Outcomes Focused Conversations

Every interaction is an intervention. Evidence shows the value of supportive relationships in human services, and that conversations about what matters are important in their own right. There are times when a quick response to a crisis is necessary. But mostly, conversations which support people to reflect on their situation, form and voice their views and consider ways forward can build confidence, restore identity and improve wellbeing. This also results in better decisions.

From a practitioner perspective, being outcomes focused can involve a move from ‘fixer’ to ‘facilitator.’ The exchange model of engagement supports the shift from a hierarchical Q and A approach to valuing the person’s perspective as essential, blending it with the views of key others to support effective decision-making. Collaboratively defining outcomes also provides a clear shared purpose.

The Exchange model of assessment, originally developed by Smale et al, adapted by Miller and Barrie 2015

This video supports thinking about how to identify outcomes with people who can’t verbalise their outcomes.

Colleagues in Wales have worked with us for years exchanging learning to embed outcomes in practice in each country. In this video, Rhoda Emlyn Jones provides a helpful overview of collaborative conversations. Below that we include diverse resources for outcome focused conversations. No one prescriptive tool is sufficient. It is helpful to draw on a range of resources to support a ‘way of being’ that is outcome focused.

Outcomes & Co: Conversation Openers

Developed by Iriss supports conversations about outcomes with colleagues

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 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.

Our resource based on practitioner stories gathered during covid includes reflective questions in the final section to promote trauma informed discussions in organisations.

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 Outcomes Card Game is intended to help with that:

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. 

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 produced by Thistle Foundation is intended to support enabling conversations.

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 is a common thread.

Making Connections with Self Management

This report identifies similarities between engagement practices used within support for self management scenarios and a personal outcomes approach. It also describes development of context-specific outcomes prompts by a community nursing team.

Communication Support

With regard to specific communication supports, there is a wealth of materials online. Communication Forum Scotland is a good starting point.

Talking Mats for children and adults

While no one tool can support everyone, the low tech visual communication framework, Talking Mats, can support people with diverse communication needs to express their views.

Recent work in Scotland tested out Talking Mats as a tool for promoting rights based participation for children. This Scottish Government funded project explored the use of Talking Mats in three different service contexts for children.Under Article 12 of UNCRC every child has the right to give their views in matters affecting them. That view should be listened to by those who can influence and bring about the change required to maximise wellbeing: can-scotland-be-brave?

Earlier we worked with the Talking Mats team to develop symbols for Talking Points. Our report captured the learning from practitioner training in Talking Mats, and the testing of the framework in support of discussions about personal outcomes with individuals with communication support needs.

Communicating with People with Dementia

Supporting people following a diagnosis of dementia

NHS Education Scotland and the Scottish Social Services Council produced resources for working with people with dementia following diagnosis. This guide includes a strong focus on personal outcomes.

Work with My Home Life on personal outcomes in care homes

My Home Life Scotland produced a briefing sheet on their work on personal outcomes in care homes.