Outcomes Focused Conversations
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 jump in and ‘fix’ people. There are times when a quick response to a crisis is necessary. But more often, conversations which allow people to reflect on their situation and possible ways forward can build confidence, restore identity and improve wellbeing. Being outcomes focused can involve a shift from being a ‘fixer’ to a ‘facilitator.’
Our colleagues in Wales have worked with us for several years now embedding outcomes in practice across both countries. In this video, Rhoda Emlyn Jones provides a very helpful overview of what is called a collaborative approach to conversations.
In 2011 we worked with colleagues in several settings to develop examples of outcomes focused conversations, captured in a brief guide to outcomes focused conversations
Shifts in Thinking: From Outputs to Outcomes
A key challenge in embedding outcomes is supporting the shift from outputs (services) to outcomes (intended impact). The following resources are intended to help with that.
The Cake Slide
Several resources have been built around the cake slide, which includes inputs, processes, outputs and outcomes. The slide was developed many years ago by North Lincolnshire Council. It has been widely used in Scotland and is intended to keep the focus on the purpose of activity.
Outcomes Card Game
At our November 2019 meeting we resurrected the outcomes card game which was developed by North Lanarkshire Council and the Joint Improvement Team. Built around the cake slide, it is a fun way to promote discussion and thinking about what an outcome is. POA Cards and Facilitator notes – Cards Exercise
The Conversation Prompt
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
Shifts in Thinking: From Deficits to Strengths
A further challenge is that the system has focused on identifying deficits and matching deficits to services. 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 health 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 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.
You can find further relevant resources on our Communicating with people with dementia page