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3.7 Involving people: Stakeholder workshops

What are stakeholder workshops?

Stakeholder workshops can take a variety of forms. They offer a way of facilitating different groups of people to address issues or relevant areas of a process. Workshops offer the same advantages as focus groups for exploring issues but, because they are generally longer and look at more specific issues, participants have time to think through issues in-depth. Examples of approaches to facilitated stakeholder workshops that may be particularly appropriate for IP include:

• process mapping
• 'deliberative' workshops
• Appreciative Inquiry sessions.

An example report from a stakeholder workshop held by Northumbria pilot site can be found here.

1. Process mapping

Process mapping is a simple exercise to help teams to understand real problems from a user's point of view. When both patients and professionals are involved in the mapping session, professionals are able to make better decisions about improving care, based on fact and understanding rather than just their own perceptions of how the service works.^[1]

Why use process mapping?

Process mapping helps you to:

• Identify bottlenecks and constraints
• Identify and understand variations in clinical practice
• Develop a shared understanding of the problem
• Identify issues to do with quality of care
• Gain an in-depth understanding of a patient's perspective
• Identify steps that don't directly contribute to patient care (those that contribute are sometimes called 'value added' steps)

How?

You don't need to map everything. Concentrate on the area where there is a gap in your understanding, or which needs improvement. Knowing where the bottleneck is before you go into more detailed mapping will help you concentrate on the information you need.

Things to consider

• The process may not pick up the reality of what is going on in your pathway
• Having lots of ideas for improvement can become overwhelming, so there is a risk that follow-up doesn't meet people's expectations.

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2. Deliberative workshops

Deliberative workshops are a form of facilitated group discussion that provide participants with the opportunity to consider an issue in depth, challenge each other's opinions and develop their views/arguments to reach an informed end position. For example, an organisation that wishes to identify priorities for service development might find that the deliberative workshops approach allows participants to consider all the options and the implications of focusing on different areas.^[1]

Why use deliberative workshops?

This method:

• Allows participants the time and resources to consider an issue in depth, including costs, benefits and long-term consequences
• Allows participants, through discussion with others, to gain an insight into other perspectives, which allows their own views to be developed and challenged
• Can build and improve relationships between participants
• Can give participants new knowledge and skills.

How?

Deliberative workshops typically involve between 8 and 16 participants. Who is involved will depend on the issue at stake; participants could be selected on the basis of demographics, interest group, or random selection.

Things to consider

Like all forms of qualitative research, deliberative workshops are open to manipulation: how the discussions/activities are framed, how the participants are introduced to the topic, and what questions are asked will all influence the results.

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3. Appreciative Inquiry

Appreciative Inquiry is a form of action research that attempts to help organisations create new 'images' for themselves, based on an understanding of their past. These new images are expected to lead to developmental changes in the systems in which they are created.

Appreciative Inquiry is a particular way of asking questions and envisioning the future that fosters positive relationships and builds on the basic goodness in a person, a situation, or an organisation. The basic idea is to build organisations around what works, rather than trying to fix what doesn't^[2]

Why?

• The method is story-based, and people speak from their own experience
• It promotes community involvement
• It is easy to include the people who normally don't take part;
• It builds on what has worked in the past
• It creates a strong vision
• Appreciative inquiry is useful in developing partnerships by helping people to identify the values and behaviour they want their partnership to have in the future.
• It uses a set of principles that can be applied to other decision-making methods.

How?

The process begins with a core group setting the focus of the Inquiry, and developing and testing the appreciative questions. These are used by many people in the community to gather information through stories, as well as to set out their hopes and wishes for the future.

Things to consider

• Appreciative Inquiry is a philosophy first and a method second, so it is quite a 'loose' approach.
• People often find it an enjoyable process that builds on their natural sociability.
• Some people view the lack of direct attention to problems as a weakness of the method.
• Appreciative Inquiry pays little attention to who should be involved.^[3]

On the next page: interviews (qualitative interviews)