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 consider possible ways forward can build confidence, restore identity and improve wellbeing. Being outcomes focused can involve moving 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

Being Trauma Informed

In the context of COVID-19 some of our members asked about resources to support trauma informed practice. Colleagues at NHS Education Scotland (NES) have produced animations designed to be relevant to all within the Scottish workforce. It supports workers to know how to adapt the way they work to make a positive difference to people affected by trauma and adversity: Trauma is everybody’s business.

John McCormack is a PON member who has shared resources to support self-management and recovery.  These can be useful in supporting staff wellbeing as well as people using services: Recovery wisdom.

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

Picture 1The cake slide includes inputs, processes, outputs and outcomes, developed years ago by North Lincolnshire Council.  It is widely used in Scotland and is intended to keep the focus on the purpose of activity, rather than the activity/resource.

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. 

The Conversation Prompt

storycloud2 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.  This guide is intended to support enabling conversations.

Communication Support

Work with practitioners and people using services has broadened our understanding of ‘conversation’ 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 is a good starting point. While no one tool can support communication with everyone, the low tech visual communication framework, Talking Mats, can support people with a range of communication difficulties to express their views. We worked with the Talking Mats team from Stirling Dementia Services Centre to develop symbols for Talking Points.

Further  resources are available on our Communicating with people with dementia page

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: This 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: This 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