7 research outputs found
Shared decision making implementation: A case study analysis to increase uptake in New South Wales
Experience-Based Co-Design: Tackling common challenges
There has been a surge in experience-based co-design (EBCD) efforts for quality improvement in health care and systems design globally. The authors identify common, shared challenges with using EBCD and their subsequent impact
“Anyone can co-design?”: A case study synthesis of six experience-based co-design (EBCD) projects for healthcare systems improvement in New South Wales, Australia
Experience-based co-design (EBCD) is a quality improvement approach that is being used internationally to bring service users and health professionals together to improve healthcare experiences, systems and processes. Early evaluations and case studies of EBCD have shown promise in terms of improvements to experience and organisational processes, however challenges remain in participation around shared power and decision making, mobilisation for implementation, sustainment of improvements and measurement of outcomes. The objective of this case study was to explore the emergent issues in EBCD participation and implementation in six quality improvement projects conducted in mental health, rehabilitation, blood and bone marrow transplant, brain injury rehabilitation, urinary incontinence and intellectual disability settings by the Agency for Clinical Innovation (ACI), New South Wales, Australia (2015-2018). Methods: A two stage process of analysis was employed. The first stage involved a case to case synthesis using a variable-oriented approach. In this approach themes were identified within individual cases and compared across cases in workshops with all project leads. In the second stage the case themes were synthesised within an overarching thematic that was identified as the main challenge in effective participation and implementation in these EBCD projects. The results: themes identified in the first stage of analysis related to different methods for gathering experiences and the activities used for the co-design of improvements. Variability in service user participation within co-design workshops was also discussed. Four out of the six projects implemented improvements in full. The prominent thematic overarching all six EBCD cases was the need for guidance on capability development and co-design preparedness for all participants in co-design not only project leads. In conclusion, variability in EBCD implementation makes it difficult to identify which component parts are essential for improving experiences and services, and which of these lead to sustained changes and benefits for service users and health professionals. One way to address this is to develop a model for co-design capability and preparedness that is closely linked with a set of eight mechanisms that have been previously identified as essential to achieving change in healthcare improvement initiatives.
Experience Framework
This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len
The CHOICE Project: Integrating Peer Support and Shared Decision Making in a Youth Mental Health Service
Experience-Based Co-Design: Tackling common challenges
As an improvement method, experience-based co-design (EBCD) is premised on creating better quality experiences and systems of health care. Distinguishing features of EBCD are the way in which experience is
central to the identification of and goals for improvements; and combined with participatory action research and design thinking approaches leading to the co-creation of improvements. Commonly shared challenges from completed EBCD studies include: the need to explore power dynamics; commitment to the process; methods to gather experience data; the design of improvements; and variations in implementation and subsequent impact. We discuss these challenges in the context of five
examples from Australia. We offer a contribution to the international discussion on developing the next level of maturity to build on the acknowledged and agreed importance of collaborating with service users and staff to improve health care