I designed the One-Day Consensus Conference for clients who need to fully and fairly engage stakeholders in their decision making, but do not have much time to do it. By asking participants to work ahead and by writing the consensus report after the meeting, organizers can achieve in about eight hours what takes several days to several weeks using traditional consensus conference methods.
How It Works
A One-Day Consensus Conference takes a diverse and sometimes large group of stakeholders with varying amounts of knowledge about and interest in a topic and puts them on a level playing field so they can reach consensus on some decision needing to be made. Typically, the objective is to draft a recommended action plan for using limited resources to solve a problem. The consensus built around the action plan helps conference sponsors secure internal and external funding and buy-in to solve the problem at hand.
The process allows each participant a full and fair opportunity to influence the outcome, even when many people need to be consulted. Consensus conferences are designed to minimize or eliminate some negative things that can happen when diverse groups interact, such as domination of the discussion by one or two influential or high-ranking people. They are also more efficient, stimulating and rewarding for participants than alternative processes such as brainstorming sessions and formal committee meetings.
To understand a One-Day Consensus Conference, it helps to examine each of its parts.
Briefing Materials:
Briefing materials are the foundation of a One-Day Consensus Conference. If organizers had to bring participants up to speed on the issue at hand through educational presentations on the day of the conference, there would be no way to accomplish so much in one day.
Organizers send participants briefing materials well in advance of the conference. Organizers carefully prepare the materials to present an objective summary of the matter to be discussed, including such things as the history of the problem, current statistics, and pro-and-con accounts of solutions tried in other times and places. Lack of knowledge is a key obstacle to people’s full and fair participation in a discussion; the briefing materials help eliminate this obstacle.
Session 1: Draft questions
Participants are randomly assigned to small groups of 6-12 people. In this session, small-group members have a broad discussion of the issue at hand, relying heavily on the briefing materials. They ask each other questions about the briefing materials. Drawing on their own experiences and expertise, they offer additional information to the group that was not covered in the briefing materials. They determine what they still need to know in order to make a good decision, and work together to draft questions to ask a panel of experts. Small-group facilitators assist each group.
Session 2: Q&A with Experts
Participants meet in a large group for the Q&A. An invited panel of subject experts, chosen for their knowledge and their commitment to speak objectively, answers questions written by the small groups. The conference facilitator ensures the panel answers each question fully.
Session 3: Draft recommendations
Each small group drafts a limited number of recommendations for the action plan (e.g. this action should be taken; money should be spent this way). Groups submit their recommendations to the conference facilitator, who prepares and distributes paper handouts listing all the recommendations.
Session 4: Discuss recommendations
The conference facilitator leads a discussion about the recommendations. The facilitator calls on each group to briefly describe their ideas, and invites questions from members of other groups. If all the participants agree that clarifying changes are needed, the facilitator re-types the recommendations on a laptop computer, displaying the work for all to see on a projection screen.
Session 5: Generate voting ballot
The final discussion concerns combining recommendations, where appropriate, and finalizing the recommendations list. With everyone’s agreement, the facilitator finishes revising the recommendations text on screen. At this point, the conference can go two ways. If sufficient time remains, the conference facilitator can immediately conduct a vote on the recommendations, using individual ballots, and display the results on screen. This helps enhance the sense of group consensus because the voting usually shows strong support for a few key items. But if time does not allow, the facilitator posts the recommendations online and sends participants an e-mail inviting them to vote. The vote is held open for only a short time to ensure the large group’s discussion, and points of consensus that emerged during it, is fresh in the participants’ minds.
History of Consensus Conferences
The National Institutes of Health (NIH) developed a “consensus development conference” in 1977 to “produce evidence-based consensus statements addressing controversial issues in medicine important to health care providers, patients, and the general public.” Recent NIH conferences have dealt with producing “state of the science” reports on Cesarean delivery, chronic insomnia, menopause, and improving end-of-life care.
While the NIH is still using the process several times a year, consensus conferences have seen the greatest development in Europe. In the late 1980s the Danish Board of Technology adapted the process to involve lay citizens, aiming to help lawmakers understand the social context of emerging technologies and create an informed public debate about technology. The Danes have applied the model recently to teleworking, electronic surveillance, and road pricing. Elsewhere, the most popular consensus conference topic has been genetic modification of food.
The Danish consensus conference procedure employs eight days of discussion over a period of three months. The NIH’s conferences typically take two and a half days. Compressing the consensus conference process into one day requires eliminating one key aspect: the writing of a recommendations report during the conference by the participants themselves. Instead, the conference facilitator writes a report based on the priorities selected in the large-group discussion, information gleaned from a debriefing session with the small-group facilitators, and a review of recordings taken during the small-group discussions. The conference facilitator e-mails the draft report to every participant and accepts comments by e-mail for a two-week period before preparing a final report and submitting it to the conference organizer.
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