Outcomes Focused Conversations
The first element of a personal outcomes approach is engagement. Getting to the outcomes involves a shift from the use of tick box tools to having conversations with people to achieve a shared understanding about their priorities. Although it is not always possible to achieve everything that matters to people, conversations about what matters are important in their own right. Active listening is an under-rated skill which requires an open mind, concentration and resisting the natural tendency to always jump in and ‘fix’ people. There are times when an instant response to a crisis is necessary. But more often, facilitating conversations which allow people to reflect on their situation and possible ways forward can build confidence, restore identity and improve wellbeing.
In 2011 we worked with colleagues in several settings to develop illustrative examples of outcomes focused conversations, which were captured in a brief guide to outcomes focused conversations (MS Word: 947kb).
Shifts in Thinking: From Outputs to Outcomes
The biggest challenge is supporting the shift from outputs (or services) to outcomes (clarity of purpose or intended impact). To support this, East Renfrewshire CHCP produced a prompt card, illustrating a conversation structured around the outcomes important to people. Other organisations have adapted this for local use:
- Talking Points Card (PDF: 213kb)
Shifts in Thinking: From Deficits to Strengths
A further challenge is that the system has focussed on identifying deficits and matching the deficits to services. We have worked with the Scottish Recovery Network and Thistle Foundation, to blend solutions focused approaches with an outcomes approach. The attached guide provides examples of techniques to support enabling conversations.
- Constructing Good Conversations which Support an Outcomes Approach (MS Word: 830kb)
Conversations in Healthcare Settings
From 2012 to 2013, the Personal Outcomes and Quality Measures project considered possibilities and challenges of a personal outcomes approach in NHS settings.
Broadening the Conversation: The second project report draws on practice examples to illustrate personal outcomes in healthcare scenarios. The value of supportive relationships developed through outcomes focussed conversations emerges as a common thread .
Making Connections with Self Management: The third project report identifies similarities between the engagement practices used within support for self management scenarios and a personal outcomes approach. It also describes development and application of context-specific outcomes prompts in the language used by a community nursing team
Work has been carried out with practitioners and people using services to broden our understanding of ‘conversation’ and to develop resources to include people with communication support needs.
With regard to specific communication supports, there is a wealth of materials online and Communication Forum Scotland can be a good starting point. While no one tool can support communication with everyone, the low tech visual communication framework, Talking Mats, can be a powerful tool in helping people with a range of communication difficulties express their views. We worked with the Talking Mats team from Stirling Dementia Services Centre to develop symbols for Talking Points.
- Talking Mats and Talking Points Report (PDF: 725kb)
You can find further relevant resources on our Communicating with people with dementia page