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Principles Into Practice: Co Design in Healthcare


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Co-design is a relationship where professionals and citizens share power to plan and deliver support together, recognising that both partners have vital contributions to make in order to improve quality of life for people and communities.

Published in: Healthcare

Principles Into Practice: Co Design in Healthcare

  1. 1. Principles and Praxis Co-Design in Healthcare Marie Ennis-O’Connor
  4. 4. 3 WAYS TO DO HEALTH CARE IMPROVEMENT • Don’t listen very much to users and do the designing for them • Listen to users then go off and do the designing for them • Listen to users and then go off with them to do the designing together Paul Bate, 2007
  5. 5. TO For With
  6. 6. Co-design challenges power paradigm
  7. 7. Lived experience is equal to other forms of knowledge, evidence and expertise
  8. 8. “Co-production is a relationship where professionals and citizens share power to plan and deliver support together, recognising that both partners have vital contributions to make in order to improve quality of life for people and communities.” Source: nef/NESTA (National Endowment for Science, Technology and the Arts UK) Co-production Critical Friends
  9. 9. Co Design
  10. 10. Edgar Cahn in his book No More Throw-Away People relates the parable of the Blobs and Squares to explain co-production. THE PARABLE OF THE BLOBS AND SQUARES
  11. 11. WHAT, WHO, WHY, WHEN, HOW
  13. 13. STAKEHOLDERS patients service users carers front line staff communities health professionals researchers industry policy makers
  14. 14. WHAT, WHO, WHY, WHEN, HOW
  16. 16. #1 Democratic people have the right to participate in the design of things that impact them
  17. 17. #2 PRAGMATIC we can achieve more by working together than we can apart
  18. 18. #3 USER EXPERTISE drawing on user experience and expertise will accomplish a better outcome
  19. 19. #4 INNOVATION seeing things from different points of view leads to new perspectives and greater innovation
  20. 20. #5 DIVERSITY more diverse and accessible care for all
  21. 21. #6 TRUST AND TRANSPARENCY improves interactions and understanding
  22. 22. #7 COLLECTIVE OWNERSHIP develops a sense of joint ownership
  23. 23. WHAT, WHO, WHY, WHEN, HOW
  25. 25. use co-design when… • Starting a new service improvement project. • Developing a new process, product or service. • Exploring a specific service issue, e.g. reducing waiting times. • Wanting to understand services from the patient perspective. • Implementing changes.
  26. 26. WHAT, WHO, WHY, WHEN, HOW
  28. 28. FOUR CO-DESIGN PRINCIPLES 1. Prioritise the patient experience 2. Trust the process 3. The ‘means’ is as important as the ‘ends’ 4. Acknowledge the patients’ contributions throughout the process
  29. 29. #1 Prioritise the patient experience What would this look like?
  30. 30. #2 Trust the process What would this look like?
  31. 31. #3 The ‘means’ is as important as the ‘ends’ What would this look like? The social outcomes of co-design work are just as important as the co-design outputs OUTPUTS
  32. 32. #4 Acknowledge contributions What would this look like?
  33. 33. some ideas… • Assistance to attend meetings (travel expenses, accommodation, etc) • Personal thank you cards after workshops or other events • Celebratory events when improvements have been made • Written recognition in publications, reports and website
  34. 34. CO-DESIGN PROCESS Engage Plan Explore Develop Decide Change
  35. 35. STEP 1 ENGAGE who needs to be involved? engage them early in the process ensure engagement is meaningful
  36. 36. what are the ethical considerations?
  37. 37. PRINCIPLES OF GOOD PRACTICE 1. The improvement initiative should be designed and undertaken in a way that ensures its integrity and quality 2. All people who are involved, must be informed fully about the purpose, methods and intended possible uses of any information they provide 3. All participants must formally consent to the use of any information they provide, including attribution of quotations, film extracts, etc 4. All people involved participate on a strictly voluntary basis, free from any coercion and able to withdraw at any time without need for explanation 5. All people involved must not be knowingly exposed to harm or distress 6. Privacy and confidentially must be respected as requested (Ethical Considerations for Experience Based Design: 2007)
  38. 38. what are the barriers to meaningful engagement?
  39. 39. some thoughts • Lack of time • Accessibility • Entrenched thinking • Reluctance to cede power • Tokenism • Balance of power • Trust
  40. 40. STEP 2 PLAN establish the goals of your improvement work and how you might go about achieving them ensure you have adequate funding and organisational commitment in place to see the process through map assets
  41. 41. ASSET MAPPING • The resources, including the skills, knowledge and networks which people and communities have to offer • Transforming the perception of people from passive recipients to equal partners
  42. 42. STEP 3 EXPLORE learn about patient experiences how are they treated? how would they like to be treated? what outcomes do they want?
  43. 43. how will you do this?
  44. 44. some ideas experience based survey co-design workshop patient journey mapping
  45. 45. Focus on designing experiences rather than systems or processes!
  46. 46. drill down into the emotions
  47. 47. how will you turn it around?
  48. 48. STEP 4 DEVELOP turn your ideas into specific improvements what are the desired outcomes of this work for patients and their communities?
  49. 49. STEP 5 DECIDE brainstorm as many specific goals and ideas as you wish, then narrow these down to two or three key goals and ideas
  50. 50. DECISION MATRIX idea strengths uniqueness weakness fixes transform
  51. 51. STEP 6 CHANGE turn your IDEAS into ACTION
  52. 52. National Voices UK
  53. 53. @JBBC