Louise Locock1, Glenn Robert2, Annette Boaz3, Sonia Vougioukalou4, Caroline Shuldham5, Jonathan Fielden6, Sue Ziebland7, Melanie Gager8, Ruth Tollyfield9, John Pearcey10. 1. Director of Applied Research, Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK, and Health Experiences Fellow, NIHR Oxford Biomedical Research Centre, UK louise.locock@phc.ox.ac.uk. 2. Professor of Healthcare Quality and Innovation, National Nursing Research Unit, King's College London, UK. 3. Reader in Healthcare Research, Faculty of Health, Social Care and Education, St George's Medical School, University of London and Kingston University, UK. 4. Research Associate, School of Healthcare Sciences, Cardiff University, UK. 5. Director of Nursing and Clinical Governance, Royal Brompton and Harefield NHS Foundation Trust, UK. 6. Medical Director, University College London Hospitals NHS Foundation Trust, UK. 7. Director, Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, UK. 8. Senior Sister, Intensive Care, Royal Berkshire NHS Foundation Trust, UK. 9. Senior Sister, Intensive Care, Royal Brompton and Harefield NHS Foundation Trust, UK. 10. Cancer and Thoracic Surgery Manager, Royal Brompton and Harefield NHS Foundation Trust, UK.
Abstract
OBJECTIVES: To evaluate an accelerated form of experience-based co-design (EBCD), a type of participatory action research in which patients and staff work together to improve quality; to observe how acceleration affected the process and outcomes of the intervention. METHODS: An ethnographic process evaluation of an adapted form of EBCD was conducted, including observations, interviews, questionnaires and documentary analysis. Whilst retaining all components of EBCD, the adapted approach replaced local patient interviews with secondary analysis of a national archive of patient experience narratives to create national trigger films; shortened the timeframe; and employed local improvement facilitators. It was tested in intensive care and lung cancer in two English National Health Service (NHS) hospitals. A total of 96 clinical staff (primarily nursing and medical), and 63 patients and family members participated in co-design activities. RESULTS: The accelerated approach proved acceptable to staff and patients; using films of national rather than local narratives did not adversely affect local NHS staff engagement, and may have made the process less threatening or challenging. Local patients felt the national films generally reflected important themes although a minority felt they were more negative than their own experience. However, they served their purpose of 'triggering' discussion between patients and staff, and the resulting 48 co-design (improvement) activities across the four pathways were similar to those in EBCD, but achieved more quickly and at lower cost. CONCLUSIONS: Accelerated EBCD offers a rigorous and relatively cost-effective patient-centered quality improvement approach.
OBJECTIVES: To evaluate an accelerated form of experience-based co-design (EBCD), a type of participatory action research in which patients and staff work together to improve quality; to observe how acceleration affected the process and outcomes of the intervention. METHODS: An ethnographic process evaluation of an adapted form of EBCD was conducted, including observations, interviews, questionnaires and documentary analysis. Whilst retaining all components of EBCD, the adapted approach replaced local patient interviews with secondary analysis of a national archive of patient experience narratives to create national trigger films; shortened the timeframe; and employed local improvement facilitators. It was tested in intensive care and lung cancer in two English National Health Service (NHS) hospitals. A total of 96 clinical staff (primarily nursing and medical), and 63 patients and family members participated in co-design activities. RESULTS: The accelerated approach proved acceptable to staff and patients; using films of national rather than local narratives did not adversely affect local NHS staff engagement, and may have made the process less threatening or challenging. Local patients felt the national films generally reflected important themes although a minority felt they were more negative than their own experience. However, they served their purpose of 'triggering' discussion between patients and staff, and the resulting 48 co-design (improvement) activities across the four pathways were similar to those in EBCD, but achieved more quickly and at lower cost. CONCLUSIONS: Accelerated EBCD offers a rigorous and relatively cost-effective patient-centered quality improvement approach.
Authors: Victoria J Palmer; Patty Chondros; Donella Piper; Rosemary Callander; Wayne Weavell; Kali Godbee; Maria Potiriadis; Lauralie Richard; Konstancja Densely; Helen Herrman; John Furler; David Pierce; Tibor Schuster; Rick Iedema; Jane Gunn Journal: BMJ Open Date: 2015-03-24 Impact factor: 2.692
Authors: Nancy F Berglas; Molly F Battistelli; Wanda K Nicholson; Mindy Sobota; Richard D Urman; Sarah C M Roberts Journal: PLoS One Date: 2018-01-05 Impact factor: 3.240
Authors: Sarah Knowles; Rebecca Hays; Hugo Senra; Peter Bower; Louise Locock; Jo Protheroe; Caroline Sanders; Gavin Daker-White Journal: Health Expect Date: 2017-12-20 Impact factor: 3.377