Yes / Background: Experience-based co-design (EBCD) brings patients and staff together to co-design services. It is normally conducted in one organization which initiates and implements the process. We used the traditional EBCD method with a number of adaptations as part of a larger research study in the British National Health Service.Methods: The primary aim was to assess the feasibility and acceptability of conduct-ing research-initiated EBCD, to enhance intervention development prior to testing. As well as embedding the method in a research study, there were 3 further key adap-tations: (a) working across primary and secondary care sectors, (b) working on multi-ple sites and (c) incorporating theory-informed analysis.Results: We recruited four sites (covering both primary and secondary care) and, on each site, conducted the initial traditional EBCD meetings, with separate staff and patient groups—followed by a single joint patient-staff event, where four priority areas for co-design were agreed. This event was driven by theory-informed analysis, as well as the traditional trigger film of patient experiences. Each site worked on one priority area, and the four co-design groups met over 2-3 months to design prototype tools. A second joint event was held (not usually undertaken in single-site EBCD) where they shared and compared outputs. The research team combined elements of these outputs to create an intervention, now being tested in a cluster randomized controlled trial.Conclusions: EBCD can be successfully adapted for use across an entire patient pathway with multiple organizations and as part of a research process to identify an intervention for subsequent testing in a randomized trial. Our pragmatic approach used the patient experience to identify areas for improvement and co-designed an intervention which directly reflected patient priorities. / National Institute for Health Research programme ‘Improving the safety and continuity of medicines management at care transitions (ISCOMAT)’ RP‐PG‐0514‐2009.

Background: Recent focus on quality and patient safety has underlined the need to involve patients in improving healthcare. “Experience-based Co-design” (EBCD) is an approach to capture and understand patient and staff (i. e. users) experiences, identifying so called “touch points” and then working together equally in improvement efforts. Purpose: This article elucidates patient (defined as the mother-newborn couple with next of kin) and staff experiences following improvement work carried out according to EBCD in a maternity ward and neonatal intensive care unit (NICU) in a small, acute hospital in Sweden. Method: An experience questionnaire, derived from the EBCD approach tool set, was used for continuously evaluating each event of the EBCD improvement project. Furthermore, a focus group interview with staff and in-depth interviews with mother-father couples were held in order to collect and understand the experiences of working together according to EBCD. The analysis and interpretation of the interview data was carried through using qualitative, problem-driven content analysis. Themes, categories and sub-categories presented in this study constitute the manifest and latent content of the participants’ experiences of Experience-based Co-design. Results: The analysis of the experience questionnaires, prior to the interviews, revealed mostly positive experiences of the participation. Both staff and patient participants stated generally happy, involved, safe, good and comfortable experiences following each event of the improvement project so far. Two themes emerged during the analysis of the interviews. For staff participants the improvement project was a matter of learning within the microsystem through managing practical issues, moving beyond assumptions of improvement work and gaining a new way of thinking. For patients, taking part of the improvement project was expressed as the experience of involvement in healthcare through their participation and through a sense of improving for the future. Discussion: This study confirms that, despite practical obstacles for participants, the EBCD approach to improvement work provided an opportunity for maternity ward /NICU care being explored respectfully at the experience level, by assuring the sincere sharing of useful information within the microsystem continuously, and by encouraging and supporting the equal involvement of both staff and patients. Staff and patients wanted and were able to contribute to the EBCD process of gathering information about their experiences, analyzing and responding to collected data, and engaging themselves in improving the same. Furthermore, the EBCD approach provided staff and patients the opportunity of learning within the microsystem. Nevertheless, the responsibility of the improvement work remained the responsibility of the healthcare professionals. Keywords: Quality Improvement, Maternity Care, Neonatal Intensive Care, Experience-based Co-design

