Consumer perspectives on co-design
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In this presentation, I reflect on 12 months participation in a number of service improvement projects using co-design methodology. With the help of fellow consumers, we generated a list of things we love and want to see more of in co-design projects.
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Consumer perspectives on co-design
- 1. A consumer perspective on piloting co-design in service improvement Belinda MacLeod-Smith Consumer consultant @belmac_ic
- 2. Co-design by the numbers at Western Health 1. Two day workshop with Lyn Maher in April 2016 2. Six service improvement projects identified as potential starters 3. Each project linked with process and method support from a Quality/Redesign team member and ‘gateway’ consumer support 4. Ongoing support to the teams with six support webinar sessions & project reflection session with Lyn Maher
- 3. Co-design and other bonus learnings Co-design is an approach that enables staff and patients (or other service users) to co-design services and/or care pathways, together in partnership. The Kings Fund (EBCD toolkit)
- 4. Tricky Top Three Recognising knowledge, skills and attitude needed – for staff and consumers Understanding/managing co-design ‘readiness’ at the individual and organisational level Respecting relationships and managing expectations
- 5. The hidden skills of co-design
- 7. Co-design and consumer engagement readiness: “nothing about us without us”
- 8. What consumers love and want to see more of… What we love What it looks like Professional approach to project management Plan, structure and resource appropriately Shared and accessible work spaces Clear timelines, deliverables and roles Being acknowledged and treated with respect Take the time to ‘stocktake’ skills that each person brings to the team – use and acknowledge those skills* Inclusion in emails, meetings, decision-making Acknowledgement of involvement Opportunities for professional development/training Knowing that feedback makes a difference Demonstrate how edits/reviews/inputs have changed a process – think ‘you said/we did’ Be transparent about how feedback will be gathered, used and reported back Authenticity about level of engagement Be clear about the who, why, when and how often. What level of engagement is on offer – is it a three course meal, or a cup of tea?
- 9. Thank you Thank you to the following people for their time, patience and expertise: • Members of the CHF Consumer representative online forum • Western Health co-design project team volunteers and consumer members • Western Health co-design project team staff members
Editor's Notes
- Good morning Show of hands from any other consumers, patients, carers, volunteers in the room this morning? <respond appropriately> Today I’ll use the word ‘consumer’ when I’m talking about patients, families and carers My name is Belinda MacLeod-Smith, and I work 3 days per week as a consumer consultant with the Quality, Safety and Patient Experience team. I’m a consumer with seven years lived experience as a carer for my husband who has chronic and complex health needs. My professional background is that of a strategic communication and engagement advisor. I’m here this morning to talk about my experience of being involved in a pilot of co-design projects at Western Health I’ll also be drawing upon the experiences of other Western Health consumers involved in co-design projects, and a network of consumers from here and interstate. In the next six or so minutes I’ll briefly cover three main areas: my role in the co-design projects the things I believe organisations (and consumers) need to consider when it comes to co-design the recommendations from consumers to staff thinking about co-design
- A little background on the co-design pilot Started last year with a two day workshop where six service improvement projects were identified as starters Each project was bundled with support from Quality and Risk team, and ongoing support from Lynne Maher My role with each project team varied depending on the problem to be solved and the relevance of my lived experience. Hence use of term ‘gateway’ – while I was at the project establishment stage for all teams to provide support and recommendations. My involvement in other projects has been at different times in the six stage process So what have I, and other consumers, learnt through this experience? NXT slide – as you’d expect, we’ve learnt a LOT about co-design
