Tools to help build person-centred responses

Building a Person-Centred Pathway

Every organisation has to find a way to organise its work, so that each step leads to the next. In human services, the steps often cover the following themes: information, referral, triage, allocation, assessment, planning, coordination, delivery, review, and exit.

Often, these pathways can feel complex and impersonal for people being served. Sometimes this is because of longstanding practices that made sense when they were designed but which make less sense now. But the problem is no one seems confident about changing them ("we've always done it this way, why change now").

Sometimes, complex and impersonal pathways happen because of the needs of funders, the people who are paying for the service. This can create a disconnect in the way the pathway happens, where it might be overly focused on the needs of the people paying for the service instead of the needs of the people using the service.

Sometimes, complex and impersonal pathways happen because of the needs of professional or managerial people, who are seeking to manage perceived risks. again, this can result in a pathway that appears to serve the needs of professionals and managers instead of the needs of the people using the service.

For these reasons and others, service pathways can leave people feeling like they are having to adapt to the needs of the organisation's pathway rather than the other way around.

But if an organisation wants to have a true impact in a person's life, then it would want a pathway that allows it get to know the person well, on the person's own terms, so it can design a response that is right for that person.

So the challenge here is how to build momentum for a truly person-centred pathway.

Step 1 Map the current pathway

Write down the steps that happen in the current pathway. you may need to talk with a few different people in the organisation, because it is possible no single person knows the details of all the steps. It is also important to talk to people using the service, because they will have experienced the steps and can describe what happened.

Step 2 What are the problems in the current pathway, and how could it be better

Ask those same people which parts of the pathway are working well, and which bits are not, and why it's a problem. These conversations can help build urgency about the need for change, and also shows people's views are important.

Step 3 How specifically could the pathway be improved

At this point, unless you're the boss, you'll need to get your boss's support to make the changes. This is also a good opportunity to suggest that the organisation runs a small working group of people involved in the pathway - especially frontline staff and people using the services.

The anchopoint for the work must be about how to make the pathway more person-centred. so that each step is an opportunity for the organisation to deepen its relationship to the person, to discover insights, and to tailor a response that is right for the person's unique circumstances. If a part of the existing pathway doesn't do this, that is a target for improvement, The group can then focus on concrete practical improvements that can be made. This can either be as a complete redesign of the whole pathway, or by tackling one or two specific parts that are particularly troubling.

during this step, it is important to stay in touch with everyone involved in the pathway. This could be an update email, a forum posting, etc. Whatever it is, it needs to keep people in touch with what's going on, because you will likely need their help and support when you try new bits of the pathway out.

Step 4 Building support for the changes

Once your working group has designed new parts of the pathway (for example a new way of getting to know people when they are first referred, or a new way of individual planning) you need to intensify your communication to people involved in the pathway, so that people know what changes are happening, when, why, and what they will be doing differently. It is also important your boss is seen to support the changes, so s/he can persuade their boss and their peers to support the changes.

If you're the boss, this is more straightforward. Based on the above, get out and about and communicate communicate communicate.

Step 5 Trying the changes out

first, decide how you will know if these changes are working. Then, based on that, decide what information you will gather, when and from who, so that you know how the changes are going. These are your evaluation arrangements.

Once you are clear about evaluation, introduce the changes. If you are changing just one part, for example the planning process, push it out in one go. If you have redesigned the whole pathway, roll out the changes one stage at a time.

Step 6 Evaluation and refinement

Stay in touch with people, and listen to their experiences. Bring those to your working group, so you can decide if things are working well and if there are any refinements that will help. Bottom line: the changes are successful if they are creating a pathway that is genuinely person-centred.

Step 7 Ongoing learning

encourage your organisation to make it part of one person's job to be the 'keeper' of the pathway. This means they are responsible for staying in touch with how the pathway is going, and seeking ongoing improvements. Regular conversations with service users and staff will be part of this.

This helps consolidate a culture of continuous learning.

Summary

While this seven-step approach is about system change (how to improve the way work is organised, it is also about how to start, build and maintain a conversation about how to be more person-centred.