Care coordination for chronic and complex health conditions: An experienced based co-design study engaging consumer and clinician groups for service improvement

Abstract

BackgroundEvidence shows that engaging consumers and clinicians in development of health services creates a more responsive, integrated service that better meets the needs of consumers and the community of practice it serves. Further, consumer and clinician participation in service development processes can boost confidence and motivation levels in organisational employees and help foster clinical accountability.ObjectiveTo see where consumers’ care experiences could be improved by better understanding where care coordination organisational systems needed improvement.MethodsExperienced based co-design informed an investigation of consumer and clinician experiences of a care coordination service and involved the sharing of those experiences across service employees in a series of iterative and feedback loops over eighteen months (July 2012-January 2014). Formal participants included care coordination clinicians (n = 13) and consumers. Data from formal participants were collected during September-December 2012, consisting of consumer video-recorded and clinician audio-recorded interviews. Interview transcriptions were analysed to identify service “touch points”, being emotionally significant events related to key service aspects that connect or disconnect consumers and/or clinicians.ResultsResults revealed that consumers highly valued the transdisciplinary skill base of the care coordination workforce, though service improvements were needed for transition support, quality discharge planning and conveying better understandings of care coordination activity both internally and externally.ConclusionIncorporating consumer and clinician view-points about their experiences, including the production of a DVD, facilitated conversations across the entire service about care coordination provision and provided a catalyst for design improvement that may otherwise have been difficult to achieve. Some changes to the service were made such as improved client complaints processes, new roles for the care coordination service, and enlisting clinical staff to undertake motivational interviewing training to promote greater consumer self-management capacity. In this study, the user experience was given a platform within a larger healthcare workforce capability development project.

Weaving community-based participatory research and co-design to improve opioid use treatments and services for youth, caregivers, and service providers

“…Consequently, working collaboratively with service providers and healthcare organizations using CBPR can help recruit participants in the early stages of co-design and support ongoing engagement while navigating competing priorities. For example, Heslop and colleagues (2022) [ 15 ] appointed a clinical champion to enhance clinician and patient engagement in the co-design process and support the overall success of a project. Similarly, working with CCs who committed much of their time, skills, and efforts to this project was invaluable to the co-design process.…”

“…Power dynamics among patients, families, and service providers are also important to consider when planning co-design studies [ 63 ]. Service users and service providers are often concurrently engaged in co-design to bring multiple perspectives together and increase service providers’ understanding of service user experiences [ 10 , 12 , 15 , 16 , 60 ]. Yet, this can lead to conflicting priorities among stakeholder groups and result in negative co-design experiences if service user perspectives are not properly considered [ 12 , 15 , 17 , 35 ].…”

“…Service users and service providers are often concurrently engaged in co-design to bring multiple perspectives together and increase service providers’ understanding of service user experiences [ 10 , 12 , 15 , 16 , 60 ]. Yet, this can lead to conflicting priorities among stakeholder groups and result in negative co-design experiences if service user perspectives are not properly considered [ 12 , 15 , 17 , 35 ]. People who use substances can be subjected to stigma and negative attitudes from service providers, which can undermine their autonomy, self-confidence, and self-worth [ 35 , 41 , 51 ].…”

Reducing Time to Discharge after Chemotherapy by Standardizing Workflow and Providing Outpatient Intravenous Hydration

“…Due to time and resource limitations, the team decided not to explore causes and interventions for patients who were uncomfortable with outpatient hydration. Several tools and interventions to help understand and improve patients’ comfort level with self-management include shared decision-making models, 20 , 21 motivational interviewing, 22 , 23 face-to-face support, 24 and supervised practice. 25 Some of these interventions could be tested and explored in future quality improvement projects.…”

Synergy through Making: Co-designing with Educational Stakeholders in Northeastern Nigeria

“…According to Heslop, Cranwell, and Burton (2019), engaging stakeholders in the development of educational material and services creates a more responsive, integrated service that better meets the needs of the community of practice. Furthermore, the engagement and participation of stakeholders in the development of educational programs and learning materials can boost confidence and motivation levels and help to foster accountability (Matuk, Gerard, Lim-Breitbart & Linn, 2016).…”