Patient co-design, also known as co-production or co-creation, involves actively integrating patients into the design and improvement of healthcare services. While offering an opportunity to better align healthcare services with patients' needs and preferences, its implementation faces notable challenges, ranging from resource allocation to power dynamics. What are the core elements of patient co-design, its potential benefits, and the obstacles it faces in achieving meaningful outcomes?
Engaging Patients Effectively
Active engagement and empowerment of patients are central to successful co-design. Patients must feel their contributions are valued and will genuinely influence the care provided. Trust is foundational to this engagement; without it, patients may be reluctant to participate. Health literacy also plays a critical role, as patients need to understand healthcare processes to provide meaningful input. However, co-design should not only include patients who are well-versed in healthcare but also those with varying levels of understanding. For this reason, it’s crucial to ensure that materials and communication methods are accessible, fostering an inclusive environment for diverse perspectives across age, ethnicity, socioeconomic status, and health conditions. While enriching the design process, this diversity poses challenges to Patient Family Advisory Councils (PFACs) responsible for patient input. Recruiting and retaining participants from different backgrounds, especially those with limited language proficiency, can be demanding, highlighting a pitfall in broadening the reach of co-design.
Collaboration and Power Dynamics
Patient co-design requires seamless interdisciplinary collaboration among healthcare providers, designers, and patients. Open, transparent, and respectful communication is paramount, yet it is often hindered by real-world constraints such as provider burnout and understaffing. Incorporating patient feedback necessitates ongoing dialogue and iterative refinement, which can be difficult in a healthcare environment with limited time and resources. A feedback loop, while an ideal mechanism for evaluation and adjustment, requires commitment and effort that many healthcare organisations find challenging to maintain. Another aspect critical to the success of patient co-design is levelling the power dynamics between healthcare professionals and patients. Often, there is an unspoken hierarchy in which patients are seen as outsiders, mere observers of the decision-making process. Shifting this mindset is crucial; patients are not outsiders—they are the reason for the healthcare system’s existence, and their insights should be considered with the same weight as those of full-time employees. Addressing these imbalances fosters a collaborative environment where patients feel like equal partners in the process.
Organisational Support and Flexibility in Design
For patient co-design to achieve its full potential, it requires a flexible, iterative approach that accommodates patients' and their families' varying needs and capabilities. This means that ideas should be prototyped, tested, and refined based on continuous patient feedback, adapting as necessary to reflect their physical, emotional, and practical constraints. However, this flexibility must be matched with robust organisational support. Leadership buy-in is critical; without a strong commitment from healthcare leaders to back patient involvement and act on the insights gathered, co-design efforts are often sidelined. Some leaders may view bringing patients into the design process as threatening their established protocols and “siloed” innovation processes, leading to resistance against co-design. In addition to leadership support, adequate resources—such as financial backing, staff time, and infrastructure—are essential to sustain meaningful co-design activities. Many healthcare settings are under-resourced, making it difficult to allocate the necessary investment in patient engagement, further complicating efforts to embed co-design as a core practice.
Patient co-design holds immense promise to transform healthcare services into more patient-centred, effective, and efficient care systems. By engaging patients and families directly in the design process, healthcare organisations can benefit from insights that align care services more closely with patient needs and preferences. However, this approach is not without its challenges. Engaging diverse patient populations, ensuring equal collaboration and power-sharing, and securing organisational support all require significant effort and resource allocation. While co-design has the potential to drive positive change in healthcare, its success ultimately depends on the willingness and ability of healthcare organisations to commit to true partnership with patients, overcoming the barriers of resource constraints, leadership apprehensions, and communication challenges. By thoughtfully addressing these factors, patient co-design can become a cornerstone of patient-centred healthcare innovation.
Source: Digital Health Insights
Image Credit: iStock
