Annette Boaz, Glenn Robert, Louise Locock, Gordon Sturmey, Melanie Gager, Sofia Vougioukalou, Sue Ziebland and Jonathan Fielden
The potential for including patients in implementation processes has received limited attention in the literature. The purpose of this paper is to explore the different roles…
Abstract
Purpose
The potential for including patients in implementation processes has received limited attention in the literature. The purpose of this paper is to explore the different roles adopted by 63 patients that emerged during and after four participatory quality improvement interventions, and the nature of their impact upon implementation processes and outcomes.
Design/methodology/approach
A cross-case ethnographic comparison of Experience-based Co-design in two clinical pathways in two UK NHS Trusts.
Findings
Two key themes emerge from the data. First, the authors found a range of different roles adopted by patients within and across the four projects; some were happy to share their experiences, others also helped to identify improvement priorities alongside staff whilst others were also involved in developing potential solutions with the staff who had cared for them. A few participants also helped implement those solutions and became “experts by experience” through engaging in the whole co-design process. Second, in terms of the impact of patient engagement with the co-design process whilst the changes championed by patients and carers were often small scale, as co-designers patients provided innovative ideas and solutions. Through their involvement and contributions they also acted as catalysts for broader change in the attitudes of staff by providing a motivation for wider organisational and attitudinal changes.
Research limitations/implications
The research was conducted in two clinical pathways in two NHS trusts. However, the findings complement and add to the growing body of knowledge on experience based co-design.
Practical implications
Patient engagement is likely to require support and facilitation to ensure that patients can play a meaningful role as partners and co-designers in service improvement and implementation. Different roles suited particular individuals, with participants stepping in and out of the co-design process at various stages as suited their needs, capacities and (albeit sometimes perceptions re) skills. In this context, facilitation needs to be sensitive to individual needs and flexible to support involvement.
Social implications
Patients and carers can play active roles in service improvement, particularly where the approach facilitate active engagement as co-designers.
Originality/value
Analysis of the role patients and carers in implementation and improvement.
Details
Keywords
Bagus Nuari Harmawan and Sofia Al Farizi
Co-production improves the quality of healthcare services by prioritizing patient-centred care and ensuring optimal implementation. Current patient participation research have…
Abstract
Purpose
Co-production improves the quality of healthcare services by prioritizing patient-centred care and ensuring optimal implementation. Current patient participation research have primarily concentrated on the co-production stages, despite patient participation being the central emphasis of its implementation. A study conducted analysed four specific attributes of patient participation, with patient engagement specifically emphasizing the interactions between patients and healthcare workers. Several studies have concluded that the interaction between the two actors is inefficient. This article examines current study trends concerning patient participation and identifies knowledge gaps from these studies.
Design/methodology/approach
This study used bibliometric analysis. This study used VOSviewer software for bibliometric analysis. The Scopus database contained 398 publications about patient participation in co-production in healthcare, which served as the basis for the analysis.
Findings
The study on patient engagement in a co-production context for healthcare had grown fast in recent years. Patient-centred approach and patient-centred care were two important things in patient engagement. Several factors influenced the implementation of patient engagement: attitude, ability, awareness, responsibility and knowledge. It is still uncommon to do research on the measurement of output and results from patient engagement implementation. Studies on instruments for measuring these two factors, particularly in a quantitative manner, are still few.
Research limitations/implications
Various recommendations have been put forward for additional investigation. Firstly, further examination of outcome measurement in patient engagement is necessary, given the lack of decisive instruments available. Secondly, examining the most influential factors on patient engagement in co-production in healthcare. Thirdly, a more thorough analysis is needed regarding the dimensions of co-production, considering that some dimensions overlap, such as the activation and empowerment dimensions, which are really carried out during engagement. The researcher acknowledges the inherent limitations of bibliometric studies, including the dependence on the Scopus databases for extracting data and the choice of search phrases. Furthermore, conducting a systematic literature review may be necessary to thoroughly examine and delineate the research topics, methodologies and outcomes of this study.
Originality/value
This study updates us on patient engagement study trends and establishes a framework for implementing patient engagement in healthcare services.