SPIKES is a six-step protocol designed to guide healthcare professionals in delivering bad news to patients and their families. The acronym stands for:
- S – Setting Up the Interview:
- Ensure privacy, involve significant others, sit down, make connections, and manage time constraints and interruptions.
- P – Patient’s Perception:
- Understand the patient’s perspective and what they already know about their medical condition.
- I – Invitation:
- Gauge how much information the patient wants to know about their diagnosis and prognosis.
- K – Knowledge:
- Deliver the medical facts, avoiding medical jargon, and giving information in small chunks, followed by checks for understanding.
- E – Emotions with Empathic Responses:
- Observe for and identify emotions, then identify the reason for the emotion and show understanding, respect, and support.
- S – Strategy and Summary:
- Provide a summary of what has been discussed, and work together to develop a plan for the next steps.
This protocol is aimed at making the process of delivering difficult news as supportive and effective as possible, recognizing the emotional impact such news can have on patients and their loved ones.