Background: Recent focus on quality and patient safety has underlined the need to involve patients in improving healthcare. “Experience-based Co-design” (EBCD) is an approach to capture and understand patient and staff (i. e. users) experiences, identifying so called “touch points” and then working together equally in improvement efforts. Purpose:This article elucidates patient (defined as the mother-newborn couple with next of kin) and staff experiences following improvement work carried out according to EBCD in a maternity ward and neonatal intensive care unit (NICU) in a small, acute hospital in Sweden. Method: An experience questionnaire, derived from the EBCD approach tool set, was used for continuously evaluating each event of the EBCD improvement project. Furthermore, a focus group interview with staff and in-depth interviews with mother-father couples were held in order to collect and understand the experiences of working together according to EBCD. The analysis and interpretation of the interview data was carried through using qualitative, problem-driven content analysis. Themes, categories and sub-categories presented in this study constitute the manifest and latent content of the participants’ experiences of Experience-based Co-design. Results:The analysis of the experience questionnaires, prior to the interviews, revealed mostly positive experiences of the participation. Both staff and patient participants stated generally happy, involved, safe, good and comfortable experiences following each event of the improvement project so far. Two themes emerged during the analysis of the interviews. For staff participants the improvement project was a matter of learning within the microsystem through managing practical issues, moving beyond assumptions of improvement work and gaining a new way of thinking. For patients, taking part of the improvement project was expressed as the experience of involvement in healthcare through their participation and through a sense of improving for the future. Discussion: This study confirms that, despite practical obstacles for participants, the EBCD approach to improvement work provided an opportunity for maternity ward /NICU care being explored respectfully at the experience level, by assuring the sincere sharing of useful information within the microsystem continuously, and by encouraging and supporting the equal involvement of both staff and patients. Staff and patients wanted and were able to contribute to the EBCD process of gathering information about their experiences, analyzing and responding to collected data, and engaging themselves in improving the same. Furthermore, the EBCD approach provided staff and patients the opportunity of learning within the microsystem. Nevertheless, the responsibility of the improvement work remained the responsibility of the healthcare professionals.

Introduction: Patient-centred communication is vital to ensure a good patient experience in the emergency department. Visits to the emergency department leave patients disillusioned regarding the communication experienced and this increases patient dissatisfaction. There is a need to put the "patient" back in communication in order to make it more patient-centred and provide the patient the opportunity to voice their individual needs pertaining to patient-centred communication. The aim of the study was to co-design patient-centred communication in an emergency department. In order to reach the aim of the study the following objectives were set: To explore current communication in an emergency department as experienced by patients and healthcare professionals. To collaboratively co-design strategies to enhance patient-centred communication in an emergency department. Research design and methods: An Experience-based Co-design has been used. Unstructured observation was done to observe existing communication in the emergency department. Patients have told their stories through narrative-based film interviews and healthcare professionals have been interviewed to share their experiences regarding communication in the emergency department. The observation notes and interviews have been shared during a Co-design event. Patients and healthcare professionals have collaboratively analysed the data to identify key touch points and co-design strategies to enhance patient-centred communication in the emergency department. Results: Three (3) key touch points were identified namely; professionalism, communication and daily focus. The patients and healthcare professionals were equal partners to change the communication culture in the emergency department to be more patient-centred. This may lead to positive patients' experiences with an increase in patient satisfaction. Conclusion: The ultimate goal of this study was to raise awareness relating existing communication in the emergency department and collaboratively plan strategies to work towards patient-centred communication. / Dissertation (MCur)--University of Pretoria, 2017. / Nursing Science / MCur / Unrestricted

Bakgrund: Patienters ställning har stärkts genom Patientlagen som trädde i kraft första januari 2015 och betonar patientens delaktighet i vården. Trots detta är patientens ställning oförändrad eller till och med något försvagad efter lagens införande.   Syfte: Förbättringsarbetets övergripande syfte var att öka hemsjukvårdspatienternas delaktighetsupplevelse. Det specifika syftet var att ta reda på vad patienter, anhöriga och personal ansåg viktigt för delaktighetsupplevelsen i vården och utifrån det formulera och testa förbättringsförslag. Studiens syfte var att beskriva deltagande personers erfarenheter av medverkan i ett förbättringsarbete med metoden Experience-Based Co-Design (EBCD).   Metod: Förbättringsarbetet genomfördes enligt Nolans förbättringsmodell och EBCD. Kvantitativ datainsamling skedde genom en enkät före och efter förbättringsarbetet. Studien av förbättringsarbetet är en kvalitativ fallstudie och baseras på fokusgruppsintervjuer. Intervjumaterialet analyserades med kvalitativ innehållsanalys och abduktiv ansats.   Resultat: Förbättringsarbetet visade förbättrade delaktighetsupplevelser efter sex månaders förbättringsarbete och att den sammantagna nöjdheten med delaktigheten ökade. Studien visar att EBCD bidrar till olika grader av delaktighetsupplevelser beroende på vilka steg man deltar i och att metoden genererar förståelse och drivkraft hos personal. Metoden möjliggör även att se vården utifrån patientens perspektiv.   Slutsats: Förbättringsarbetet medförde lärande även om det mätbara målet inte uppnåddes. Att tillämpa EBCD hade stor betydelse då det påverkade de medverkandes motivation. / Background: Patients’ position and participation is strengthened through the Swedish Patient Act that came into force January 2015. Nevertheless, the patients’ position remains unchanged or slightly weakened.   Purpose: The overall purpose with the improvement work was to increase the patients' participation experience. The specific purpose was to discover what patients, relatives and staff considered to be important for experiencing participation and together formulate and test improvement ideas. The purpose of the study was to describe participants' experiences of using Experience-Based Co-Design (EBCD). Method: Nolan's improvement model and EBCD was used as improvement methods. The study is a qualitative case study, based on focus group interviews. To analyse the interviews a qualitative content analysis with an abductive approach was used. Results: Result showed improved participation experiences and that the overall satisfaction of participation increased. The study shows that EBCD contributes to different levels of participation experiences depending on what steps one participates in and that EBCD generates understanding and motivate staff. The method makes it possible to see the care from the patient's perspective. Conclusion: The improvement work resulted in learning even though the SMART goal was not achieved. Applying EBCD was of great importance as it affected the participants' motivation.