- We’ve learnt a LOT about co-design Though it useful to refer to a definition so we’re all on the same page The important and unique bit is that consumers and staff WORK TOGETHER IN PARTNERSHIP. For many consumers being included in conversations about problem solving is an utterly new experience. Being truly listened to can also be a new experience, and one that I’ve been privileged to have with my co-design teams Many of them have shown me the value of my experience, and the fresh perspective that I, and other consumers, bring to the table. Another key learning for me has been about the complexity of the hospital business And that it can be as complex for staff as it is for consumers. As I worked through co-design stages with staff, I realised that we share many of the same challenges and frustrations. Time pressures. Resource pressures. Access to information. Frustration about the way ‘the system’ works. While there will always be differences in the way a patient experiences hospital compared to a staff member, during this process it struck me that the co-design approach creates a unique opportunity for us to understand our shared frustrations. Which brings us to my Tricky Top Three
- Number One – knowledge, skills and attitude Skills, knowledge and attitude – for consumers, they want to know that the professional skills they have will be recognised, used and valued. For staff, they were keen to build their capacity in skills they might not have – common area related to engaging and communicating effectively with consumers. Number Two - readiness When it comes to readiness, the most common feedback from all my fellow consumers was just how inconsistent the experience of co-design can be. Consumer/staff sometimes have been left wondering if the timing and co-design process is right for the problem that’s being solved. It’s worth keeping in mind that readiness can also impact on how long a co-design project takes – something all of the pilot projects are very aware of. Number Three - relationships and expectations Co-design methodology can challenge certain kinds of consumer/staff relationship dynamics. Working as partners comes naturally in some areas of a hospital, but is a big change for others. I speak for myself and other when I say - as consumers, while we hope for a more equal partnership in decision-making, what we need is transparency and consistency in the relationship will be. In co-design, as in any other participation process, the greatest dissatisfaction and disengagement for consumers happens when the expectation of involvement and participation is not met. The greatest dissatisfaction and disengagement for consumers happens when the expectation of involvement and participation is not met. To use a metaphor, don’t invite consumers around for a three course meal, and then just give us a cup of tea and biscuits.
- Firstly – Knowledge, skills and attitude I want to take a moment to unpack my observation some of the ‘hidden’ skills implicit in using co-design methodology, using the six-step process that’s guided our teams. I want you to keep in mind that the range of skills involved presents both challenges and opportunities. The challenge of not recognising the depth and breadth of skills needed is that those skill gaps are what cause poor consumer experiences. And those same skill gaps are what cause frustration, delays and complications for staff.
- Secondly – understanding readiness These are just some of the skill sets I’ve observed as useful in a co-design project team Emotional intelligence – Empathy - Project management - Resource management - Organisational values - Co-design principles - Communication skills - Research planning & protocols - Ethics applications – Facilitation - Focus group design - - Data-analysis & interpretation - Service planning - Problem solving - Consumer engagement - Stakeholder management These last two I want to focus on – recruitment, engagement a key theme for both staff and consumers.
- Third cab off the rank – Respecting relationships and managing expectations. You might have heard the phrase ‘nothing about us without us’ It’s a decades old catch-cry of the 1960’s disabaility advocacy movement, often cited because of just how perfectly it captures the vibe of what consumers are looking for in healthcare The right to be involved in decisions that affect them. What we know about participation and engagement, in healthcare and a whole lot of other sectors is that Higher levels of participation lead to more meaningful and sustainable outcomes. If you haven’t had much to do with consumer engagement methodology, which is what underpins co-design, I STRONGLY RECOMMEND you read Cancer Voices Australia National Framework for Consumer Involvement.
- Finally, to bring us home, what is it that consumers love and want to see more of: Professional approach to project management Treated with respect – on this point, all consumers I spoke to highlighted how important it is for staff to recruit consumers thoughtfully – again I urge you to check the Cancer Voices Australia framework – has a brilliant section on different types of consumer involvement and how they benefit from different types of consumer Knowing that our feedback makes a difference Authenticity about engagement – 3 course meal vs tea and a biscuit Next slide – and that brings me to the end. Thank you very much, and enjoy the rest of the conference.
- National Framework for Consumer Involvement in Cancer Control https://canceraustralia.gov.au/sites/default/files/publications/national_consumer_framework_web_504af020f2184.pdf