Using Principles of Co-Production to Improve Patient Care and Enhance Value

Turakhia, Puja; Combs, Brandon

doi:10.1001/journalofethics.2017.19.11.pfor1-1711

Cited by 41 publications

(17 citation statements)

References 14 publications

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“…In this study, respondents believed that co-production could improve the quality of health and care by considering patients' experiences when designing health care services and promoting patients' self-care abilities. These beliefs mirror those found in previous studies [1][2][3][4][5]. Vennik et al [1] suggested that co-production facilitates health care process improvement through the use of patients' experiences.…”

Section: Comparison With Prior Worksupporting

confidence: 79%

“…The goal for co-production is best possible health and care [1][2][3][4][5][6]. Understanding barriers to and facilitators of co-production, previously examined in diverse health care contexts, can in turn guide subsequent improvement initiatives.…”

Section: Co-production Of Health and Carementioning

confidence: 99%

“…Promotion of the best possible health for persons living with chronic disease is challenging for health systems worldwide. There is growing interest in co-production of health care services-involving patients, families of patients, and professionals in care processes-to create joint learning about how to meet patients' needs, thus promoting the best possible health [1][2][3][4][5][6]. Although barriers and facilitators to co-production have been examined previously in various health care contexts [1,2,[7][8][9][10][11][12][13][14][15][16][17][18][19], the preconditions in Swedish chronic cardiac care contexts are yet to be explored.…”

Section: Introductionmentioning

confidence: 99%

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Improving Health for People Living With Heart Failure: Focus Group Study of Preconditions for Co-Production of Health and Care

Suutari¹,

Thor²,

Nordin³

et al. 2021

J Particip Med

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Background Co-production of health and care involving patients, families of patients, and professionals in care processes can create joint learning about how to meet patients’ needs. Although barriers and facilitators to co-production have been examined previously in various health care contexts, the preconditions in Swedish chronic cardiac care contexts are yet to be explored. This study is set in the health system of the Swedish region of Jönköping County and is part of system-wide efforts to promote better health for persons with heart failure (HF). Objective The objective of this study was to test the usefulness of the Capability, Opportunity, and Motivation Behavior (COM-B) model when assessing the barriers to and facilitators of co-production of health and care perceived by patients with HF, family members of patients with HF, and professionals in a Swedish chronic cardiac care context as a guide for subsequent initiatives. Methods Data collection involved 1 focus group interview (FGI) with patients with HF (n=5), 1 FGI with family members of patients with HF (n=5), 1 FGI with professionals in primary care (n=7), and 1 FGI with professionals in cardiac care (n=4). In addition, patients with HF kept diaries of their thoughts regarding co-production. Using a deductive approach to content analysis, underpinned by the COM-B model, barriers and facilitators were categorized into capabilities, opportunities, and motivations to co-produce health and care. Results The participants showed limited understanding of co-production as a practice. They appeared to view it as a privilege to be offered to patients on top of traditional care and rarely as an approach for improving health care processes. The interviews revealed the limited health literacy among patients and the struggle of professionals to convey health information to these patients. Co-production was considered to be more resource-intensive than traditional care. Different expectations of stakeholders’ roles were revealed: professionals expected older patients not to want to co-produce health and care, and all participants expected professionals to be in charge of health care services. The family members’ position involved trying to balance their desire to support their relatives with understanding when, how, and with whom to co-produce. Presumed benefits motivated stakeholders: co-production was recognized to motivate patients to improve self-care. However, the participants recognized that motivation to get involved in health and care decisions varies over time among stakeholders. Conclusions Co-production can be facilitated by the stakeholders’ motivation. However, varying levels of understanding of co-production, patients’ limited health literacy, unease with power sharing between patients and professionals, and resource constraints are barriers that need to be managed to promote co-produced care and better health for persons living with HF. Further research is warranted to explore how to co-produce health care services with patients with HF and how leaders can facilitate the inevitable cultural change it requires and represents.

