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Patients and staff: a truly special relationship

Joanna Goodrich 02 June 2017

Joanna Goodrich and Catherine Dale went to the IHI’s co-design college earlier this year to build delegates’ skills and confidence in co-design. In this blog, Joanna reflects back on the experience.


Last month I had the privilege of going to Boston to teach for two days at the IHI’s Co-Design College along with Catherine Dale, one of our Associates at The Point of Care Foundation. Catherine led our first co-design project with us in cancer services, trains regularly with us, and co-wrote the Experience Based Co-Design toolkit.

Delegates came from all over the USA and from Canada to learn about co-designing health services with patients. Our goal was that they would go away with the skills and confidence to teach and champion this new way of working in their own organisations. Alongside us, the faculty included experts from the IHI and the Veterans Administration.

Over the two days we introduced and practised using tools from EBCD, the Veterans Administration’s human-centred design methods and the IHI’s Always Events framework. At the heart was an emphasis on finding ways to understand the experience of care through the patient’s eyes, and then to work with patients to find solutions and to test and implement them. We offered a range of tools to gather information: observation; shadowing; interviewing to gather patients’ stories; using personas and scenarios; trigger films; and journey mapping with emotional touchpoints. We also offered ways of creating ideas for improvement and how to prototype and test them.

But more is needed than just these tools. Co-design is a change process, and it therefore requires a shift in our mindset. Patients and staff must work together as equals, and their different skills and knowledge must be recognised as equally valuable.

For me, the highlight of the two days was the amazing contribution made by Tiffany Christansen. Tiffany spoke for an hour at the very beginning about her experience as a patient with cystic fibrosis who has had not one, but two, double lung transplants. Her story was shocking, and funny, and full of emotional touchpoints which taught us all how small things in our experience of care can stay with us forever, and make a huge difference both positively and negatively. You can take a look at Tiffany’s story here. Tiffany brings this experience to her professional work as Patient and Family Engagement Specialist at the North Carolina Quality Center; she is in what must be a fairly unique position, being able to advocate for both patients and staff in her work.

We finished the two days with the Shark Tank (our Dragons’ Den) exercise – not as scary as it sounds! It was wonderful to hear teams pitch the co-design projects they are planning. They included work to improve experience for children going through haemo-oncology services, in rural primary care together with a children’s hospital, in community mental health, in cardiac services, in intensive care and in ED to tackle violence on staff. Teams talked about the tools they would try and how they would go about changing mindsets.

The Co-Design College was a first for the IHI and there was a clear sense from everyone there that co-design is an exciting and logical next step on the quality improvement journey.