ISQua's 39th International Conference 2023

Experience-based codesign (EBCD) in healthcare is a participatory approach to quality improvement that involves staff and health service users. It integrates ethnographic research and service design methods with the principles of user involvement to improve patient care and the experience of care from user and provider perspectives. Despite the availability of toolkits and published guidance that describe the EBCD process, implementation appears to be variable.

In this analysis, three case studies have been selected to explore how EBCD has been used to address diverse health service issues in regional Tasmania, Australia. The focus will be on identifying common and project barriers and enablers to project implementation.

Project documentation including reports, proposals, meeting minutes, and project team members’ personal reflections were included in the analysis. A general inductive approach was used to summarise common and project-based barriers and enablers.

The physiotherapy needs of patients with central neurological conditions are specific, and this cohort are generally under-serviced in rural and remote areas in Australia. This study collected stakeholder experiential information to inform redesign of a rural outpatient physiotherapy service.

In response to growing demand for cancer survivorship services, the Northern Cancer Service (NCS) partnered with service users and the Cancer Council Tasmania (CCT) to develop a cancer survivorship service for Northern Tasmania.

•Set up: project team consisted of 2 NCS clinicians, 1 service user rep, 1 CCT clinician, 1 researcher

•Gather: 10 service user interviews, 5 clinician interviews

•Understand and Improve: 3 workshops, 23 service users, 14 clinicians.

Recommendations for improving the experience (under consideration)

•Implement a nurse-led specialist Cancer Survivorship Service and a multidisciplinary survivorship clinic to provide tailored, supportive care.

•Improve the use of existing resources – educating clinicians about survivorship, providing consistent resources and information to service users at the right time.

•Strengthen partnerships with other organisations, such as CCT, to promote awareness of and participation in various community-led support programs, and to work with GPs.

EBCD used to develop and implement a reablement training program at the request of the organisation. The leadership team at the community care organisation formed a group of direct care workers and care coordinators who they considered to understand the nature of reablement (N=8).

EBCD = research team and organisation developing appropriate strategies for successful implementation and maintenance of reablement as a new model of care.

Staff embraced the opportunity to make positive change and were well supported to apply their learnings.

•EBCD is less supported and understood in health services.

oBe clear about the expectations of EBCD to the health provider, including executive levels.

oUpskill all health providers involved with the project about EBCD to avoid key person dependency.

oProvide a process for recruiting those with lived experience and to ensure appropriate renumeration.

•In EBCD user priorities can vary from the provider or organisation priorities, flexibility and adaptability is required.

•Successful EBDC needs support from health services – it must be engrained in the organisation’s culture.

ISQua's 39th International Conference 2023

USING EXPERIENCE-BASED CODESIGN TO SOLVE COMPLEX HEALTH SERVICE ISSUES IN REGIONAL AUSTRALIA – A CASE STUDY ANALYSIS

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