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What outcomes are associated with developing and implementing co-produced interventions in acute healthcare settings?: A rapid evidence synthesis
Academic Unit of Elderly Care and Rehabilitation, Leeds Institute of Health Sciences, Bradford, United Kingdom.
Faculty of Health Social Care and Education, St George's University of London, London, United Kingdom.
Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, United Kingdom.
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, United Kingdom.ORCID iD: 0000-0001-8781-6675
2017 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 7, article id e014650Article in journal (Refereed) Published
Abstract [en]

Background

Co-production is defined as the voluntary or involuntary involvement of users in the design, management, delivery and/or evaluation of services. Interest in co-production as an intervention for improving healthcare quality is increasing. In the acute healthcare context, co-production is promoted as harnessing the knowledge of patients, carers and staff to make changes about which they care most. However, little is known regarding the impact of co-production on patient, staff or organisational outcomes in these settings.

Aims

To identify and appraise reported outcomes of co-production as an intervention to improve quality of services in acute healthcare settings.

Design

Rapid evidence synthesis.

Data sources

Medline, Cinahl, Web of Science, Embase, HMIC, Cochrane Database of Systematic Reviews, SCIE, Proquest Dissertation and Theses, EThOS, OpenGrey; CoDesign; The Design Journal; Design Issues.

Study selection

Studies reporting patient, staff or organisational outcomes associated with using co-production in an acute healthcare setting.

Findings

712 titles and abstracts were screened; 24 papers underwent full-text review, and 11 papers were included in the evidence synthesis. One study was a feasibility randomised controlled trial, three were process evaluations and seven used descriptive qualitative approaches. Reported outcomes related to (a) the value of patient and staff involvement in co-production processes; (b) the generation of ideas for changes to processes, practices and clinical environments; and (c) tangible service changes and impacts on patient experiences. Only one study included cost analysis; none reported an economic evaluation. No studies assessed the sustainability of any changes made.

Conclusions

Despite increasing interest in and advocacy for co-production, there is a lack of rigorous evaluation in acute healthcare settings. Future studies should evaluate clinical and service outcomes as well as the cost-effectiveness of co-production relative to other forms of quality improvement. Potentially broader impacts on the values and behaviours of participants should also be considered. 

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2017. Vol. 7, no 7, article id e014650
Keywords [en]
acute healthcare, co-production, rapid evidence synthesis, systematic review, behavior, Cinahl, Cochrane Library, controlled clinical trial, controlled study, cost effectiveness analysis, Embase, feasibility study, female, human, male, Medline, randomized controlled trial, staff, synthesis, total quality management, Web of Science
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:hj:diva-38551DOI: 10.1136/bmjopen-2016-014650ISI: 000410203700050PubMedID: 28701409Scopus ID: 2-s2.0-85024377650Local ID: HHJIMPROVEISOAI: oai:DiVA.org:hj-38551DiVA, id: diva2:1174497
Available from: 2018-01-15 Created: 2018-01-15 Last updated: 2018-08-20Bibliographically approved

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