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How to do quality improvement ‘with patients’, not ‘to patients’

Sophie Lansdowne 11 August 2016

Sophie Lansdowne explores a recent Experience Based Co-Design masterclass with Health Innovation Network and looks at the Foundation’s partners as advocates for our improvement work.

Earlier this year, Health Innovation Network (HIN), the Academic Health Science Network for South London, approached us to run an Experience Based Co-design (EBCD) masterclass for all of the academics, NHS commissioners and providers, local authorities, patients and industry members which they bring together in South London.

Identifying the issues that matter to patients

Developed from the design industry, EBCD is a radical approach which brings staff and patients/service users together as partners to identify ways to improve the experience of care. The proven EBCD method places equal value on the voices of patients/service users and staff, which breaks down hierarchies and provides the opportunity to really see what improvements need to be made from the user perspective.

EBCD therefore not only encourages innovative ideas and solutions, but ensures that the right problems are identified from the very beginning. Too often it is easy to rush in to designing interventions for what we think needs to be improved, without asking what it is that really matters to patients.

Learning from the best: our Faculty of Improvement champions

Professor Glenn Robert and Catherine Dale led the workshop, drawing on their extensive experience of implementing EBCD projects and the successes and challenges that come with it. Ioanna Xenophontes, Senior Lived Researcher, also shared her experiences of co-designing improvements within an acute mental health trust from which she had previously received services. Such rich insight really brought the methodology to life, and discussion was reflective of how the approach could be put in to practice in each participant’s area of work.

We are always incredibly grateful to our partners who lead the training and act as advocates for our improvement work. This workshop once again made me reflect on how valuable this first-hand experience is; not just in understanding the practical applications of the method, but also in providing the inspiration and motivation to challenge traditional practices and create a new culture where patients and staff alike are empowered to do things differently.

Building an improvement community

One of our biggest challenges is ensuring that our locally based improvement work is scaled up, and it is a delight to see this develop organically as those we train embark on projects of their own and use the principles of co-design to move closer to delivering care that is truly person-centred. This is with a model for spread that we will use in our ambitious ‘Living Well to the Very End’ programme in end-of-life care, built on the Patient and Family Centred Care (PFCC) method.

We will train current programme participants as coaches in the methodology, who, alongside our current network of coaches from previous PFCC projects, will spread the approach both within their own organisations and further afield, as we take on new sites across the UK. We hope that this will help to build cultures where all staff understand that improving quality and experience is part and parcel of the job, not the responsibility of one team or group.

EBCD ‘breaking America’

We would like to thank HIN for inviting us to share the methodology with their network, and also to the visitors from the Institute for Healthcare Improvement, who came all the way across the pond in order to learn more about how EBCD might be used in the US.

We hope to follow up with all of those who attended the training soon, and follow their EBCD journey. If you’d like to find out more about EBCD please click here, or view the toolkit which was developed at the Kings Fund. We are running our next open EBCD workshop on the 14 October 2016 in central London; for more information and to register for your place, please click here or email Sophie –