Enablers and Barriers to an Experience-Based Co-Design Process to Develop Service Improvements in Enhanced Community Care in Ireland: A Qualitative Study

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES Health Expectations Pub Date : 2025-03-12 DOI:10.1111/hex.70206

Fay O'Donoghue, Máire T O'Donnell, Tomás P. Griffin, Eileen Fahy, Elaine Newell, Ann-Marie Creaven

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Abstract

Background

Experience-Based Co-Design (EBCD) is a popular collaborative process where service users and healthcare providers share their experiences of using and delivering services to identify ways to adapt services to enhance those experiences.

Objective

This study aimed to identify enablers and barriers to the successful implementation of EBCD as part of Ireland's recently adopted Enhanced Community Care (ECC) programme.

Design

Service users and staff at two sites (N = 17) participated in an accelerated EBCD process designed to enhance service provision for older people and those living with chronic conditions. This included four co-design working group sessions per site.

Methods

Transcripts from the co-design working groups and from brief follow-up interviews with individual participants were analysed. Thematic analysis was used to identify enablers and barriers to the EBCD process.

Results

We generated six key themes reflecting barriers and enablers; enablers were the fundamental role of the facilitator (Theme 1), a flexible approach that met group members' needs (Theme 2) and active and interactive activities to support participant engagement (Theme 3). The fundamental role of the facilitator was also identified as a barrier (Theme 4); additional barriers included balancing experience-sharing and decompressing (Theme 5) and the scope of the group as an invisible barrier (Theme 6), which reflected challenges in facilitating dialogue about change when participants were aware of system-level constraints on the potential for change.

Conclusions

The facilitator is critical in ensuring the successful implementation of the EBCD process. Considering how best to draw on the facilitator strengths while also ensuring that the service user perspectives are equally weighted with staff perspectives is important for effective communication within EBCD projects.

Patient or Public Contribution

Service users (also including carers) at two sites participated in EBCD projects alongside health and social care professionals, ultimately generating two service improvements for the ECC programme. The participation of these service users was celebrated at an academic conference, which was attended by a number of service users, and where the outcomes of the EBCD project were presented.

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.