Visit to Changsha, China

Prof Gerry Humphris and Dr Yuefang Zhou visit Changsha 8th – 11th January to support the Chinese Medical Board-Intensive Care Unit Project: The effects of family-clinician shared decision making model on patient-centred care in advanced critical illness: Multi-centred cluster randomised control trial: Kick-off Meeting and Training the Trainers Workshop: Changsha, China.

A research grant from CMB was successfully secured in the middle of last year (2015) for a 4 year study using a cluster-randomised clinical trial with severely ill intensive care unit families as the focus.  The study was designed to test a new psychosocial pragmatic intervention.  The basis of the intervention was to encourage staff to develop their skills in using shared decisions with the patient’s family members.  The changes in staff approach and care delivery that this intervention demands was deliberately encouraged though the design of a single day workshop in Changsha, China.

IMGP0300

The day started with the signing of the research agreement and continued with the training event.

The Workshop was run by Dr Angela Liu with Prof Gerry Humphris and Dr Yuefang Zhou in attendance from St Andrews University on 8th January 2016 at the Jasmine International Hotel Conference centre in Changsha, China.  The study was constructed to test a new family based decision making intervention for ICUs.  The aim of the intervention was to increase satisfaction by families of the process of care provided and eventual outcome of how their seriously (terminally) ill relative was treated.

The local research co-PIs and Participants were present including staff from the various ICUs to exchange experiences on the two Pilot Studies (Control and Intervention arms).

Training session included 4 components:

(1) Warm up consisting of spotting communication skills in a video of a patient and doctor consultation on decision making.

(2) Role-play exercise of a relevant ICU scenario with doctor, relative and observer conducting a structured exercise.  Feedback system reviewed and applied.

(3) Role-play exercise with a different scenario but relevant to the ICU situation of managing a terminally ill patient.  Introduced a new component of Trainer to practice feedback in a constructive manner.

(4) A ‘Theatre’ event which consisted of a complex and engaging scenario played over 2 family planned meetings.  Three family members were present and also included two nurses, 1 junior and 1 senior doctor.  A moving and highly illustrative acting of the scenario was played out to demonstrate the intervention process.  This component was audio recorded and photographs taken.

Plenary discussions were held at key points during the day and lectures on the pilot study results, ethics and modern palliative care practice were given.  Excellent language translation was available to ensure good comprehension throughout the proceedings.  Photographic recording of key events during the day were performed to provide evidence of the work completed and a Workshop Dinner completed this opening day of the visit.

The proceedings were punctuated midway by the presentation to Prof Gerry Humphris of a Visiting Professorship to the Central South University of China.  The presentation was made by Professor Aijing Luo the General Secretary of the Party Committee of the 3rd Xiangya Hospital of the Central South University of China.

The following day (9th Jan) presentations by Prof Humphris and Dr Zhou were given to the Medical Faculty of the 3rdXiangya Hospital of Central South University on emotion expression in patient consultations, followed by a Round Table Discussion.

IMG_20160111_103701

A cultural visit to Orange Island was organised by the host (Dr Angela Lui) on 10th January where a monument to Chairman Mao had been constructed in the last decade.  The gardens and sights were appreciated even during wintry conditions.

The final day concluded the academic visit with introductions to Clinical Staff in the Clinical Skills Unit at the 3rdXiangya Hospital of Central South University and its Intensive Care Unit on the 19th Floor of the main Hospital Complex. A highlight of the trip was that Prof Humphris and Dr Zhou were able to observe the shared-decision making model applied in the Unit with a family consultation (husband, son and two sisters of a seriously ill patient) by the medical and nursing staff.

IMGP0187

contact: Prof Gerry Humphris