Improving healthcare services and pathways through co-design
Meaningfully engaging with communities and care professionals to design new services
There are several key drivers for improving services and redesigning pathways:
Health needs assessments and health equity audits may highlight services in specific communities and contexts that require focused attention.
Benchmarks and performance indicators may identify sub-optimal outcomes where the health return on investment is poor.
Patient and carers may provide service feedback and complaints.
Care professionals may flag opportunities for improved integration, improved treatment regimes and opportunities to apply new clinical and information technologies.
Co-design brings together the right stakeholders in a coordinated program to improve services. This ensures that:
- There is a full understanding of the existing care pathway from all perspectives, the intended improvements in outcomes and value.
- There is balanced attention on the treatment pathway, the patient experience, the professional experience and the strategic ‘fit’ within the overall system blueprint.
- The case for change can be communicated to different audiences with confidence.
- The new pathway is ‘owned’, which is a crucial enabler for decommissioning the legacy pathway.
- The resulting service specification has the defined outcomes and performance indicators that matter most to the people using the service and their improvement trajectory can be tracked.
Co-design is not straightforward. It requires a willingness to listen to messages that may be different to what was expected.
Co-design should never be used to endorse a service pathway that has been developed by professionals and commissioners at the exclusion of patients and carers.
Co-design should not shy away from discussions about priorities, relative investment and the recognition that demand will typically exceed the resources that can be invested.
Patients and carers involved in co-design will expect and demand a mature dialogue that is framed in the realities of healthcare funding.
It also needs to be culturally responsive to recognise that healthcare requires a holistic response.
What we do
We apply a systematic approach to co-designing services that blends diverse engagement techniques
We bring together a range of co-design techniques to build a service that resonates with the people who use the service, their carers and the professionals who work together to run the service.
Co-design with patients, consumers and carers generates honest feedback and innovative ideas on how to improve the service
Listening events facilitate a discovery of the status quo, the drivers for change, the inefficiencies and fragmentation in existing pathways.
These listening events are shaped according to the cultural context and use combinations of ‘hard’ analysis of activity, finance, access and outcomes alongside ‘soft’ data about patient experiences, complaints and the impact of sub-optimal pathways on patients and care professionals.
Our patient engagement techniques include gathering patient stories, shadowing patients, mapping patient journeys, conducting experience surveys and developing patient personas.
Co-design with clinicians, providers and system partners ensures robust services are developed based on expertise and evidence
To develop robust services, we conduct literature and evidence reviews, and run interviews and focus groups with the professionals involved in running the service.
We engage closely with consumers and professionals to develop a strong service logic model which underpins the new care pathway and the new model of care.
An example co-design plan is shown below:
- The new care pathway and model of care describes the desired ‘inputs’, ‘activities’, ‘outputs’ and ‘outcomes’ so there is a confident platform for implementation using procurement, decommissioning and change management.
- Significantly, it identifies the key dependencies requiring support from information technology, data management, workflow and workforce.
- It also provides the means to evaluate success from the different stakeholder perspectives and track the improvement trajectories compared to the intended outcomes and identified deficiencies in the legacy pathway.