O'Donoghue Fay, O'Donnell Máire T, Griffin Tomás P, Fahy Eileen, Newell Elaine, Creaven Ann-Marie
Department of Psychology, University of Limerick, Limerick, Ireland.
School of Medicine, University of Galway, Galway, Ireland.
Health Expect. 2025 Apr;28(2):e70206. doi: 10.1111/hex.70206.
Experience-Based Co-Design (EBCD) is a popular collaborative process where service users and healthcare providers share their experiences of using and delivering services to identify ways to adapt services to enhance those experiences.
This study aimed to identify enablers and barriers to the successful implementation of EBCD as part of Ireland's recently adopted Enhanced Community Care (ECC) programme.
Service users and staff at two sites (N = 17) participated in an accelerated EBCD process designed to enhance service provision for older people and those living with chronic conditions. This included four co-design working group sessions per site.
Transcripts from the co-design working groups and from brief follow-up interviews with individual participants were analysed. Thematic analysis was used to identify enablers and barriers to the EBCD process.
We generated six key themes reflecting barriers and enablers; enablers were the fundamental role of the facilitator (Theme 1), a flexible approach that met group members' needs (Theme 2) and active and interactive activities to support participant engagement (Theme 3). The fundamental role of the facilitator was also identified as a barrier (Theme 4); additional barriers included balancing experience-sharing and decompressing (Theme 5) and the scope of the group as an invisible barrier (Theme 6), which reflected challenges in facilitating dialogue about change when participants were aware of system-level constraints on the potential for change.
The facilitator is critical in ensuring the successful implementation of the EBCD process. Considering how best to draw on the facilitator strengths while also ensuring that the service user perspectives are equally weighted with staff perspectives is important for effective communication within EBCD projects.
Service users (also including carers) at two sites participated in EBCD projects alongside health and social care professionals, ultimately generating two service improvements for the ECC programme. The participation of these service users was celebrated at an academic conference, which was attended by a number of service users, and where the outcomes of the EBCD project were presented.
基于经验的协同设计（EBCD）是一种流行的协作过程，服务使用者和医疗保健提供者分享他们使用和提供服务的经验，以确定调整服务的方法来提升这些体验。
本研究旨在确定作为爱尔兰最近采用的强化社区护理（ECC）计划一部分的EBCD成功实施的促进因素和障碍。
两个地点的服务使用者和工作人员（N = 17）参与了一个加速的EBCD过程，旨在改善为老年人和慢性病患者提供的服务。这包括每个地点举行四次协同设计工作组会议。
对协同设计工作组的记录以及对个别参与者的简短后续访谈进行了分析。采用主题分析法确定EBCD过程的促进因素和障碍。
我们生成了六个反映障碍和促进因素的关键主题；促进因素包括协调员的基本作用（主题1）、满足小组成员需求的灵活方法（主题2）以及支持参与者参与的积极互动活动（主题3）。协调员的基本作用也被确定为一个障碍（主题4）；其他障碍包括平衡经验分享和减压（主题5）以及小组范围作为一个无形障碍（主题6），这反映了当参与者意识到系统层面的变革潜力限制时，在促进关于变革的对话方面所面临的挑战。
协调员对于确保EBCD过程的成功实施至关重要。考虑如何最好地利用协调员的优势，同时确保服务使用者的观点与工作人员的观点得到同等重视，对于EBCD项目中的有效沟通很重要。
两个地点的服务使用者（也包括护理人员）与健康和社会护理专业人员一起参与了EBCD项目，最终为ECC计划带来了两项服务改进。这些服务使用者的参与在一次学术会议上得到了认可，许多服务使用者参加了该会议，会上展示了EBCD项目的成果。
