michael clausen quality enhancement specialist€¦ · the art of purposeful conversation....
TRANSCRIPT
MICHAEL CLAUSENQuality Enhancement Specialist
THE ART OF PURPOSEFUL CONVERSATION
PURPOSEFUL CONVERSATIONOVERVIEW
• Getting Started: Setting up a POM (Personal Outcome Measures) conversation
• Techniques that are specific to people who communicate differently
• Techniques used during the conversation• Follow-up• Evidence gathering techniques specific to each POM• Additional ResourcesNote: This webinar will not cover decision making. For the upcoming webinar series on decision making, register at: https://c-q-l.org/resource-library/webinars/webinar-series--decision-making-with-the-poms/
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Effective preparation will help to ensure a successful interview
The Art of Purposeful ConversationGETTING STARTED
PURPOSEFUL CONVERSATIONSETTING UP THE CONVERSATION
• Explain the purpose of the conversation• Consent• Where and When• How long will the interview be? • Record review?
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PURPOSEFUL CONVERSATIONEXPLAINING THE PURPOSE
• You may have to explain the purpose to the person, those who support the person, and their advocates and/or guardians
• Discuss what the conversation will look like and who will be involved
• Discuss how your organization uses the POM’s• Consider writing a letter or info sheet to explain the process and
why your organization does this• Provide a copy of the Outcomes Overview Guide (attached)
“This is a tool that we use to improve the quality of our services for the person and to monitor how well the organization is doing as a whole”
PURPOSEFUL CONVERSATIONOBTAINING CONSENT
• An authorization to participate in the Personal Outcome Measures is the equivalent of a consent to release personal information
• Follow all of the rules of your organization and any applicable laws based on where you live
• Involve the person even if they have a guardian!
PURPOSEFUL CONVERSATIONWHERE AND WHEN
• From the perspective of being able to gather the most evidence, the person’s home is usually the best place to have the conversation. However…
• It is up to the person where they would like to meet• Offer to meet with the person wherever they are most
comfortable• Other than a place that would not ensure privacy, there
is no wrong place to have this conversation• There is a lot of value in breaking the interview up into
more than one part, and meeting with the person at different locations where they spend time (but don’t spread out the interview too much)
PURPOSEFUL CONVERSATIONHOW LONG WILL IT TAKE?
• Work with the person to establish how long the conversation will last
• Some people can sit and talk with you for 3 hours, others may not want to talk for more than 30 minutes-establish this ahead of time
• Respect the person’s time: If they said they would meet with you for 1 hour, it is important to abide by that
PURPOSEFUL CONVERSATIONRECORD REVIEW
• It is not always necessary to review the person’s record• Remember the goal: To understand how the person
defines each of the POM’s, what their current situation is, and whether that matches with their definition
• The record review is most useful for measuring supports• Examples: Is the person up to date on their medical services? Do the goals in the plan match what the person
told you their goals were?• The record review should always be done last
Techniques that are helpful for, but not limited to people
who communicate differently
The Art of Purposeful ConversationCONVERSATIONS WITH PEOPLE WHO
COMMUNICATE DIFFERENTLY
PURPOSEFUL CONVERSATIONTECHNIQUES SPECIFIC TO PEOPLE WHO COMMUNICATE DIFFERENTLY
• What do we mean by “communicating differently”?
• Support or no support?• Coaching the support• The conversation
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PURPOSEFUL CONVERSATIONWHAT DO WE MEAN BY “COMMUNICATING DIFFERENTLY?”
• Some people communicate with words• Some people communicate with a device- make sure it
is available• Some people use interpreters- make sure they are
available• Most people use body language• Some people use written communication• Most people communicate in more than one way• But most importantly…Everyone Communicates!
PURPOSEFUL CONVERSATIONSUPPORT OR NO SUPPORT?
As we discuss during the workshop, the preference is always to meet with the person without staff or family present
But, if we must…
• Consider trying an interview without support and see how it goes. You can always bring in support later on
• Consider alternatives other than family or staff- does the person have a friend that can provide support?
