Participatory design facilitates Person Centred Nursing in service improvement with older people: a secondary directed content analysis

Abstract

Aims and objectivesTo explore, using the example of a project working with older people in an outpatient setting in a large UK NHS Teaching hospital, how the constructs of Person Centred Nursing are reflected in interviews from participants in a Co‐design led service improvement project.BackgroundPerson Centred Care and Person Centred Nursing are recognised terms in healthcare. Co‐design (sometimes called participatory design) is an approach that seeks to involve all stakeholders in a creative process to deliver the best result, be this a product, technology or in this case a service. Co‐design practice shares some of the underpinning philosophy of Person Centred Nursing and potentially has methods to aid in Person Centred Nursing implementation.Research designThe research design was a qualitative secondary Directed analysis.MethodsSeven interview transcripts from nurses and older people who had participated in a Co‐design led improvement project in a large teaching hospital were transcribed and analysed. Two researchers analysed the transcripts for codes derived from McCormack & McCance's Person Centred Nursing Framework.ResultsThe four most expressed codes were as follows: from the pre‐requisites: knowing self; from care processes, engagement, working with patient's beliefs and values and shared Decision‐making; and from Expected outcomes, involvement in care. This study describes the Co‐design theory and practice that the participants responded to in the interviews and look at how the co‐design activity facilitated elements of the Person Centred Nursing framework.ConclusionsThis study adds to the rich literature about using emancipatory and transformational approaches to Person Centred Nursing development, and is the first study exploring explicitly the potential contribution of Co‐design to this area.Implications for practiceMethods from Co‐design allow older people to contribute as equals in a practice development project, co‐design methods can facilitate nursing staff to engage meaningfully with older participants and develop a shared understanding and goals. The co‐produced outputs of Co‐design projects embody and value the expressed beliefs and values of staff and older people.

The TiM system: developing a novel telehealth service to improve access to specialist care in motor neurone disease using user-centered design

“…It also ensures that the focus remains on the end-user (24). These approaches have been successfully used in health service redesign (25)(26)(27), to promote self-management (for example the Intelligent Shoe in stroke rehabilitation (28,29)) and in MND (patient-education websites (30), and the Head-Up collar (31)).…”

A co-design approach to service improvement resulted in teams exhibiting characteristics that support innovation

“…There are many models for delivering innovation, but, particularly in response to the drive for person-centred approaches (Berwick 2013), the approach offered by design is gathering support (Asch and Rosin 2015) whilst more evidence around participatory designs' ability to promote person-centred behaviour (Wolstenholme et al 2016) is reported.…”

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“…In nursing practice, Wolstenholme, Ross, Cobb, and Bowen (2017) provide such an example in an industrialized country, by describing the co-design of a service improvement project, where older people and other stakeholders were involved in the creative process. The authors found that the participatory or co-design practice inheres some of the underpinning philosophy of Person-Centred Nursing.…”