1.
2.
Gremyr, Andreas, et al.
(author)
The role of co-production in Learning Health Systems
2021
In: International Journal for Quality in Health Care. - : Oxford University Press. - 1353-4505 .- 1464-3677. ; 33:Supplement 2, s. ii26-ii32
Journal article (peer-reviewed) abstract
BACKGROUND: Co-production of health is defined as 'the interdependent work of users and professionals who are creating, designing, producing, delivering, assessing, and evaluating the relationships and actions that contribute to the health of individuals and populations'. It can assume many forms and include multiple stakeholders in pursuit of continuous improvement, as in Learning Health Systems (LHSs). There is increasing interest in how the LHS concept allows integration of different knowledge domains to support and achieve better health. Even if definitions of LHSs include engaging users and their family as active participants in aspects of enabling better health for individuals and populations, LHS descriptions emphasize technological solutions, such as the use of information systems. Fewer LHS texts address how interpersonal interactions contribute to the design and improvement of healthcare services.OBJECTIVE: We examined the literature on LHS to clarify the role and contributions of co-production in LHS conceptualizations and applications.METHOD: First, we undertook a scoping review of LHS conceptualizations. Second, we compared those conceptualizations to the characteristics of LHSs first described by the US Institute of Medicine. Third, we examined the LHS conceptualizations to assess how they bring four types of value co-creation in public services into play: co-production, co-design, co-construction and co-innovation. These were used to describe core ideas, as principles, to guide development.RESULT: Among 17 identified LHS conceptualizations, 3 qualified as most comprehensive regarding fidelity to LHS characteristics and their use in multiple settings: (i) the Cincinnati Collaborative LHS Model, (ii) the Dartmouth Coproduction LHS Model and (iii) the Michigan Learning Cycle Model. These conceptualizations exhibit all four types of value co-creation, provide examples of how LHSs can harness co-production and are used to identify principles that can enhance value co-creation: (i) use a shared aim, (ii) navigate towards improved outcomes, (iii) tailor feedback with and for users, (iv) distribute leadership, (v) facilitate interactions, (vi) co-design services and (vii) support self-organization.CONCLUSIONS: The LHS conceptualizations have common features and harness co-production to generate value for individual patients as well as for health systems. They facilitate learning and improvement by integrating supportive technologies into the sociotechnical systems that make up healthcare. Further research on LHS applications in real-world complex settings is needed to unpack how LHSs are grown through coproduction and other types of value co-creation.
3.
Batalden, Maren, et al.
(author)
Coproduction of healthcare service
2016
In: BMJ Quality and Safety. - : BMJ. - 2044-5415 .- 2044-5423. ; 25:7, s. 509-517
Journal article (peer-reviewed) abstract
Efforts to ensure effective participation of patients in healthcare are called by many names - patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always 'coproduced'. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services.
4.
5.
Batalden, Paul B., et al.
(author)
Episode 1: Coproduction is everywhere [podcast]
2021
Other publication (pop. science, debate, etc.) abstract
Paul invites his guests, Kathryn Sabadosa and David Leach, to share a time when healthcare services worked well.Kathryn describes the experience of her son, born 20+ years ago with Cystic Fibrosis. She describes the recent changes in the routine care for people with CF and the way together they are changing “good” care for him, and some of the ways that COVID-19 has changed her son’s interactions with professionals.David describes his experience deciding to have heart surgery. He focuses on how he sought out the ‘person’ in the professionals he met and worked with.After a three-way conversation, Paul offers this episode’s takeaways, focused on the importance of discovering and noticing coproduction in daily healthcare services.
6.
Batalden, Paul B., et al.
(author)
Episode 10: My work depends on the setting ... [podcast]
2022
Other publication (pop. science, debate, etc.) abstract
John tells us how his work environments influence the content of his work. In his experiences with two settings, he illustrates concretely how this happens and what difference it makes to him as a physician-person.
7.
Batalden, Paul B., et al.
(author)
Episode 11: From principles to practices [podcast]
2022
Other publication (pop. science, debate, etc.) abstract
After describing a situation where learning and the “learner” seem “blocked”, Bill explores the creative ways teachers address situations like this. Together, Bill and Paul discuss the multiple issues that arise when learning new/different knowledge, skills and dispositions (habits) and using them in daily work. Their conversation explores traps that commonly occur and an overview of ways to start.
8.
Batalden, Paul B., et al.
(author)
Episode 12: Coproduction and macrosystems of healthcare [podcast]
2022
Other publication (pop. science, debate, etc.) abstract
April and Doug bring their long familiarity to describe the transformative change when the indigenous community became the “customer-owners,” as they now call the members of the Native American community. They explore the way commonly occurring meetings happen and some of the implications for their work as executive-persons in the setting. April describes what it’s like getting a professional-person’s help for a problem. Doug describes some of the data that is used to measure the changes that have occurred since the change.
9.
Batalden, Paul B., et al.
(author)
Episode 13: Safer together [podcast]
2022
Other publication (pop. science, debate, etc.) abstract
The realization that safer healthcare is not a “binary” phenomenon, but a result from a complex set of factors working together in various ways and that healthcare is not limited to what occurs in hospitals led Charles and his colleague to work together to write their important book. Maren and her colleagues at Cambridge Health Alliance near Boston took those ideas and built their efforts. She describes how direct involvement of a patient and his spouse offered a much more helpful understanding of a fall that occurred shortly after this patient-person was admitted to the hospital. Together they illustrate how ideas become new ways of conducting the daily work of making safer healthcare. They open consideration of how automation enters the co-productive workspace and illustrate both its opportunities and its challenges.
10.
Batalden, Paul B., et al.
(author)
Episode 14: Looking back and ahead [podcast]
2022
Other publication (pop. science, debate, etc.) abstract
Paul, Christian, and Tina weave the foundational content for coproducing healthcare service and a frame for thinking. They reflect on several possible additional themes for subsequent attention. They discuss some of the personal tips that have been helpful in their own thinking & work to further the work of coproducing healthcare service. They hint at the exciting challenges they see moving forward
