Experience-Based Co-Design: Tackling common challenges

Dimopoulos-Bick, Tara; Dawda, Paresh; Maher, Lynne; Verma, Raj; Palmer, Victoria

doi:10.21853/jhd.2018.46

Cited by 49 publications

(72 citation statements)

References 8 publications

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“…Coproduction approaches are increasingly seen as a way to address power inequities in collaborating with patients and the public [71]. However, further work is needed to ensure that imbalances of power between healthcare staff, patients, public and organisations as well as issues of equality and diversity are addressed within these collaborative approaches [26,72]. The testing of approaches that can involve a more diverse representation of patients, the public and healthcare staff in line with the protected characteristics in the Equality Act 2010 [73] (e.g.…”

Section: Implications For Developing Patient Experiencementioning

confidence: 99%

The importance of power, context and agency in improving patient experience through a patient and family centred care approach

Ocloo

Goodrich

Tanaka

et al. 2020

Health Res Policy Sys

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Background: Research shows that the way that healthcare staff experience their job impacts on their individual performance, patient experience and outcomes as well as on the performance of organisations. This article builds on this literature by investigating, with multi-disciplinary clinical teams as well as patients and relatives, what factors help or hinder changes designed to improve patient experience. Methods: Qualitative research looking at patient-and family-centred care (PFCC) on two care pathways (stroke and hip fracture) was conducted in England and Wales. A realist approach combined with participatory action research was used to account for the complexity of organisational context and power relations. Multiple methods were used, including documentary analysis, participatory steering groups with staff and patient representatives, observations of the care pathways (n = 7), staff and patient and relative focus groups (n = 8), and hospital staff, patient and PFCC staff interviews (n = 47). Results: Findings highlight multiple factors that support and hinder good patient experiences. Within individual care, paternalistic values and a lack of shared decision-making and patient-centred care still exist. Supportive interdisciplinary teamwork is needed to address issues of hierarchy, power and authority amongst staff and managers. At the organisational level, key issues of waiting times, patient flow, organisational resources and timely discharge affect staff's time and capacity to deliver care. In addition, macro contextual factors, such as finance, policy, targets and measures, set particular limits for improvement projects. Conclusions: Given this context, improving patient experience needs to go well beyond small-scale projects at the micro and meso level to incorporate a more critical understanding of systems, the wider organisational context and how power operates at multiple levels to enable and constrain action. In order to more meaningfully understand and address the factors that can help or hinder activities to improve patient experiences, PFCC frameworks and methods need to account for how power inequities operate and require the adoption of more participatory coproduced and empowering approaches to involve patients, relatives, carers and staff in improving complex healthcare environments.

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Section: Implications For Developing Patient Experiencementioning

confidence: 99%

The importance of power, context and agency in improving patient experience through a patient and family centred care approach

Ocloo

Goodrich

Tanaka

et al. 2020

Health Res Policy Sys

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“…In any case, the combination of diverse cognitive approaches and different knowledge sets promotes new ideas or the adoption of old ones in new contexts . Co‐design challenges include overcoming power imbalances and variations in commitment, allocating sufficient time and resources to co‐design, clarifying what is actually negotiable and the nature and timing of service user demands …”

Section: Introductionmentioning

confidence: 99%

A realist evaluation of a regional Dementia Health Literacy Project

Grace

Horstmanshof

2019

Health Expectations

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Background A Dementia Health Literacy Project was undertaken in the north coast region of NSW, Australia, after it was identified as having a high prevalence of dementia. A Dementia Support Kit was produced with service user engagement to provide useful information to people with dementia and their families. Objective To evaluate the Dementia Health Literacy Project using a realist evaluation framework. Setting and participants The setting was the region of the north coast of New South Wales. Eight people diagnosed with dementia and their carers, 13 members of social groups of older people in the local area, and 22 local GPs and other health‐care and service providers participated in this study. Results Two context‐mechanism‐outcome configurations were identified: (a) co‐design workshops where the stakeholders’ opinions were equally valued (context) led service users to feel listened to and prompted them to provide feedback (mechanism) to develop a practical resource that they would use (outcome); and (b) use of health professionals to distribute the resources (context) that they consider useful and valuable (mechanism) resulted in the target audience receiving the resources (outcome). Discussion and conclusions The Dementia Health Literacy Project produced a Dementia Support Kit that is likely to provide locally relevant and useful information for people with dementia and their carers. The results highlight the value of the co‐design approach in producing and disseminating dementia health literacy resources. Further evaluation is required to confirm the impact of the Kit over time on service users’ behaviour and consequently on their health outcomes.

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“…Obtaining relevant and useful input from groups who have no design experience is problematic [7,16,18]. Design professionals are concerned that users are lacking in design conceptual knowledge and experience [10].…”

Section: Discussionmentioning

confidence: 99%

“…Prior research has identified a number of limitations when using the EBCD and POE strategies to elicit user input. A consistent observation relates to the difficulty users experience when asked to comment on an issue (building design) where they have limited conceptual knowledge or experience [8,10,16]. Jellema, Annemans and Heylighen (2019) suggests that, when examining the role of architecture, most individuals would have difficulty describing how they experience a 'space'.…”

Section: Introductionmentioning

confidence: 99%

A Structural Format to Facilitate User Input for the Co-design of a Cardiac Health Unit

Waroonkun¹

2020

cea

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Experience-based co-design and post occupancy evaluation are two mechanisms adopted for future planning and design of built spaces. They share a common strategy in that they both require input from a prospective, or current, built environment user. In the case of healthcare spaces, these users include doctors, nurses, patients and family. However, obtaining relevant and useful information from these sources is problematic. The users lack any specific conceptual knowledge and skills required in the design process. Several authors have addressed this issue by asking the user to comment on specific healthcare environment variables. These variables are the results of prior evidence-based research. Based on the work of Van der Voort and Van Wegen (2005) the author has developed a survey questionnaire and user input procedure Waroonkun (2019) that addresses the functional elements of a healthcare, built environment (in this case, a cardiac health unit). The strength and impact of this method was its ability to tap into a broad functional view of the users' experience of a built environment. The results of the present study indicate using a POE based, structured assessment strategy provided a solid guideline for determining a wide range of design issues from a user perspective.

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Experience-Based Co-Design: Tackling common challenges

Cited by 49 publications

References 8 publications

The importance of power, context and agency in improving patient experience through a patient and family centred care approach

The importance of power, context and agency in improving patient experience through a patient and family centred care approach

A realist evaluation of a regional Dementia Health Literacy Project

A Structural Format to Facilitate User Input for the Co-design of a Cardiac Health Unit

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