Case study | Project background | Project objective | Research aim | Research methods |
The Esther network | The Esther network—coordinated by Region Jönköping County—recently won the ICT-Enabled Social Innovation (IESI Award) from the EU Science Hub for best initiative supporting active and healthy ageing. The award was for its positive contribution to society as well as its disruptive ICT-enabled social innovation potential and high level of service integration. From its origins in 1997, the Esther model has subsequently been adopted and implemented in England, Scotland and Singapore. | To improve patient flow and coordination of care. | The story of Esther(s) is a central feature of the Esther Network. In exploring the mechanisms of coproduction in the Network we will focus on the role of narrative. The case study will also provide interesting data on leadership processes. | Qualitative study incorporating documentary analysis; interviews with project leaders and participants; and non-participant observation of network events. |
Patient Compact | At the regional level, an ongoing strategic innovation programme in Region Jönköping County (the ‘Together’ programme) started in 2012 and has developed and expanded over time. The programme is divided into several subprojects, of which—what has become—the national development and implementation of a ‘Patient Compact’ is one. | To transform healthcare delivery closer to citizens, from hospitals to primary care, from primary care to home care and with a focus on health promotion efforts together with other community actors and citizens themselves. | To enhance emerging understandings of coproduction as they evolve over time within the Together programme and establish measures relating to coproduction and its potential impact on health and well-being. | Mixed-methods evaluation incorporating interviews with patients and staff participants at micro, meso and macro levels; documentary analysis; and participant observation of programme events. Secondary analyses of datasets collected as part of programme (eg, clinical outcomes, population health). |
We Coproduce (UK) | The origins of We Coproduce as a social enterprise in 2013 are rooted in the recognition, at a mental health hospital in London, that service user involvement was not working, with subsequent development of an independent social enterprise. We Coproduce then also began to work with other community organisations and providers across London to help them embed coproduction in their service design and delivery. | Ongoing projects include coproducing a community owned and run radio station; coproducing with frontline mental healthcare staff to support them to make their own films about trauma-based approaches; and coproducing with a local council to embed micro businesses in partnership with bigger local businesses to challenge isolation. | Our research with We Coproduce will focus on exploring the challenges and opportunities of coproducing the implementation of coproduced service standards in mental health wards. | Qualitative study incorporating documentary analysis; interviews with project leaders and participants; and non-participant observation of coproduction events and meetings. |
Djursdala community project | This case study is funded by an European Union initiative and seeks to identify needs and initiate the development and use of digital solutions that promote the health and well-being of a population of ~400 citizens in a rural area. Staff at Jönköping Academy are coordinating research into this initiative which is led by the local community. | To support rural development projects initiated at the local level in order to revitalise rural areas and enhance local community/rural area. | To explore how user-driven digital development can enable cocreated and coproduced services that lead to value for a rural area, and whether digital solutions contribute to sustainable development and, if so, in what way. | To explore the process of using participatory action research to coproduce methods and solutions with local people from the area, through interviews with community leaders, participants and researchers; and participant observation of community-led events. |
Chemotherapy-induced peripheral neuropathy (UK) | Some cancer drugs cause damage to nerves, a condition called chemotherapy-induced peripheral neuropathy (CIPN). The most common symptoms, felt mainly on hands and feet, are numbness, tingling, pain, muscle weakness and/or sensitivity to cold. People with CIPN can have functional difficulties in carrying out tasks involving their hands and feet. It is important to prepare patients about the possibility of developing CIPN to help them recognise and report symptoms early so healthcare professionals (HCPs) can support them. | To codesign and test an intervention to reduce falls and injuries and improve functional status and quality of life among individuals with CIPN. | To study how codesigned interventions can be developed and put in place early to prevent subsequent CIPN-related falls and injuries, reduce costs to healthcare systems and lessen the burden on HCPs and services. | Feasibility of randomised controlled trial with embedded process evaluation (will include semistructured telephone interviews with all patient participants (n=40) to assess acceptability of the intervention and evaluation methods). Patients will complete outcome measures (early symptom reporting; reduction in symptoms and self-efficacy in managing symptoms; improved functional status; quality of life) at various timepoints. |
Learning Café: cardiac care | A Learning Café project is underway where people with cardiac care needs come together to collectively discuss how they can improve different aspects of their health and well-being. Clinical measures—as well as patient-reported outcome measures and patient-reported experience measures—are being codesigned with patients and families and professionals. In addition, a codesigned conceptual model of the Learning Café which can be adapted to other groups of patients with chronic disease is being developed. | To explore whether, how and why the coproduction of healthcare services, particularly for individuals (and their families) with cardiac care needs, can contribute to high quality care. | To explore what role motivation plays for patients, family members and healthcare professionals when coproducing healthcare. | Mixed-methods study incorporating patient surveys (sense of security in everyday life, patient satisfaction); focus groups and semistructured interviews with patients and professionals; patient diaries; and non-participant observation. |
Disabled children and adolescents | This study is mainly taking place in a not-profit organisation in Solberga By, near Stockholm, and is drawing on an action research design to study local quality improvement initiatives to enhance individual support to children with intellectual disability living in special care residence. This includes studying if and how the children’s role as coproducers is reinforced by these initiatives. | To enhance staff capacity to design, test and follow-up individual support to children with intellectual disabilities. | The overall aim is to explore the usefulness of integrating improvement knowledge and the International Classification of Functioning, Disability and Health in staff working procedures to improve goal fulfilment and coproduction for children living in special care residence. | Realistic evaluation study design including data collection from observations, behaviour and function assessments, field notes from staff sessions, QI-documentation and focus groups. |
Therapeutic engagement on an acute psychiatric ward (UK) | Therapeutic engagement has long been regarded as the essence of mental health nursing. Its benefits are well documented: inpatients who are socially engaged adjust better to community life, have greater symptom improvements during treatment and exhibit fewer violent and aggressive behaviours. Nurses who spend more therapeutic time with patients have greater job satisfaction and take fewer sick days, which may reduce the costly use of unfamiliar agency nurses. Despite this, research spanning 35 years shows that just 4%–12% of nurses’ time was spent on therapeutic activities. | To empower a service-user group to take a lead role, and in partnership with NHS staff, codesign and implement an intervention to improve nurse–patient therapeutic engagement on acute mental health wards. | To assess the project in terms of improvements in the amount, type and quality of nurse–patient engagement; improved service user/service provider relations; and the fostering of a culture of collaborative working/research practices within a psychiatric ward. | Mixed-methods evaluation incorporating interviews with patients and staff participants; non-participant observation of codesign events; event questionnaires; and a pre–post test design on an intervention and control ward using structured qualitative and quantitative observations, a self-report measure and data from ward registers to assess type, quality and amount of engagement. |
Learning health system for severe mental illness | In the department for psychosis at Sahlgrenska University Hospital in Gothenburg, a Learning Health System has begun to be developed and tested along with patients, case managers and the management team. Patients and families are active participants in considering system design, user-experience design, choice of outcome measures and development of care processes. | To enable learning throughout the whole ‘system’ and continuous improvement. | To explore the role of patients in, first, the development of data-visualisation-design and how this impacts on learning both for the patient and their case manager, and second in evaluating outcome measures useful for the patient and their case manager in ongoing treatment. | Mixed-methods study incorporating surveys; interviews; and non-participant observation. |