Breaking Bad News - THE SPIKES MODEL

S = 	Setting up the interview
•	Prepare yourself: familiarise with pts background, medical info and anticipate some likely questions
•	Environment: arrange for privacy, minimise interruptions and time-constraints
•	Establish a connection with the pt, involve pts family, nurses etc

P = 	Assessing the patients perceptions
•	How much do they know?
•	Correct any errors or gaps in pts knowledge

I = Obtaining the pts invitation
•	How much does the pt want to know?
•	Little detail/too much detail?

K = 	Giving knowledge and information to the pt
•	Warning shot
•	Clear and simple information, BUT avoid excessive bluntness
•	Avoid jargon
•	Check understanding

E = 	Addressing the pts emotions
•	Give time to express feelings
•	Observe and acknowledge emotions
•	Show empathy
•	Encourage questions and allow time

S = 	Strategy and summary
•	Clear plans
•	Offer follow-up support