotional, and social impact of the problem on the patient and their family.

2. Manage ongoing problem: Any ongoing problems that the patient has, such as chronic diseases or long-term health conditions.

3. Manage opportunistic health promotion: Opportunities to promote health and prevent disease, such as discussing lifestyle factors, screening for early detection of disease, and providing health education.

4. Modify help-seeking behavior: Helping the patient to understand and manage their own health, including encouraging self-care, promoting appropriate use of healthcare services, and providing coping strategies.

Steps 

1. Review the patient's agenda and presenting complaint: This will help you to understand the patient's main concern and what they hope to achieve from the consultation.

2. Review recent consultation documents: This will help you to identify any ongoing problems or issues that the patient has raised in previous consultations.

3. Review any unfiled documents and results: This will ensure that you are aware of all relevant information, including any recent test results or referrals.

4. Make sure actions are followed up: Review any outstanding actions from previous consultations and make sure that they have been followed up on.

5. Carry over past problems that need follow-up: Identify any past problems that require ongoing monitoring or management, and link them to the current consultation.

6. Review PMH and DH: Review the patient's past medical history and social history to identify any potential risk factors or areas of concern.

7. Review alerts: Review any alerts in the patient's medical record to identify any potential risks or issues.

8. Consider other opportunistic health promotion: Identify any opportunities to promote health and prevent disease, based on the patient's age, risk factors, and lifestyle.

9. Scan and screen for risk and tasks lost to follow-up: Look for any potential risks or issues that may not be immediately apparent, and identify any tasks that have been lost to follow-up.

10. Integrate relevant findings into assessment and plan: If any of the findings from the screening and scanning process are relevant to the current consultation, incorporate them into your assessment and plan.

11. Create a follow-up plan for non-urgent issues: If there are any issues that are not relevant to the current consultation and you do not have time to address them, create a follow-up plan and inform the patient.

12. Document all findings and actions: Document all of your findings, including the results of the screening and scanning process, as well as any actions taken or follow-up plans created.