Yes / Background: Experience-Based Co-Design (EBCD) is a participatory design method which was originally developed and is still primarily used as a healthcare quality improvement tool. Traditionally, EBCD has been sited within single services or settings and has yielded improvements grounded in the experiences of those delivering and receiving care. Method: In this article we present how EBCD can be adapted to develop complex interventions, underpinned by theory, to be tested more widely within the healthcare system as part of a multi-phase, multi-site research study. We begin with an outline of co-design and the stages of EBCD. We then provide an overview of how EBCD can be assimilated into an intervention development and evaluation study, giving examples of the adaptations and research tools and methods that can be deployed. We also suggest how to appraise the resulting intervention so it is realistic and tractable in multiple sites. We describe how EBCD can be combined with different behaviour change theories and methods for intervention development and finally, we make suggestions about the skills needed for successful intervention development using EBCD. Conclusion: EBCD has been recognised as being a collaborative approach to improving healthcare services that puts patients and healthcare staff at the heart of initiatives and potential changes. We have demonstrated how EBCD can be integrated into a research project and how existing research approaches can be assimilated into EBCD stages. We have also suggested where behaviour change theories can be used to better understand intervention change mechanisms.

Yes / UK and global policies recommend whole-school approaches to improve childrens' inadequate physical activity (PA) levels. Yet, recent meta-analyses establish current interventions as ineffective due to suboptimal implementation rates and poor sustainability. To create effective interventions, which recognise schools as complex adaptive sub-systems, multi-stakeholder input is necessary. Further, to ensure 'systems' change, a framework is required that identifies all components of a whole-school PA approach. The study's aim was to co-develop a whole-school PA framework using the double diamond design approach (DDDA). Fifty stakeholders engaged in a six-phase DDDA workshop undertaking tasks within same stakeholder (n = 9; UK researchers, public health specialists, active schools coordinators, headteachers, teachers, active partner schools specialists, national organisations, Sport England local delivery pilot representatives and international researchers) and mixed (n = 6) stakeholder groupings. Six draft frameworks were created before stakeholders voted for one 'initial' framework. Next, stakeholders reviewed the 'initial' framework, proposing modifications. Following the workshop, stakeholders voted on eight modifications using an online questionnaire. Following voting, the Creating Active Schools Framework (CAS) was designed. At the centre, ethos and practice drive school policy and vision, creating the physical and social environments in which five key stakeholder groups operate to deliver PA through seven opportunities both within and beyond school. At the top of the model, initial and in-service teacher training foster teachers' capability, opportunity and motivation (COM-B) to deliver whole-school PA. National policy and organisations drive top-down initiatives that support or hinder whole-school PA. To the authors' knowledge, this is the first time practitioners, policymakers and researchers have co-designed a whole-school PA framework from initial conception. The novelty of CAS resides in identifying the multitude of interconnecting components of a whole-school adaptive sub-system; exposing the complexity required to create systems change. The framework can be used to shape future policy, research and practice to embed sustainable PA interventions within schools. To enact such change, CAS presents a potential paradigm shift, providing a map and method to guide future co-production by multiple experts of PA initiatives 'with' schools, while abandoning outdated traditional approaches of implementing interventions 'on' schools. / The conference and workshop were jointly funded through an internal Leeds Beckett Research grant, the Yorkshire Sport Foundation and Public Health England (Yorkshire and Humber). Twinkl Educational Publishing kindly sponsored the conference and workshop event. DDB and SEB’s involvement was supported by Sport England’s Local Delivery Pilot – Bradford. DDB and SEB invovlement was also funded by the National Institute for Health Research Yorkshire and Humber ARC (reference: NIHR20016), and the UK Prevention Research Partnership, an initiative funded by UK Research and Innovation Councils, the Department of Health and Social Care (England) and the UK devolved administrations, and leading health research charities. ACR is funded by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM).