Perhaps one of the greatest challenges we have faced over the last 25 years was organising and delivering a consensus meeting in 2016 to establish guidance recommendations for constipation in older people.
When everyone agrees on something, it's called consensus. But are you really giving people the best product, service, or experience? A clinical consensus statement is a view that everyone in a group of experts agrees on about a certain clinical problem. However, clinical consensus statements are more useful when there isn't a lot of evidence but there are still ways to reduce uncertainty and improve the quality of care for patients. This is different from clinical practice standards, which are mostly based on strong evidence. People on a participating team usually know a lot and have strong opinions, so conversations can get bogged down in small details. At the start of the meeting, you should choose one person to let everyone know when the conversation has gone on for too long.
Consensus decision making is an interesting and creative way for a group to agree on something. Instead of having the majority get what they want, ideas that seek consensus need to be something that everyone can agree on. This method makes sure that all thoughts, feelings, and worries are taken into account.
The group's first step in coming up with ideas that work for everyone is to hear what everyone has to say. However, consensus is not the same as either compromise or unanimity. It goes further by combining parts of everyone's best ideas and solving important issues. This method can lead to creative and exciting answers. But the process isn't perfect; it can lead to bad compromises, arguments, and a lack of drive on the team. Below are a few tips on how to make your consensus meetings run smoothly and produce valuable outcomes taken from our more comprehensive Insider’s Insight [1].
To reach a consensus, people need to look for ‘win-win’ solutions, which mean that no choice should go against the will of a single person or a small group of people. The group instead does what each member wants, and decisions are made based on the idea that everyone should have equal power over their own opinion. Because of this, it is often used to find the best way to handle tough clinical cases involving professionals with strong opinions.
Conducive consensus requires: Goals: Everyone in the group needs to share a clear common goal and be willing to work to achieve it. The first step is to clearly define the problem.
Openness: Attendees should feel safe to openly express their ideas and opinions – including dissenting opinions.
Time: The process should be given sufficient time to work, including the opportunity to consider all the facts and discussing opinions to make good decisions.
Plan: It's crucial to have a clear process for decision making.
Participation: All attendees need to participate actively - listen to what everyone has to say, voice their thoughts and feelings about the matter and pro-actively look for solutions that include everyone (see The Attendee’s Contract below).
Moderation
A skilled speaker is essential to any successful meeting because they make sure that the goals of the meeting are met and that decisions are carried out. A good monitor will help people in a group work together in a way that is fair, creative, and democratic. The moderator will make sure that the meeting stays on track with its goals and that the talk isn't dominated by a few strongly opinionated people.
Find the things that seemingly different ideas have in common and the ways that they are connected. Then, weave these things together to make plans. Pay attention to solutions that meet the basic wants and address the main concerns of the people in the group.
Recapping
A succinct and accurate summary of what's been said so far can really help a group move towards a decision. Outline the emerging common ground as well as the unresolved differences: "It seems like we've almost reached agreement on that bit of the proposal, but we need to explore this part further to address everyone's concerns." Check with everyone that you've got it right.
Decision making
Most of the time, discussions begin with what is known, which is best understood after some preparation. The topics become more general as more people join the discussion and share their unique thoughts and ideas. This gives people the information they need to have a broad conversation that looks at all the choices and helps them understand each other's worries. As time goes on, discussions move on to combining ideas and getting rid of the weaker ones.
The team member’s contract:
Avoiding mediocrity is your greatest challenge. It is relatively simple to undertake multiple iterative refinements of your consensus statements, incorporating comments from all the participants. Take care not to engineer the teeth out of your position in an attempt avoid contention. Where do new ideas come from?
Differences!
Teams can work better than individuals, but groupthink can make things worse. People in a group who aren't used to making decisions together will often settle for the lowest common standard, which leads to average results. These kinds of findings are full of doubt and ambiguity. Setting up a healthy space to work together will motivate the team and help them do their best.
So what of our challenge in 2016? Well, we managed to pull the team together and published a set of guidelines – you can find them here, you decide [2].
References
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