PURPOSEFUL CONVERSATIONCOACHING THE SUPPORT
• It is important to establish some “ground rules” before the start of the interview
• Tell the support person that they are there to serve as the person’s interpreter
• Be respectful, but remind them that you are interested in the person’s perspective, and the intent of the conversation is to find out what the person thinks, not what they think
PURPOSEFUL CONVERSATIONTHE CONVERSATION
• Maintain eye contact with and ask questions to the person
• Be mindful of the person’s body language • Use your observations to steer the conversation• Do the same things you would do for all people
General techniques for ensuring that you are able to collect the most evidence during
the time you have with the person
The Art of Purposeful Conversation
DURING THE CONVERSATION
PURPOSEFUL CONVERSATIONDURING THE CONVERSATION
• Starting the conversation• Observations are worth 1 million words• Follow the lead• The goal line: Knowing how much information you
need to gather• “Suggested Questions” for the person• The relevance of happiness as a measurement• Questions and concepts with broad applicability• Techniques to keep the interview going
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PURPOSEFUL CONVERSATIONSTARTING THE CONVERSATION
• Introduce yourself• Explain the POM’s and provide the person with a copy
of the Outcomes Overview Guide• Ask if it is okay to take notes• Comfort at all times• Use some warm up questions, and save the more
challenging areas for later. Don’t start at the beginning• Provide assurance:
There is no wrong answer They do not have to answer all the questions If there is anything they do not want shared with others we will respect
that (other than evidence of allegations of abuse and neglect or that the person is in danger)
PURPOSEFUL CONVERSATIONOBSERVATIONS AS EVIDENCE
• Ask the person to show you around• Pay close attention to the environment:
How is the home decorated and furnished? Does the door beep when you open it? Ask why… Are there chore charts or appointment calendars on the wall? Are there photos of family or others Trophies or awards? Is anything locked up? Ask why… Safety considerations? Is the person able to use this environment? Pay close attention to the
location of appliances, cabinets, etc. Smells: Does the food smell good?
• Use these observations as the springboard for your conversation
PURPOSEFUL CONVERSATIONFOLLOW THE LEAD
Ask follow-up questions that facilitate a segue:
“Who do you go with?” “Who do you talk to when you are at this place?” “When you go to this place, how do you stay safe?”
Use your questions to guide the person, but ultimately, let the person take you on a journey.
PURPOSEFUL CONVERSATIONTHE GOAL LINE
Know Where the Goal is!It is important to know what the criteria for decision making is for each Personal Outcome Measure. If you don’t have it memorized, have your book handy during the interview. Some organizations have designed their own customized notes forms that include this information.
PURPOSEFUL CONVERSATION“SUGGESTED QUESTIONS FOR THE PERSON”
• The questions in your manual are the types of questions you should be asking, but not always the questions you should be asking, or the only questions you should be asking
• Your questions should be specific to the person and their situation
• Your POM manual is not a script!• Remember that this is a conversation, not a survey
PURPOSEFUL CONVERSATIONTHE RELEVANCE OF HAPPINESS AS A MEASUREMENT
• The Personal Outcome Measures are built on choice and control
• Avoid asking the question, “are you happy with that?”• Instead, ask… “Who chooses?” “Who decides?” “Is anyone helping you with that?” “How are you being supported to do that?” “What do you want that to look like?”
PURPOSEFUL CONVERSATIONOTHER CONCEPTS WITH BROAD APPLICABILITY
• What does the person want to be different about their situation? Ask, “What would you like to change?”
• Assess how much experience a person has had- are they making an informed choice? Ask, “What other options have you had?”
• Tense: For the most part, decision making is based on present-tense. Your questions should be presented that way as well
• Type and Frequency: Remember that people may not always know that they can have more Being content is different than making an informed choice about a
situation after having access to an array of options Instead of asking, “Is this enough?” ask, “How much do you want?” or
“What type of roles, relationships, etc., would you like?”
PURPOSEFUL CONVERSATIONKEEP IT GOING
• Comfort at all times• Be sure to encourage insist on breaks• Move around• Go for a walk• Don’t just sit there- Be creative!
