Establishing a contingency plan with your patient in case their disease course does not go as planned is important for patient safety and the maintenance of a fruitful doctor-patient relationship.

Safety-Netting involves explaining to your patient:

1. Possible unlikely but possible outcomes
   1. ‘There is a small chance your chest pain may be due to your heart, things to look out for would be…’
2. What certain developments might mean
   1. ‘If you start getting a fever, or the redness on your arm is getting larger, this might mean the infection is spreading…”
3. What to do if management plan isn’t working
   1. ‘I suspect you have a viral infection, but if it’s not better in X days/weeks, please come back to see me’
4. When and how to seek help (return precautions)
   1. ‘Please come back if your baby seems lethargic, isn’t feeding enough, etc…’
5. How the patient can contact you

Exercise: What discharge instructions (safety-netting) might you give to patients with the following chief complaints:

• Chest pain
• Syncope
• Calf pain
• Shortness of breath
• Flank pain, likely Renal colic

Silverman, J., Kurtz, S., & Draper, J. (2013). Skills for Communicating with Patients (Thrid Edit). London: Radcliffe Publishing.