Response to: 'A 'work smarter, not harder' approach to improving healthcare quality' by Hayes et al (original) (raw)
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Experience-based Co-design (EBCD) to improve the quality of healthcare: mapping where we are now and establishing future directions Please cite as: Donetto, S., Tsianakas, V. & Robert, G. (2014). Using Experience-based Co-design to improve the quality of healthcare: mapping where we are now and establishing future directions. London: King's College London. Contact Dr Sara Donetto for further information: sara.donetto@kcl.ac.uk 2 PREFACE It is now almost 10 years since what has become the Experience-based Co-design (EBCD) approach to improving patient experience was first planned and piloted in a head & neck cancer service at Luton & Dunstable NHS hospital in England. A decade on and the roots of over 80 projects in seven different countries can be traced back to the hard work and commitment of the coming together of a small group of staff, patients and carers involved in that original work. Over time, naturally and quite rightly, the original 'blueprint' for EBCD has bee...
Patient Experience Journal, 2019
Experience-based co-design (EBCD) is a quality improvement approach that is being used internationally to bring service users and health professionals together to improve healthcare experiences, systems and processes. Early evaluations and case studies of EBCD have shown promise in terms of improvements to experience and organisational processes, however challenges remain in participation around shared power and decision making, mobilisation for implementation, sustainment of improvements and measurement of outcomes. The objective of this case study was to explore the emergent issues in EBCD participation and implementation in six quality improvement projects conducted in mental health, rehabilitation, blood and bone marrow transplant, brain injury rehabilitation, urinary incontinence and intellectual disability settings by the Agency for Clinical Innovation (ACI), New South Wales, Australia (2015-2018). Methods: A two stage process of analysis was employed. The first stage involved a case to case synthesis using a variable-oriented approach. In this approach themes were identified within individual cases and compared across cases in workshops with all project leads. In the second stage the case themes were synthesised within an overarching thematic that was identified as the main challenge in effective participation and implementation in these EBCD projects. The results: themes identified in the first stage of analysis related to different methods for gathering experiences and the activities used for the co-design of improvements. Variability in service user participation within co-design workshops was also discussed. Four out of the six projects implemented improvements in full. The prominent thematic overarching all six EBCD cases was the need for guidance on capability development and co-design preparedness for all participants in co-design not only project leads. In conclusion, variability in EBCD implementation makes it difficult to identify which component parts are essential for improving experiences and services, and which of these lead to sustained changes and benefits for service users and health professionals. One way to address this is to develop a model for codesign capability and preparedness that is closely linked with a set of eight mechanisms that have been previously identified as essential to achieving change in healthcare improvement initiatives.
BMJ Open Quality
BackgroundHealthcare organisations require systems to consistently meet the needs of their patients while providing excellent quality of care. The value improvement (VI) approach was developed by the Institute for healthcare improvement and successfully piloted at Raigmore Hospital, Scotland. It showed positive results in improving outcomes and reducing costs. Our multidisciplinary team from a tertiary care cardiac hospital in Doha, Qatar wanted to see if we could improve value in a clinically and geographically distinct context. We sought to understand the effectiveness of this approach as an integrative management philosophy that aims for continuous improvement in the quality of services by increasing efficiency and reducing waste.MethodsThis study evaluates the outcomes achieved from applying the VI methodology. The method is rooted in a framework that emphasises standardisation, continuous process improvement and rightsizing capacity to demand. The main tools include a data box ...
International journal of health care quality assurance, 2012
Key words: Lean Thinking, productive ward, efficiency, quality improvement, diffusion of innovation ABSTRACT Purpose: This paper is concerned with facilitating large-scale quality improvement in health care, and specifically understanding more about the known challenges associated with implementation of Lean innovations: receptivity, the complexity of adoption processes, evidence of the innovation, and embedding change. Lessons are drawn from the implementation of The Productive Ward: Releasing Time to Care TM programme in English hospitals.
ServDes.2014 Service Future; Proceedings of the fourth Service Design and Service Innovation Conference; Lancaster University; United Kingdom; 9-11 April 2014, 2014
Growing attention has been paid to the potential value of design theory and practice in improving public services. Experience-based Co-design (EBCD) is a participatory research approach that draws upon design tools and ways of thinking in order to bring healthcare staff and patients together to improve the quality of care. Through a six-stage facilitated process, EBCD uses filmed patient narratives to promote change that is grounded in people's experiences and engages participants in co-design activities to implement improvements. The co-design stage is a powerful and yet challenging one, as it requires both staff and patients to renegotiate their roles and expectations. When applied in the healthcare sector design approaches acquire a distinct political dimension by re-configuring the relationships of power between citizens and public services. From a critical review of approximately 60 EBCD projects, we reflect on lessons for effective participatory co-design approaches.
Journal of health services research & policy, 2014
To evaluate an accelerated form of experience-based co-design (EBCD), a type of participatory action research in which patients and staff work together to improve quality; to observe how acceleration affected the process and outcomes of the intervention. An ethnographic process evaluation of an adapted form of EBCD was conducted, including observations, interviews, questionnaires and documentary analysis. Whilst retaining all components of EBCD, the adapted approach replaced local patient interviews with secondary analysis of a national archive of patient experience narratives to create national trigger films; shortened the timeframe; and employed local improvement facilitators. It was tested in intensive care and lung cancer in two English National Health Service (NHS) hospitals. A total of 96 clinical staff (primarily nursing and medical), and 63 patients and family members participated in co-design activities. The accelerated approach proved acceptable to staff and patients; usin...