Healthcare interventions co-produced with users can lead to higher user satisfaction

Lim S, Morris H, Pizzirani B, Kajewski D, Lee WK, Skouteris H. Evaluating hospital tools and services that were co-produced with patients: A rapid review International Journal for Quality in Health Care. 2020; 32(4): 231-239.

Review question

•      What are the organizational outcomes and patients’ clinical and health outcomes from co-produced interventions?

Background

•      Healthcare improvement could occur on many levels, including individual, organizational or governmental, with patients having the ability to contribute to beneficial changes across all of these levels.

•      Co-production refers to the involvement of public service users in any of the design, management, delivery and/or evaluation of public services.

•      Emerging evidence suggests that engaging patients in quality and safety improvement strategies within hospitals will improve patient outcomes as well as support clinicians in their professional practice. However, this has not been studied extensively in the scientific literature.

•      The aim of this review is to identify the organizational outcomes and the patients’ clinical and health outcomes from co-produced interventions.

How the review was done

•      Review authors conducted a detailed search of three research databases for articles published between January 2008 and April 2019.

•      A total of 655 articles were retrieved from the initial search, of which 13 were included in this review.

•      The lead author of this review was funded by the National Health and Medical Research Council Fellowship.

What the researchers found

•      Most studies reporting on co-production in the hospital setting had ‘health services improvements’ as the end product, either in the form of service improvements or new services. Some examples include introducing ‘teach-back’ to help clients to understand instructions or having better access to podiatry services.

•      Co-production was also used to develop ‘tools and resources’ such as patient incident reporting tools, patient-oriented discharge summaries or list of questions to prompt discussion between care providers, patients and caregivers.

•      Co-production of ‘technology-based products’ was reported by several studies, including the development of information and communication technology platform for patient-reported symptoms or multimodal ICT tool for cancer rehabilitation.

•      In one study, co-production resulted in a working group, which was an experience-based co-production collaborative.

•      Most of the organizational or provider outcomes were focusing on acceptability, usability, uptake, and retention among the providers. Co-produced outputs received high ratings on satisfaction (80–100% satisfaction), moderate ratings on usability (60–100% easy to use), and had moderate-to-high levels of uptake and retention (50–100%). One potential adverse outcome was reported, which was the potential increase in clinical workload resulting from a co-produced ICT platform.

•      The impact of the co-produced outputs was reported to have resulted in reduction in wait times, improved timely delivery of home medication, increased patient understanding of medication and improved in knowledge, confidence, and skills.

Conclusion

•      Co-produced outputs have moderate-to-high acceptability, usability or uptake.

•      There was insufficient evidence to draw a conclusion about the effect of these products on organizational or patient outcomes.