Co-design in practice is guided by a set of six foundation principles which form the ABC of co-design. It is important that everyone involved, and health practitioners in particular, understands the foundation principles and are committed to them.
Foundation Principle #5 – E is for Evaluation
Evaluation structures are an integral feature of the co-design process. Every opportunity is taken to ensure that care systems and health services are continuously assessed, reviewed and improved in direct response to consumer feedback.
Co-design involves a cyclical process of continuous evaluation and improvement. Individuals with complex needs, their carers and families are directly involved in developing relevant, appropriate health and care strategies that will be most effective at meeting their needs. They are also central to the ongoing review of services to refine them to adapt to changing circumstances, shifting priorities and any weaknesses that come to light after a strategy has been implemented.
CQI is part of standard practice and a requirement of all health and disability services (under the National Standards for Disability Services, 2013 and the National Safety and Quality Health Service Standards, 2012). What is different about doing CQI in the co-design context is the involvement of consumers in the process.
The Report on Government Services (2014) includes the satisfaction and perceptions of consumers as part of its framework of performance indicators for health and disability services in Australia. Often services have ways of finding out from consumers their thoughts on, or experiences of, a service and their suggestions for improvement, but that is where consumer involvement stops. The co-design philosophy is different and says that consumers need to be involved in every step of the process.
Health services in New South Wales often use the Plan-Do-Check/Study-Act cycle to guide the process of CQI. There are four parts to this process:
- Plan a change
- Do it in a small test
- Check/Study its effects
- Act on results
Five factors are critical for the effective implementation of this evaluation cycle within any health service:
- CQI using a co-design philosophy needs to be embedded within the culture of a health service with all staff from the executive down having a commitment to the process;
- All consumers must have access to mechanisms for providing feedback about their experiences of health care strategies and support –using both formal and informal tools;
- CQI is understood and accepted as a partnership between consumers and professionals;
- Health professionals must recognise that the expectations and requirements of any health service change and develop over time, nothing is fixed;
- CQI is continuous – it does not stop.
- For more about Clinical Practice Improvement and the Plan, Do, Study, Act cycle visit the Clinical Excellence Commission website.
