How can I make sure we have person-centred outcomes for people?
So often for people who have long-term conditions, outcomes may be imposed on them by the services supporting them.
They do not feel engaged with them and, more importantly, are often not motivated to achieve them. Ensuring that we support people to develop person-centred outcomes means that they are much more likely to achieve success.
Step 1 - Checking that we know what matters to people
Before we can think about outcomes, we need to make sure we know and have recorded what matters to the person. This means we can make sure that when we develop outcomes with the person, they will be meaningful to them. One way of capturing this is through a one-page profile.
Step 2 - Where are we now?
It is really important that we understand the person’s specific situation right now, comparing it with the life they have described in their one-page profile and truly understanding from their perspective what the issues are that they may want to address, rather than what we think they should address. One way of doing this is to use the person-centred thinking tool working/not working from different perspectives, including the health practitioner’s perspective. This can help to identify issues that the person wants to address, as well as issues that the health practitioner feels should be addressed.
Step 3 - Prioritising
Having identified the issues that the person would like to address, they can be prioritised by mutual agreement.
Step 4 - What would success look like?
For each of the issues the person has prioritised, we can start developing outcomes by identifying what success would look like if each of the issues were addressed successfully. This gives us the basis of the outcome.
Step 5 - Test it
There are some simple questions you can ask to test the outcome. Sometimes, outcomes have solutions embedded in them, and asking questions like ‘What would it give you, do for you or make possible for you if you had that outcome?’ can help to uncover the true outcome. Exploring what is truly important to the person specifically regarding the issue can also be useful. This can help us to develop the outcome further to be more specific.
Step 6 - What is getting in the way?
Having identified what the person wants to achieve, we then need to identify the obstacles that may be getting in the way of achieving it.
Step 7 - Creating clear goals/steps and actions
Having identified what is getting in the way of achieving the outcomes, the person can then set goals or steps to address these obstacles and move forward with their outcomes. They will need to be SMART, and they may need resources to be assigned to ensure that they happen.
Step 8 - Record in the plan
The outcomes and the steps and support needed to achieve them can then be recorded in the plan. We should also record how the outcomes will be reviewed.
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Passionate about personalisation, choice and control in practice.
Blog by Madeline Cooper-Ueki, NDTi