Engineering Design Centre, University of Cambridge, Engineering Department, Trumpington Street, Cambridge, CB2 1PZ, UK.
Health Policy. 2013 Oct;112(3):179-86. doi: 10.1016/j.healthpol.2013.05.008. Epub 2013 Jun 17.
A number of recent policies promote public participation in health service design. Yet, a growing literature has articulated a gap between policy aims and actual practice resulting in public participation becoming tokenistic. Drawing on theory from participatory design, we argue that choosing appropriate artefacts to act as representations can structure discussions between public participants and health professionals in ways that both groups find meaningful and valid. Through a case study of a service improvement project in outpatient services for older people, we describe three representational artefacts: emotion maps, stories, and tracing paper, and explain how they helped to mediate interactions between public participants and health professionals. We suggest that using such representational artefacts can provide an alternative approach to participation that stands in contrast to the current focus on the professionalisation of public participants. We conclude that including participatory designers in projects, to chose or design appropriate representational artefacts, can help to address the policy-practice gap of including public participants in health service design.
最近出台了一些政策，以促进公众参与医疗服务设计。然而，越来越多的文献表明，政策目标与实际实践之间存在差距，导致公众参与流于形式。借鉴参与式设计理论，我们认为选择合适的代表物作为代表，可以以一种双方都认为有意义和有效的方式，来组织公众参与者和卫生专业人员之间的讨论。通过对老年人门诊服务改善项目的案例研究，我们描述了三种代表性的代表物：情感地图、故事和描图纸，并解释了它们如何帮助调解公众参与者和卫生专业人员之间的互动。我们认为，使用这种代表物可以为参与提供一种替代方法，与当前关注公众参与者专业化的方法形成对比。我们得出结论，让参与式设计师参与项目，选择或设计合适的代表物，可以帮助解决将公众参与者纳入医疗服务设计中的政策与实践之间的差距。