Techniques for the follow-up
conversation
The Art of Purposeful Conversation
FOLLOW-UP
PURPOSEFUL CONVERSATIONFOLLOW-UP
• Assurance: No right or wrong answers, and we are not here to judge
• We’re not looking at what this one person does specifically, but looking at the person’s supports as a whole
• Many of the same conversation techniques are used during follow-up
• Use the question, “How do you know?” • Challenge vague, general responses by asking for examples• Focus on challenges and solutions• Follow-up with family?
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Techniques for formulating advanced questions and making
insightful observations in relation to each
outcome
The Art of Purposeful ConversationPOM and FACTOR-SPECIFIC QUESTIONS,
TECHNIQUES AND OBSERVATIONS
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
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People Are Safe• Observations: Safety equipment, exits,
other people in the environment• Frame your questions in a way that is
person-specific and situation-specific
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Interactions, body language, the environment
• Person-specific questions in this area
People Are Free FromAbuse and Neglect
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PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Health-related equipment or devices, symptoms
• Ask person-specific questions
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People Have The Best Possible Health
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Clothing and personal possessions, photographs
• Favorite questions in this area
People Experience ContinuityAnd Security
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PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Buzzers, charts, locks, does the person carry a wallet or purse?, do they have a locked box in their room?, do they have keys?
• Focus on choice, control and the day to day: Who chooses…? Who decides…? Who do you have to ask if…?
People Exercise Rights
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PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Now that you know which rights are exercised and which are not…
• Assess the person’s perception in a way that is open-ended
People Are Treated Fairly
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PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Interactions (with everyone), decorations, clothing, art work
• Save this area for last• Favorite questions in this area
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People Are Respected
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Adaptations and modifications, appliances, cabinets, light switches, keys and locks, stairs and egress
• Favorite questions in this area• Focus on access- not just in the home, but
everywhere!
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People Use Their Environments
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Does the home look like others in the neighborhood?, Is it a typical neighborhood?, Are there markings on vehicles?, How are the staff dressed?
• Questions I don’t ask• The person’s perception?
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People Live In Integrated Environments
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Photos, memorabilia, clothing
• Favorite questions in this area
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People Participate In The Life Of The Community
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Now that you know where the person goes…separating interaction from participation
• Favorite questions in this area
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People Interact with Other Members of the Community
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Photos, cards, address books, electronic devices
• Use seasonally specific questions
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People Are Connected to Natural Support Networks
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Photos and mementos• Opportunities for friendship outside
of the service environment?• Favorite questions in this area
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People Have Friends
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Photos, jewelry• Ask about goals for their
relationship- Where do you want this relationship to go?
• Keep your questions neutral- say “sweetheart” or “romance” instead of “boyfriend” or “girlfriend”
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People Have Intimate Relationships
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Binders, technology, any information posted where people can see it
• Favorite questions in this area
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People Decide When To Share Personal Information
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Other people in the home, shared bedrooms
• Who chooses, who decides, where do you want to live?
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People Choose Where And With Whom To Live
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Awards from work, photos, paychecks
• Where would you like to work, what is your dream job, who decides?
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People Choose Where to Work
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Magnets, calendars, business shwag (pens, notepads, etc.)
• Where does the person spend their money, use their health insurance or their other benefits? (think outside the service system) and ask who chooses that
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People Choose Services
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Pictures, posters, clothing, everything!
• If you are at the end of the interview, you should already know some of the person’s goals
• To truly understand what the person wants their life to be like, ask questions that transcend barriers
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People Choose Personal Goals
PURPOSEFUL CONVERSATIONPOM-SPECIFIC QUESTIONS AND OBSERVATIONS
• Observations: Medals, Certificates, Photographs
• Favorite questions in this area
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People Choose Realize Personal Goals
Resources to continue developing
your interviewing skills
Purposeful ConversationADDITIONAL RESOURCES
PURPOSEFUL CONVERSATIONADDITIONAL RESOURCES
• Spend time interviewing with others• Webinars, webinars, webinars! https://c-q-l.org/resource-library/webinars
• E-community on Facebook• CQL Capstone• Consider hosting a training, workshop or certification
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PURPOSEFUL CONVERSATIONADDITIONAL RESOURCES
Perhaps most importantly…
HAVE FUN!
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PURPOSEFUL CONVERSATIONADDITIONAL RESOURCES
QUESTIONS ??
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