44The Three Ps of Co-Designing Person-Centred Care for Frail Older People in Acute Care Settings: Public, Patient and Practitioner Involvement

O’Donnell, Deirdre; Shé, Éidín Ní; McCarthy, Mary; Doran, T; Donnellan, Anne; P, Ruane; Savin, Bibiana; Smith, Freda; Milton, Jim; O'Brien, B; Callan, Eugene; Thornton, Shirley; McAuliffe, Éilish; Gray, Simone; O’Shea, Diarmuid; Patton, Andrew; Carey, Therese; Carroll, Paula; Boyle, Nichola; O’Brien, Michelle; Cooney, Marie Therese

doi:10.1093/ageing/afy140.32

Cited by 2 publications

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Section: Introductionmentioning

confidence: 99%

“…Key to enabling the involvement of public and patient representatives (PPRs) in the design of frailty pathways is the utilisation of co-design methodologies and approaches that empower and include the perspectives of older people and their family carers [12, 17–19]. The literature highlights many challenges in enabling meaningful reciprocal engagement [14, 15, 17–19]. A co-design approach within health system improvement initiatives involves creating an equal partnership of people working within the system and those individuals who have lived experience of using the system (patients and their families/carers) [2, 14, 20–22].…”

Section: Introductionmentioning

confidence: 99%

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Enabling public, patient and practitioner involvement in co-designing frailty pathways in the acute care setting

O’Donnell

Shé

McCarthy³

et al. 2019

BMC Health Serv Res

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BackgroundAlthough not an inevitable part of ageing, frailty is an increasingly common condition in older people. Frail older patients are particularly vulnerable to the adverse effects of hospitalisation, including deconditioning, immobility and loss of independence (Chong et al, J Am Med Dir Assoc 18:638.e7–638.e11, 2017). The ‘Systematic Approach to improving care for Frail older patients’ (SAFE) study co-designed, with public and patient representatives, quality improvement initiatives aimed at enhancing the delivery of care to frail older patients within an acute hospital setting. This paper describes quality improvement initiatives which resulted from a co-design process aiming to improve service delivery in the acute setting for frail older people. These improvement initiatives were aligned to five priority areas identified by patients and public representatives.MethodsThe co-design work was supported by four pillars of effective and meaningful public and patient representative (PPR) involvement in health research (Bombard et al, Implement Sci 13:98, 2018; Black et al, J Health Serv Res Policy 23:158–67, 2018). These pillars were: research environment and receptive contexts; expectations and role clarity; support for participation and inclusive representation and; commitment to the value of co-learning involving institutional leadership.ResultsFive priority areas were identified by the co-design team for targeted quality improvement initiatives: Collaboration along the integrated care continuum; continence care; improved mobility; access to food and hydration and improved patient information. These priority areas and the responding quality improvement initiatives are discussed in relation to patient-centred outcomes for enhanced care delivery for frail older people in an acute hospital setting.ConclusionsThe co-design approach to quality improvement places patient-centred outcomes such as dignity, identity, respectful communication as well as independence as key drivers for implementation. Enhanced inter-personal communication was consistently emphasised by the co-design team and much of the quality improvement initiatives target more effective, respectful and clear communication between healthcare personnel and patients. Measurement and evaluation of these patient-centred outcomes, while challenging, should be prioritised in the implementation of quality improvement initiatives. Adequate resourcing and administrative commitment pose the greatest challenges to the sustainability of the interventions developed along the SAFE pathways. The inclusion of organisational leadership in the co-design and implementation teams is a critical factor in the success of interventions targeting service delivery and quality improvement.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Enabling public, patient and practitioner involvement in co-designing frailty pathways in the acute care setting

O’Donnell

Shé

McCarthy³

et al. 2019

BMC Health Serv Res

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“…This will involve the health and social care disciplinary leads from the NICPOP Inter-Professional Interest Group, the National Clinical Lead for Older People (DO’S), the Director of Nursing for the NCPOP (DL) and the NCPOP programme manager (HW). The team will also include researcher co-authors from UCD and will be chaired by the PI (DO’D) who has extensive experience of meaningfully involving PPRs in co-designing healthcare interventions and services ( O'Donnell et al , 2016 ; O’Donnell et al , 2018 ; O’Donnell et al , 2019 ).…”

Section: Methodsmentioning

confidence: 99%

“…A co-design approach within a health system improvement initiative involves creating an equal partnership of people working within the system and those individuals who have lived experience of using the system ( Ní Shé et al , 2018a ; O’Donnell et al , 2018 ). We will follow the four pillars of effective and meaningful co-design with PPR involvement to ensure authentic and democratic participation and collaboration ( Baxter et al , 2018 ; O'Donnell et al , 2016 ; O’Donnell et al , 2019 ).…”

Section: Methodsmentioning

confidence: 99%

Embedding collective leadership to foster collaborative inter-professional working in the care of older people (ECLECTIC): Study protocol

et al. 2020

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The National Integrated Care Programme for Older People Background: (NICPOP), formerly NCPOP aims to support older people to live well in their homes by developing primary and secondary care services for older people, especially those with complex needs. The programme develops integrated intermediate care which traverses both hospital and community settings through multidisciplinary and interagency teams. This team-based approach to the integration of health services is a novel innovation in Irish health service delivery and will require, over time, a shift in cultures of care to allow for the development of competencies for inter-professional collaboration across the care continuum. The ECLECTIC project will develop an implementation framework for achieving, maintaining and monitoring competencies for interprofessional collaboration among multi-disciplinary teams charged with delivering care for older people across the continuum from acute to community settings.

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44The Three Ps of Co-Designing Person-Centred Care for Frail Older People in Acute Care Settings: Public, Patient and Practitioner Involvement

Cited by 2 publications

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Enabling public, patient and practitioner involvement in co-designing frailty pathways in the acute care setting

Enabling public, patient and practitioner involvement in co-designing frailty pathways in the acute care setting

Embedding collective leadership to foster collaborative inter-professional working in the care of older people (ECLECTIC): Study protocol

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