Co-design of interventions to improve acute care in hospital:  A rapid review of the literature and application of the BASE methodology, a novel system for the design of patient centered service prototypes

Subbé, Chris; Goodman, Ashley; Barach, P

doi:10.52964/amja.0922

Cited by 3 publications

(1 citation statement)

References 43 publications

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“…4,5 Subbe et al review the importance of co-design in acute care so that the experiences of patients and caregivers is utilised to improve service. 6…”

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confidence: 99%

Editorial - The NHS urgent and emergency care crisis: how much worse could it get?

Cooksley

2022

Acute Med

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NHS urgent and emergency care is under intolerable strain. This strain is increasingly causing harm to patients. Timely and high-quality patient care is often not being delivered due to overcrowding driven by workforce and capacity constraints. This drives low staff morale perpetuating burn out and high absence levels which currently dominate. Whilst COVID19 has accentuated and arguably expedited the crisis; the spiral of decline in urgent and emergency care has been decade long and unless urgent action is taken, we may not yet have reached its nadir.

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“…4,5 Subbe et al review the importance of co-design in acute care so that the experiences of patients and caregivers is utilised to improve service. 6…”

mentioning

confidence: 99%

Editorial - The NHS urgent and emergency care crisis: how much worse could it get?

Cooksley

2022

Acute Med

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Developing a Life Story Intervention for Older Adults With Dementia or at Risk of Delirium Who Were Hospitalized: Multistage, Stakeholder-Engaged Co-Design Study

Flessa,

Harrison,

Turnigan

et al. 2024

JMIR Aging

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Background Older adults with chronic or acute cognitive impairment, such as dementia or delirium, who are hospitalized face unique barriers to person-centered care and a higher risk for negative outcomes stemming from hospitalizations. There is a need for co-designed interventions adapted for these patients to the hospital setting to improve care and outcomes. Patient life storytelling interventions have demonstrated promise in enhancing person-centered care by improving patient–care team relationships and providing information to enable care tailored to individual needs and values. Objective This study aims to engage patients, care partners, and clinical stakeholders in a co-design process to adapt an existing life storytelling model for use with older adults with dementia and at risk of delirium in the acute care hospital setting. Methods We recruited patients with dementia or at risk of delirium who were hospitalized, their care partners, clinicians, and informaticists. A 3-stage co-design process that used a mixed methods data collection approach including in-depth interviews and surveys was completed. We used content analysis to analyze qualitative data and descriptive statistics to summarize quantitative data. Results In total, 27 stakeholder informants (ie, patients, care partners, and interdisciplinary care team [IDT] members) participated. Stakeholders were unanimously interested in using patient life stories as a tool for hospital care through electronic health record (EHR) integration. Stakeholders shared potential topics for life stories to cover, including social support, information on patients’ key life events, and favorite activities. Participants provided insights into the logistics of integrating life stories into acute care, including interview arrangement, story-sharing methods, and barriers and facilitators. IDT members shared preferences on EHR integration, resulting in 3 co-designed mock-ups of EHR integration options. Stakeholders shared ways to optimize future acceptability and uptake, including engaging with the care team and promoting awareness of life stories, ensuring suitability to the acute environment (eg, distilling information in an easily digestible way), and addressing concerns for patient capacity and privacy (eg, engaging care partners when appropriate). Thoughts on potential impacts of life stories were also elicited, including improving patient- and care partner–IDT member relationships; humanizing patients; increasing clinical team, patient, and caregiver satisfaction; and enabling more specific, tailored care for patients with dementia and at risk of delirium. Conclusions This study resulted in a co-designed life storytelling intervention for patients with dementia and at risk for delirium in an acute care hospital setting. Stakeholders provided valuable information to ensure future intervention acceptability and uptake, including potential benefits, facilitators, and challenges in the acute care setting.

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Developing a Life Story Intervention for Older Adults With Dementia or at Risk of Delirium Who Were Hospitalized: Multistage, Stakeholder-Engaged Co-Design Study (Preprint)

Flessa,

Harrison,

Turnigan

et al. 2024

Preprint

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BACKGROUND Older adults with chronic or acute cognitive impairment, such as dementia or delirium, who are hospitalized face unique barriers to person-centered care and a higher risk for negative outcomes stemming from hospitalizations. There is a need for co-designed interventions adapted for these patients to the hospital setting to improve care and outcomes. Patient life storytelling interventions have demonstrated promise in enhancing person-centered care by improving patient–care team relationships and providing information to enable care tailored to individual needs and values. OBJECTIVE This study aims to engage patients, care partners, and clinical stakeholders in a co-design process to adapt an existing life storytelling model for use with older adults with dementia and at risk of delirium in the acute care hospital setting. METHODS We recruited patients with dementia or at risk of delirium who were hospitalized, their care partners, clinicians, and informaticists. A 3-stage co-design process that used a mixed methods data collection approach including in-depth interviews and surveys was completed. We used content analysis to analyze qualitative data and descriptive statistics to summarize quantitative data. RESULTS In total, 27 stakeholder informants (ie, patients, care partners, and interdisciplinary care team [IDT] members) participated. Stakeholders were unanimously interested in using patient life stories as a tool for hospital care through electronic health record (EHR) integration. Stakeholders shared potential topics for life stories to cover, including social support, information on patients’ key life events, and favorite activities. Participants provided insights into the logistics of integrating life stories into acute care, including interview arrangement, story-sharing methods, and barriers and facilitators. IDT members shared preferences on EHR integration, resulting in 3 co-designed mock-ups of EHR integration options. Stakeholders shared ways to optimize future acceptability and uptake, including engaging with the care team and promoting awareness of life stories, ensuring suitability to the acute environment (eg, distilling information in an easily digestible way), and addressing concerns for patient capacity and privacy (eg, engaging care partners when appropriate). Thoughts on potential impacts of life stories were also elicited, including improving patient- and care partner–IDT member relationships; humanizing patients; increasing clinical team, patient, and caregiver satisfaction; and enabling more specific, tailored care for patients with dementia and at risk of delirium. CONCLUSIONS This study resulted in a co-designed life storytelling intervention for patients with dementia and at risk for delirium in an acute care hospital setting. Stakeholders provided valuable information to ensure future intervention acceptability and uptake, including potential benefits, facilitators, and challenges in the acute care setting.

show abstract

Co-design of interventions to improve acute care in hospital: A rapid review of the literature and application of the BASE methodology, a novel system for the design of patient centered service prototypes

Cited by 3 publications

References 43 publications

Editorial - The NHS urgent and emergency care crisis: how much worse could it get?

Editorial - The NHS urgent and emergency care crisis: how much worse could it get?

Developing a Life Story Intervention for Older Adults With Dementia or at Risk of Delirium Who Were Hospitalized: Multistage, Stakeholder-Engaged Co-Design Study

Developing a Life Story Intervention for Older Adults With Dementia or at Risk of Delirium Who Were Hospitalized: Multistage, Stakeholder-Engaged Co-Design Study (Preprint)

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