Holmqvist Malin, Ros Axel, Lindenfalk Bertil, Thor Johan, Johansson Linda
Department of Public Health and Healthcare, Region Jönköping County, Jönköping, Sweden.
School of Health and Welfare, Jönköping University, Jönköping, Sweden.
JMIR Aging. 2023 Apr 7;6:e41950. doi: 10.2196/41950.
Harm from medications is a major patient safety challenge. Most adverse drug events arise when a medication is prescribed or reevaluated. Therefore, interventions in this area may improve patient safety. A medication plan, that is, a plan for continued treatment with medications, may support patient safety. Participation of patients in the design of health care products or services may improve patient safety. Co-design, as in the Double Diamond framework from the Design Council, England, can emphasize patient involvement. As the COVID-19 pandemic brought restrictions to face-to-face co-design approaches, interest in remote approaches increased. However, it is uncertain how best to perform remote co-design. Therefore, we explored a remote approach, which brought together older persons and health care professionals to co-design a medication plan prototype in the electronic health record, aiming to support patient safety.
This study aimed to describe how remote co-design was applied to create a medication plan prototype and to explore participants' experiences with this approach.
Within a case study design, we explored the experiences of a remote co-design initiative with 14 participants in a regional health care system in southern Sweden. Using descriptive statistics, quantitative data from questionnaires and web-based workshop timestamps were analyzed. A thematic analysis of the qualitative data gathered from workshops, interviews, and free-text responses to the survey questions was performed. Qualitative and quantitative data were compared side by side in the discussion.
The analysis of the questionnaires revealed that the participants rated the experiences of the co-design initiative very high. In addition, the balance between how much involved persons expressed their wishes and were listened to was considered very good. Marked timestamps from audio recordings showed that the workshops proceeded according to the plan. The thematic analysis yielded the following main themes: Everyone's perspective matters, Learning by sharing, and Mastering a digital space. The themes encompassed what helped to establish a permissive environment that allowed the participants to be involved and share viewpoints. There was a dynamic process of learning and understanding, realizing that despite different backgrounds, there was consensus about the requirements for a medication plan. The remote co-design process seemed appealing, by balancing opportunities and challenges and building an inviting, creative, and tolerant environment.
Participants experienced that the remote co-design initiative was inclusive of their perspectives and facilitated learning by sharing experiences. The Double Diamond framework was applicable in a digital context and supported the co-design process of the medication plan prototype. Remote co-design is still novel, but with attentiveness to power relations between all involved, this approach may increase opportunities for older persons and health care professionals to collaboratively design products or services that can improve patient safety.
药物造成的伤害是患者安全面临的一项重大挑战。大多数药物不良事件发生在开处方或重新评估药物时。因此，该领域的干预措施可能会提高患者安全性。药物治疗计划，即持续药物治疗的计划，可能有助于患者安全。患者参与医疗保健产品或服务的设计可能会提高患者安全性。如英国设计委员会的双钻石框架中的协同设计，可以强调患者的参与。由于新冠疫情给面对面的协同设计方法带来了限制，人们对远程方法的兴趣增加。然而，尚不确定如何最好地进行远程协同设计。因此，我们探索了一种远程方法，该方法将老年人和医疗保健专业人员聚集在一起，共同设计电子健康记录中的药物治疗计划原型，旨在提高患者安全性。
本研究旨在描述如何应用远程协同设计来创建药物治疗计划原型，并探索参与者对这种方法的体验。
在一项案例研究设计中，我们探索了瑞典南部一个区域医疗保健系统中14名参与者的远程协同设计倡议的经验。使用描述性统计方法，分析了问卷和基于网络的研讨会时间戳中的定量数据。对从研讨会、访谈以及对调查问卷问题的自由文本回复中收集的定性数据进行了主题分析。在讨论中对定性和定量数据进行了并列比较。
对问卷的分析表明，参与者对协同设计倡议的体验评价很高。此外，参与者表达愿望和被倾听的程度之间的平衡被认为非常好。音频记录中的明显时间戳显示研讨会按计划进行。主题分析产生了以下主要主题：每个人的观点都很重要、通过分享学习、掌握数字空间。这些主题涵盖了有助于营造一个宽松环境的因素，使参与者能够参与并分享观点。存在一个学习和理解的动态过程，意识到尽管背景不同，但对于药物治疗计划的要求存在共识。远程协同设计过程似乎很有吸引力，它平衡了机会和挑战，并营造了一个吸引人、富有创造性和宽容的环境。
参与者体验到远程协同设计倡议包含了他们的观点，并通过分享经验促进了学习。双钻石框架适用于数字环境，并支持药物治疗计划原型的协同设计过程。远程协同设计仍然很新颖，但关注所有参与者之间的权力关系，这种方法可能会增加老年人和医疗保健专业人员合作设计可提高患者安全性的产品或服务的机会。
