Interprofessional Patient Conference Worksheet Purpose of Conference: Before the team meets (completed by each professional) Review the case Identify potential concerns of the patient/family Identify information or research required for your profession Identify potential priorities for your profession in the case conference
Profession-specific priorities:
Notes:
1. 2. 3.
Preparation for interview (discussed prior to the patient’s arrival) Set priorities to address in interview: Discuss identified priorities of each team member Negotiate 1-4 team priority issues to address in the conference Identify key team members for each priority
Priority #1
Priority #2
Priority #3
Priority #4
Names:
Names:
Names:
Names:
Clarify meeting processes: **Identify appropriate team roles required for each team member, in order to facilitate team process. **Not all roles may be employed in every meeting; however, assign roles to ensure that those process duties are filled when they are required. **All team members occupy both a team role, to contribute to team process, and a professional role.
Initiator: guides goal setting and facilitates meeting progress
Recorder: records the proceedings, provides notes to patient/family
Timekeeper: ensures that the team is on track and the meeting ends on time
Advocate: advocates for perspectives that are not heard, including the patient’s
Name:
Name:
Name:
Process Observer: comments on methods to enhance group process
Energizer: encourages and supports team members, where required
Participant: supports team members in their roles, where required
Name: Participant: supports team members in their roles, where required
Name:
Name:
Name:
Name: