在大型急性医院环境中与患者代表和临床医生共同设计医疗保健解决方案:过程和参与

M. Bollard, Alison Dowling, L. Westwood, Ann-Marie, Cannaby
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引用次数: 0

摘要

让患者和更广泛的公众参与护理的好处越来越得到国际认可。据报道,联合设计是促进以患者为基础的医疗服务改进的方法之一,并提供了一种参与式方法,让患者和公民参与解决医疗保健挑战。然而,目前的局限性是针对这一工作主体的,这表明缺乏可持续性和任何已知的相关过程的实质性证据,这些过程可以产生可持续的长期患者利益。该服务改进项目以以人为本的设计(HCD)方法为基础,结合了设计委员会的流程发现、定义、开发和交付[1]。这有助于提供一个参与性框架,在12个月的时间里,与中风、儿童和青年(CYP)以及学习和发展障碍(LD)三个临床路径团队共同制作工作。为了实现特定的项目目标,使用工具包和协作行动计划开发了基于患者的项目,并引导了整个项目的参与。评估结果引出了三个主题,共同产生了一个产品理念,承认了所有人的贡献、障碍和挑战。在这方面,临床医生和患者代表报告了拥有安全空间与各自的患者代表一起进行经验丰富的工作的价值。此外,他们报告了所选择的HCD框架指导了参与过程,确定了针对患者衍生挑战的共同生产的医疗保健解决方案。得出的结论表明,需要进一步的工作和研究来测试与健康和社会护理中成功的联合设计相关的“如何”过程。这可以为医疗保健微观和宏观层面所需的可持续以人为本设计的价值和过程提供经验基础。
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Co-Designing Health Care Solutions with Patient Representatives and Clinicians in a Large Acute Hospital Setting: Process and Engagement
The benefits of involving patients and wider members of the public as partners in care are being increasingly recognised internationally. Co-design is one of the methods reported to promote patient-based health service improvements and offers a participatory approach to engage patients and citizens in solving health care challenges. However, current limitations are levelled at this corpus of work, indicating a lack of sustainability and substantive evidence of any known associated processes that can yield sustainable longer-term patient benefit. This service improvement project was underpinned by a Human Centred Design (HCD) methodology incorporating the Design Council’s process Discover, Define, Develop and Deliver [1]. This assisted in providing a participatory framework of co-produced work over a twelve-month period with three clinical pathway teams, Stroke, Children and Young People (CYP) and Learning and Developmental Disabilities (LD.) Meeting specific project objectives, patient-based projects were developed using a toolkit and Collaborative Action Plans that steered involvement throughout. Evaluative results elicited three themes, generating a product idea together, acknowledging the contribution of all, barriers and challenges. Within this, the clinicians and patient representatives reported the value of having a safe space to carry out experienced based work with their respective patient representatives. Additionally, they reported the chosen HCD framework guided the process of engagement determining co-produced health care solutions to patient derived challenges. Conclusions are drawn that suggest further work and research is required to testbed the ‘how to’ processes associated with successful co-design in health and social care. This could provide an empirical basis for the value and process associated with sustainable human centred design required at both a micro and macro level of healthcare.
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