Applying Elinor Ostrom’s Design Principles to Guide Co-Design in Health(care) Improvement: A Case Study with Citizens Returning to the Community from Jail in Los Angeles County

Abstract

Introduction: Increased interest in collaborative and inclusive approaches to healthcare improvement makes revisiting Elinor Ostrom’s ‘design principles’ for enabling collective management of common pool resources (CPR) in polycentric systems a timely endeavour. Theory and method: Ostrom proposed a generalisable set of eight core design principles for the efficacy of groups. To consider the utility of Ostrom’s principles for the planning, delivery, and evaluation of future health(care) improvement we retrospectively apply them to a recent co-design project. Results: Three distinct aspects of co-design were identified through consideration of the principles. These related to: (1) understanding and mapping the system (2) upholding democratic values and (3) regulating participation. Within these aspects four of Ostrom’s eight principles were inherently observed. Consideration of the remaining four principles could have enhanced the systemic impact of the co-design process. Discussion: Reconceptualising co-design through the lens of CPR offers new insights into the successful system-wide application of such approaches for the purpose of health(care) improvement. Conclusion: The eight design principles – and the relationships between them – form a heuristic that can support the planning, delivery, and evaluation of future healthcare improvement projects adopting co-design. They may help to address questions of how to scale up and embed such approaches as self-sustaining in wider systems.

Mapping definitions of co‐production and co‐design in health and social care: A systematic scoping review providing lessons for the future

“…Despite this, this review highlights how values and principles are infrequently discussed and seemingly rarely applied. However, we are beginning to witness their discussion in peer‐review discussion papers in co‐production 69 and co‐design 70 . This ongoing shift from defining concepts and distinguishing contexts towards agreeing values and principles that are considered essential is a promising way forward.…”

“…However, we are beginning to witness their discussion in peer‐review discussion papers in co‐production 69 and co‐design. 70 This ongoing shift from defining concepts and distinguishing contexts towards agreeing values and principles that are considered essential is a promising way forward. More clearly articulating the shared values and principles underpinning both co‐production and co‐design is recommended.…”

UK Healthcare Workers’ Experiences of Major System Change in Elective Surgery During the COVID-19 Pandemic: Reflections on Rapid Service Adaptation

“…Involving staff in ongoing planning should be a priority, enabling staff to contribute their knowledge and experience to decisions about how to sustainably change service provision in response to the affordances and constraints of local context. A range of pragmatic tools and resources for approaching service co-design this are widely available within the improvement and co-production literature, [59][60][61] all of which emphasise the importance of clear, ongoing communication between staff delivering changes, management teams and patients.…”

Common Demand vs. Limited Supply—How to Serve the Global Fight against COVID-19 through Proper Supply of COVID-19 Vaccines

“…The eight design principles can promote the sustainable management of common pool resources [30], and Table 3 presents the specific principles, which include the following:…”