Post on 12-May-2019
Partners in Care Programme
Co-design in health and care services
Websession 1
Dr Lynne Maher Director for Innovation Ko Awatea Associate Professor of Nursing The University of Auckland
Web sessions – tips on etiquette and
interaction
• Interacting- an important part of everyone's learning is that you contribute with your progress and ask lots of questions. • Speaking- ‘raise your hand’- you will find an icon that you can
click on which alerts us.
• Or type into the ‘chat box’, we will monitor this throughout the call
• If you are sharing the call with others in the room can someone please type everyone's name into the chat box or send a list to us so that we know who is on the call.
Web sessions – tips on etiquette and
interaction
• Background noise- we can hear you!
If you are able to please mute your phone until you want to speak to the group
Agenda for todays web session
• Project start up- clarity of the area
you are planning to work in. Consideration of scope and time
• Engage- have you started?
• Check in- any concerns/ questions ?
• Next activities
Combined Web session and second
workshop dates
• Wednesday 9th November 12-1pm
• Wednesday 7th December 10-11am
Second workshop
Wednesday 25th January 2017 Taranaki Teams
Wednesday 8th February 2017 Hutt Valley & Capital & Coast Teams
• Wednesday 22nd February 12-1pm
• Wednesday 15th March 12-1pm
• Wednesday 5th April 12-1pm
• Wednesday 3rd May12-1pm
• Wednesday 31st May 12-1pm
Second Workshop
Will have a focus on:
• Reviewing progress, challenges, successes and
learning from each team.
• Planning actions for the remainder of the programme
including;
• Planning and running one or more co-design sessions
• Prioritising and selecting ideas
• Implementing and measuring success using the Model
for Improvement -plan, do, study act cycles.
Workbooks and case studies
Workbooks- Templates are provided and follow the
stages of the co-design methodology.
First submission 2nd March 2017
Second submission 25th May 2017
Case studies – a template is provided and it also
follows the stages of the co-design methodology
Visit the HQSC web pages
• https://www.hqsc.govt.nz/our-programmes/partners-in-
care/work-streams/co-design-partners-in-care/
• Scroll down for lots of resources and case studies from
previous programmes
Co-design approach
Co-design approach includes the following stages:
• Project start up: scope, plan, aim
• Engage: patients, families and staff
• Capture: patient, family and staff experiences using a range of methods
• Understand: emotions and “touch points” along the journey of care
• Improve: work together to identify and prioritise what to improve
• Measure: check to see if experience is improving
Stop before you start…..
“When developing new products, processes or even businesses most
companies are not sufficiently rigorous in defining the problems they are attempting to
solve”
Spradlin (2012) Harvard Business Review
If I had an hour to save the world, I would spend 59 minutes defining the problem and one minute finding solutions. Albert Einstein
Project set up- tips for project teams
• A core part of a co-design approach is to really understand the experiences of people who are receiving and delivering services and then working with them to identify their ideas for improving that service/product.
• This means that teams should not start with a project that already has a clear solution. For example – “we aim to create an education system for patients a to reduce the number of people who ‘do not attend’ outpatient clinics”.
• Teams can identify the ‘challenge’ and ‘aim’ they have for example; the do not attend rate is increasing and we aim to reduce it by x% by y month. Do recognise in this statement I have not suggested ‘how’. We don’t know that until we have captured and understood experiences.
• Co design means patients, families and staff working in partnership. It does not mean that staff develop something then show it to patients for their approval- this reflects a ‘tick box’ mentality
Use multiple data sources
Co-design enables you to define the problem or challenge clearly from multiple perspectives including……..
Organisation- How?
Staff and other stakeholders- Who?
Consumers/families – Who?
Co-design approach
Co-design approach includes the following stages:
• Project start up: scope, plan, aim
• Engage: patients, families and staff • Capture: patient, family and staff experiences using a
range of methods
• Understand: emotions and “touch points” along the journey of care
• Improve: work together to identify and prioritise what to improve
• Measure: check to see if experience is improving
How do we typically design services
with patients?
• Don’t listen very much to our users and we do the
designing
• Listen to our users then go off and do the
designing
• Listen to our users and then go off with them to do
the designing= Co-design
(Professor Paul Bate 2007)
Engaging people…
http://www.hqsc.govt.nz/our-programmes/consumer-engagement/publications-and-resources/publication/2162/
Staff and other stakeholders- Who? Consumers/families – Who?
