Co-designing interventions within quality improvement initiatives: Notes from the field

Green, Stuart A.; Carnegie, Wendy; Barber, Susan; Matthew, Dionne; Matthews, Rachel

doi:10.21853/jhd.2018.38

Cited by 7 publications

(8 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Much of the implementation and research took place at individual sites, integrated into daily hospital working, mirroring iterative quality improvement process. Including SU/Cs in this is fraught with difficulty and is currently rare in healthcare 11. Nevertheless as healthcare is increasingly using computer-aided decision support systems as a key to achieving gains in quality and patient safety,12 we suggest that codesign is necessary to maximise the successful implementation.…”

Section: Discussionmentioning

confidence: 99%

Understanding and applying practitioner and patient views on the implementation of a novel automated Computer-Aided Risk Score (CARS) predicting the risk of death following emergency medical admission to hospital: qualitative study

Dyson

Marsh²,

Jackson³

et al. 2019

BMJ Open

View full text Add to dashboard Cite

ObjectivesThe Computer-Aided Risk Score (CARS) estimates the risk of death following emergency admission to medical wards using routinely collected vital signs and blood test data. Our aim was to elicit the views of healthcare practitioners (staff) and service users and carers (SU/C) on (1) the potential value, unintended consequences and concerns associated with CARS and practitioner views on (2) the issues to consider before embedding CARS into routine practice.SettingThis study was conducted in two National Health Service (NHS) hospital trusts in the North of England. Both had in-house information technology (IT) development teams, mature IT infrastructure with electronic National Early Warning Score (NEWS) and were capable of integrating NEWS with blood test results. The study focused on emergency medical and elderly admissions units. There were 60 and 39 acute medical/elderly admissions beds at the two NHS hospital trusts.ParticipantsWe conducted eight focus groups with 45 healthcare practitioners and two with 11 SU/Cs in two NHS acute hospitals.ResultsStaff and SU/Cs recognised the potential of CARS but were clear that the score should not replace or undermine clinical judgments. Staff recognised that CARS could enhance clinical decision-making/judgments and aid communication with patients. They wanted to understand the components of CARS and be reassured about its accuracy but were concerned about the impact on intensive care and blood tests.ConclusionRisk scores are widely used in healthcare, but their development and implementation do not usually involve input from practitioners and SU/Cs. We contributed to the development of CARS by eliciting views of staff and SU/Cs who provided important, often complex, insights to support the development and implementation of CARS to ensure successful implementation in routine clinical practice.

show abstract

Section: Discussionmentioning

confidence: 99%

Understanding and applying practitioner and patient views on the implementation of a novel automated Computer-Aided Risk Score (CARS) predicting the risk of death following emergency medical admission to hospital: qualitative study

Dyson

Marsh²,

Jackson³

et al. 2019

BMJ Open

View full text Add to dashboard Cite

show abstract

“…The co-design and build work were directed by an expert advisory group (EAG) comprising individuals and carers with lived experience of psychosis and professionals working in health, social, or voluntary sectors with the target population. The EAG membership was devised to address the principles of participatory research that value contributions from expertise through experience, and that should never be underrepresented within the bigger whole-team context [47,58]. We recruited EAG members with diverse demographic characteristics and varying degrees of ease and familiarity with digital communications from various clinical and voluntary service provider organizations across South East England.…”

Section: Methodsmentioning

confidence: 99%

A Multicomponent eHealth Intervention for Family Carers for People Affected by Psychosis: A Coproduced Design and Build Study