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Section: Comparison With Prior Worksupporting

confidence: 79%

Section: Co-production Of Health and Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Improving Health for People Living With Heart Failure: Focus Group Study of Preconditions for Co-Production of Health and Care

Suutari¹,

Thor²,

Nordin³

et al. 2021

J Particip Med

View full text Add to dashboard Cite

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“…The recommendations developed as part of the current study are, to the best our knowledge, the first that specifically examine best practice for the follow-up care pathway for patients with MPM. The importance of co-production and public engagement in priority setting in healthcare research and to develop and optimise patientcentred care is well recognised, [19][20][21][22] and combining the Open access recommendations produced together with a targeted dissemination strategy and well-designed infographics will maximise their opportunity for impact regionally and nationally. Improving and streamlining the mesothelioma follow-up care pathway by focusing on continuity and joined up care, and elevating specialist mesothelioma roles and teams within a respiratory led service, have the potential to improve both the consistency and quality of care received by patients with MPM across the UK.…”

Section: Discussionmentioning

confidence: 99%

Improving mesothelioma follow-up care in the UK: a qualitative study to build a multidisciplinary pyramid of care approach

Davey

Henshall

2021

BMJ Open

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ObjectivesThe findings reported in this manuscript are part of a wider study that aimed to explore mesothelioma patients’ experiences of follow-up care. The aim of this phase of the study was to co-produce recommendations for policy and practice and to propose a revised, patient-focused, mesothelioma follow-up care service.DesignThe consultation phase was qualitative and consisted of three group discussions with separate stakeholder groups allowing for different priorities and needs for follow-up care to be compared. An implicit approach to consensus was adopted and data were analysed iteratively using the framework method.SettingThe study was conducted in three National Health Service Trusts in the South of England. Two were secondary care settings and the third was a tertiary centre.ParticipantsThe consultation exercise comprised three group discussions with key stakeholders (n=35): mesothelioma specialist nurses (n=9), mesothelioma patients and carers (n=11) and local clinical commissioning group members (n=15).ResultsRecommendations for mesothelioma follow-up care were developed using a co-production approach and highlighted the importance of continuity of care, the provision of timely information and the central role played by mesothelioma specialist nurses, supported by the wider multidisciplinary team. Recommendations were produced together with two bespoke infographics to maximise impact and facilitate patient and public engagement with the study.ConclusionsThe recommendations developed are the first that specifically examine best practice for the follow-up care pathway for mesothelioma patients. Co-production and public engagement are crucial to priority setting develop and optimising patient-centred care. Combining the recommendations produced with a targeted dissemination strategy and well-designed, patient-focused infographics will maximise opportunities for impact at a regional and national level.

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“…Batalden et al (2015) view coproduction in health care as the act of patients and professional groups engaging in civil discourse as they co-plan and execute coproduced high-value health care that improves outcomes. The personalized experience of patients/consumers can create value and ensure quality for a health organization in the process of coproduction via active collaboration (Turakhia & Combs, 2017).…”

Section: Cultural Competence and Patient / Consumer Coproductionmentioning

confidence: 99%

Patient/Consumer Codesign and Coproduction of Medical Curricula: A Possible Path Toward Improved Cultural Competence and Reduced Health Disparity

2021

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There is often a sociocultural distance between medical practitioners and patients. We bridge that gap in the therapeutic alliance via improved cultural competence and an understanding of the person in their context. The traditional approach in medical education has been of learning via expert-designed curricula, which may tend to mirror the knowledge and needs of the experts. This places individuals at risk who come from culturally and linguistically diverse groups (CALD) with known health disparities: minority groups (e.g., African American); First Nations’ people; immigrants and refugees; people who speak nondominant languages; and lesbian, gay, bisexual, transgender people. The authors briefly review the complex area of cultural competency and teaching delivery. The authors survey the Australian population to provide a tangible example of complex cultural diversity amid curriculum challenges. An evidence-based approach that recognizes specific health inequity; the inclusion of CALD stakeholders, students, care professionals, and education professionals; and codesign and coproduction of curriculum components is recommended. This method of people’s own stories and collaboration may be applied in any international context, correctly calibrating the learning experience. The aim is for medical students to improve their knowledge of self, others, others within groups, and recognition of unconscious biases to achieve better health outcomes within their specific communities.

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Using Principles of Co-Production to Improve Patient Care and Enhance Value

Cited by 41 publications

References 14 publications

Improving Health for People Living With Heart Failure: Focus Group Study of Preconditions for Co-Production of Health and Care

Improving Health for People Living With Heart Failure: Focus Group Study of Preconditions for Co-Production of Health and Care

Improving mesothelioma follow-up care in the UK: a qualitative study to build a multidisciplinary pyramid of care approach

Patient/Consumer Codesign and Coproduction of Medical Curricula: A Possible Path Toward Improved Cultural Competence and Reduced Health Disparity

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