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Abstract
Background Co-production is defined as the voluntary or involuntary involvement of users in the design, management, delivery and/or evaluation of services. Interest in co-production as an intervention for improving healthcare quality is increasing. In the acute healthcare context, co-production is promoted as harnessing the knowledge of patients, carers and staff to make changes about which they care most. However, little is known regarding the impact of co-production on patient, staff or organisational outcomes in these settings.
Aims To identify and appraise reported outcomes of co-production as an intervention to improve quality of services in acute healthcare settings.
Design Rapid evidence synthesis.
Data sources Medline, Cinahl, Web of Science, Embase, HMIC, Cochrane Database of Systematic Reviews, SCIE, Proquest Dissertation and Theses, EThOS, OpenGrey; CoDesign; The Design Journal; Design Issues.
Study selection Studies reporting patient, staff or organisational outcomes associated with using co-production in an acute healthcare setting.
Findings 712 titles and abstracts were screened; 24 papers underwent full-text review, and 11 papers were included in the evidence synthesis. One study was a feasibility randomised controlled trial, three were process evaluations and seven used descriptive qualitative approaches. Reported outcomes related to (a) the value of patient and staff involvement in co-production processes; (b) the generation of ideas for changes to processes, practices and clinical environments; and (c) tangible service changes and impacts on patient experiences. Only one study included cost analysis; none reported an economic evaluation. No studies assessed the sustainability of any changes made.
Conclusions Despite increasing interest in and advocacy for co-production, there is a lack of rigorous evaluation in acute healthcare settings. Future studies should evaluate clinical and service outcomes as well as the cost-effectiveness of co-production relative to other forms of quality improvement. Potentially broader impacts on the values and behaviours of participants should also be considered.
- rapid evidence synthesis
- systematic review
- co-production
- acute healthcare
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Footnotes
Contributors DC, FJ, RH and GR designed the rapid evidence synthesis and developed the search terms. GR conducted hand searches of the journals: CoDesign, The Design Journal and Design Issues. DC and FJ screened all abstracts and agreed on full text for review. DC, RH and FJ reviewed all full texts and agreed inclusions and exclusions. DC, FJ and RH independently completed data extraction and quality assessment for all included papers. DC prepared the manuscript, and GH, RH and FJ reviewed and revised the manuscript. All authors agreed the final version of the manuscript.
Funding This project is funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research Programme (project number 13/114/95). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Health Services and Delivery Research Programme, NIHR, National Health Service or the Department of Health.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.