Sin¹,

Henderson²,

Woodham³

et al. 2019

J Med Internet Res

View full text Add to dashboard Cite

Background Psychosis, including schizophrenia, is the most common severe mental illness affecting 1% of the population worldwide. A large number of people provide long-term support and care for a relative with psychosis. Although psychoeducational interventions, especially those delivered through a face-to-face group format, have an established evidence base for improving the caregiving experience, well-being, and health outcomes, large-scale implementation and access remain limited. There is a demand for such provision to be made through the internet for greater flexibility and wider access. Objective This study aimed to integrate participatory research methodologies by the public, patients, and carers into the eHealth (electronic health) intervention design and build process to improve the product’s usability and acceptability. Methods We adapted a structured eHealth intervention build method to include participatory research activities involving key stakeholders and end users to co-design and coproduce our intervention. An expert advisory group (EAG) comprising public involvement members led the formative design and build work using an agile build process. Carers independent from the study were consulted on the evolving drafts of the intervention prototype through focus group meetings. These results were fed back into the intervention build work continuously to ensure end users’ input inform every stage of the process. Results An EAG comprising individuals with lived experience of psychosis, carers, health care professionals, researchers, voluntary organization workers, and eLearning experts (n=14) was established. A total of 4 coproduction workshops were held over 1 year during which the alpha and beta prototypes were designed and built through the participatory research work. Alongside this, 2 rounds of focus group study with carers (n=24, in 4 groups) were conducted to seek consultation on end users’ views and ideas to optimize the intervention design and usability. Finally, the EAG carried out a Web-based walk-through exercise on the intervention prototype and further refined it to make it ready for an online usability test. The final product contains multiple sections providing information on psychosis and related caregiving topics and interactive discussion forums with experts and peers for psychosocial support. It provides psychoeducation and psychosocial support for carers through the internet, promoting flexible access and individualized choices of information and support. Conclusions The participatory research work led to the coproduction of a eHealth intervention called COPe-support (Carers fOr People with Psychosis e-support). We believe the study methodology, results, and output have optimized the intervention design and usability, fitting the end users’ needs and usage pattern. COPe-support is currently being tested for its effectiveness in promoting carers’ health outcome through an online randomized controlled trial. Trial Registration ISRCTN Registry ISRCTN89563420; http://www.isrctn.com/ISRCTN89563420

show abstract

“…All examples required experimentation, collaboration and trust between patients, carers and health-care professionals in a common endeavour to spread knowledge about and encourage the use of the innovation. These factors underpinned new ways of working suchas co-production, an approach described by Green et al in the context of health service improvement projects 10. Filipe et al considered the concept of co-production recognizing that "such a process involves dialogue and recognition of each other's capabilities and knowledge," and this type of dialogue and recognition was evident in this study 41.…”

mentioning

confidence: 71%

“…Authors have noted that co-production can enhance patient and clinician experience and patient and service outcomes, even though patients' experience and expertise are often not used to the fullest. [6][7][8][9][10][11] The positive impact that patient engagement and involvement in health care can have on outcomes, including improving patients' understanding of their health conditions, how these can be treated and managed, self-management and peer-to-peer learning, is noted in empirical and policy-focused studies. 12,13 Patients are increasingly taking on roles in setting research agendas, including suggesting research questions, becoming part of a research team was important.…”

Section: Backg Rou N Dmentioning

confidence: 99%

The role of patients and carers in diffusing a health‐care innovation: A case study of “My Medication Passport”

Barber

French

Matthews

et al. 2019

Health Expectations

Self Cite

View full text Add to dashboard Cite

Background Patients are increasingly recognized as playing important roles in improving health services. Little is known about the mechanisms by which patients develop and diffuse local innovations in a complex health‐care system. Objective To ascertain how diffusion of an innovation, My Medication Passport, occurred and roles played by patients in it. Design Case study: quantitative mapping of innovation's diffusion and analysis of the routes and occupations of those through whom the innovation spread; documentary analysis; reflective assessment of patient's roles. Setting and participants NHS Trusts, third sector organizations, patients and health‐care professionals. Interventions studied Co‐produced action to raise awareness and influence use of the innovation; order database which enabled ease of access to the innovation. Main outcome measures Geographical spread of innovation; occupations of individuals; types of organizations using the innovation. Results The innovation spread from initial development and use in Northwest London across the UK and beyond. Key roles played by patients were as follows: co‐producer; advocate; relationship builder; relationship broker; planner; presenter; awareness raiser; trainer; networker. Patients identified and introduced potential audiences and users to MMP, using social, organizational, sectoral, lay and professional networks to do so. They organized a range of awareness‐raising and communication activities, monitored feedback, evaluated the impact and responded to new interest. Discussion and conclusions The roles of patients in diffusing innovations are under‐recognized. Collaborative working between patients, carers and health‐care professionals in planning and progressing the use and supporting diffusion of the innovation was important. Principles described in this study are relevant to progressing other patient‐led ideas for innovative changes relating to health service development.

show abstract

Co-designing interventions within quality improvement initiatives: Notes from the field

Cited by 7 publications

References 11 publications

Understanding and applying practitioner and patient views on the implementation of a novel automated Computer-Aided Risk Score (CARS) predicting the risk of death following emergency medical admission to hospital: qualitative study

Understanding and applying practitioner and patient views on the implementation of a novel automated Computer-Aided Risk Score (CARS) predicting the risk of death following emergency medical admission to hospital: qualitative study

A Multicomponent eHealth Intervention for Family Carers for People Affected by Psychosis: A Coproduced Design and Build Study

The role of patients and carers in diffusing a health‐care innovation: A case study of “My Medication Passport”

Contact Info

Product

Resources

About