Engaging consumers at different levels in
projects
• Programme or project governance level
• Project ‘lived experience’ level-
• Today contributing to ‘capture’ phase
• Over time through to the ‘co-design’ phase
Check in- Engaging
How are you doing? Lets have some feedback from at least two teams.
Who has started to engage consumers and staff
• At Project/steering group level?
• At ‘front line’ level?
• Is anyone having challenges?
“The single biggest
problem in communication
is the illusion that it has
taken place.”
George Bernard Shaw, Leadership Skills for Managers
@LynneMaher1
Resistant behaviour is a good
indicator of missing relevance Harald Schirmer
http://de.slideshare.net/haraldschirmer/strategies-for-corporate-change-the-new-role-of-hr-driving-social-adoption-and-change-in-the-enterprise
Source of image: driverlayer.com
‘ ‘
When communicating connect with hearts and
minds
“What the leader cares about (and typically bases at
least 80% of his or her message to others on) does
not tap into roughly 80% of the workforce’s primary
motivators for putting extra energy into the change
programme”
Scott Keller and Carolyn Aiken (2009)
The Inconvenient Truth about Change Management
Describe the change from multiple
perspectives
What are the anticipated benefits?
What is in it for consumers, for the organisation and what is in it for staff?
Staff must be able to see that ‘they’ will benefit (WIIFM) if scepticism/anxiety is to be tackled
Communicate in a number of ways
• Use all of the organization’s communication vehicles
• Stories, metaphors, analogies, and examples are all effective means of painting a compelling picture
• “Walk the talk”
• Effectively capture both the minds (What) and hearts ( Why)
Engaging – tips for project teams
• It is important to engage early as one of the reasons to work with consumers and families ( and staff) is to understand their experiences.
• It is helpful to try to engage a small number (2-3) of consumers/family members at project/steering board level. Their role is to help steer the project with staff. These can be people from a consumer council or advisory group and they provide broad support.
• When working ‘at the front line’ teams will need to engage with people who are actually experiencing the service now or have recently ( within the last year) .
• Always try to engage more people than you need. The attrition rate is often high.
Engaging – tips for project teams 2
• A good method of approach is often via a clinician whom patients have had contact with in some way. However teams could just go and talk to people who are in the service today. Important to remember context is critical accessing via churches/charities/community groups may be most appropriate.
• Be prepared with some relevant information and remember ‘framing’ this is important so people feel safe. For example- ‘we want to explore how it feels like to be a patient in ABC service’. ‘We are keen to find out what works really well and what could be improved’.
• Communication, communication, communication
Co-design approach
Co-design approach includes the following stages:
• Project start up: scope, plan, aim
• Engage: patients, families and staff
• Capture: patient, family and staff experiences using a range of methods
• Understand: emotions and “touch points” along the journey of care
• Improve: work together to identify and prioritise what to improve
• Measure: check to see if experience is improving
Focus groups
and panels
Patient Stories
Photo booth
Complaints/compliments
Story Board Diary
Public Meetings
Comments cards
Surveys
In depth conversations
The Health Foundation Inspiring Improvement Measuring patient experience
June 2013.
There are many ways of capturing experience
Patient experience questionnaire
Observation Shadowing
Empathy/in their shoes- my view
“We can never fully experience what another does as we cannot possibly feel the same joy, fear, pain, elation or anxiety. But we can expose ourselves to part of their experience so that we can empathise, go on just try.” Lynne Maher 2015
@LynneMaher1
Numbers, numbers…
Breadth
De
pth
Conversation Shadowing Small focus groups Diarys Filming
Surveys Emotion questionnaire Focus groups Observation
Next Activities
Next activities
• Continue with your set up if needed
• Engage at Project/Steering Board Level and at ‘front line’ level. This will require some attention to communications.
• Start to plan for Capture – remember breadth and depth
Time check
• Next Websession-Wednesday 7th December 10-11am
• That is 20 days away if you are working on your project 5
days each week. Or….. four hours away if you are working
on your project one hour a week.
• Consider a time plan where you identify time for each team
member each week and remember to block out holidays.