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Coproduction of healthcare service
Open accessAbstract
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.
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“When developing interventions, involving diverse stakeholders (e.g., patients, healthcare staff and their managers, researchers, and policy makers) has been recommended to enhance accuracy, fit, and sense of ownership within the specific setting [15, 16].”
From Developing a primary care-based cognitive behavioral intervention for anxiety in children through a participatory approach: a qualitative study. (2026) · cites this paper as [15]
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“This is an extension of the coproduction concept wherein patients and clinicians combine to help support patients contributing to the management of their own conditions [48,49].”
BackgroundLearning Health Systems as Facilitators of Precision Medicine
Ramsey, L. B., Mizuno, T., Vinks, A. A. T. M. M., & Margolis, P. A. (2016) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.594 · Cited by 31
“ICN uses an actor-oriented network architecture(23) to create a flexible and dynamic system to meet the needs of all participants and enable new levels of coproduction of healthcare services.(24) An actor-oriented architecture is an organizational form that enables large-scale self-organization and multiparty collabor…”
MethodSelf-citationPatient- and Family-Centered Care
Everhart, J. L., Haskell, H. W., & Khan, A. (2019) · Pediatric Clinics of North America · doi:10.1016/j.pcl.2019.03.005 · Cited by 32
Holmqvist, M., Thor, J., Ros, A., & Johansson, L. (2019) · Health Expectations · doi:10.1111/hex.12967 · Cited by 31
Patient experience in co-production of care: perceptions about patient safety protocols
da Costa, D. G., de Moura, G. M. S. S., Pasin, S. S., da Costa, F. G., & de Magalhães, A. M. M. (2020) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.3352.3272 · Cited by 46
“The education of professionals and patients for co-production in health is highlighted as a need to train agents of change in this context(7), becoming urgent due to the occurrence of preventable adverse events related to health care(9).”
BackgroundDiagnostic Excellence Through the Lens of Patient-Centeredness
Berwick, D. M. (2021) · JAMA · doi:10.1001/jama.2021.19513 · Cited by 31
“Diagnostic excellence is an accurate and complete understanding of a patient’s condition that, from the vantage point of patientcenteredness, (1) embraces the patient’s knowledge (not just the clinician’s); (2) ensures long-term follow-up and ongoing verification, including the patient’s reports; (3) monitors and mode…”
BackgroundToward a Values‐Informed Approach to Complexity in Health Care: Hermeneutic Review
Greenhalgh, T., Engebretsen, E., Bal, R. A., & Kjellström, S. (2023) · Milbank Quarterly · doi:10.1111/1468-0009.12656 · Cited by 38
Mosson, R., Hasson, H., Wallin, L., & Schwarz, U. V. T. (2016) · The British Journal of Social Work · doi:10.1093/bjsw/bcw004 · Cited by 30
Pomey, M., Morin, É., Neault, C., Biron, V., Houle, L., Lavigueur, L., Bouvette, G., St-Pierre, N., & Beaumont, M. (2016) · Patient Experience Journal · doi:10.35680/2372-0247.1134 · Cited by 30
Loignon, C., Dupéré, S., Fortin, M., Ramsden, V. R., & Truchon, K. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3315-3 · Cited by 31
Carr, E., Wallace, J. E., Pater, R., & Gross, D. P. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16081472 · Cited by 36
Agins, B., Ikeda, D. J., Reid, M. J. A., Goosby, E., Pai, M., & Cattamanchi, A. (2019) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(19)30420-7 · Cited by 31
Achieving person-centred health systems: levers and strategies
Nolte, E., & Anell, A. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108855464.007 · Cited by 30
Gravitt, P. E., Rositch, A. F., Jurczuk, M., Meza, G., Carillo, L., Jerónimo, J., Adsul, P., Nervi, L., Kosek, M. N., Tracy, J. K., et al. (2020) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-20-0501 · Cited by 30
Hanlon, C. A., McIlroy, D., Poole, H. M., Chopra, J., & Saini, P. (2022) · Health Expectations · doi:10.1111/hex.13661 · Cited by 30
Sadler, E., Porat, T., Marshall, I. J., Hoang, U., Ćurčin, V., Wolfe, C. D. A., & McKevitt, C. (2017) · PLoS ONE · doi:10.1371/journal.pone.0177102 · Cited by 30
Latif, A., Tariq, S., Abbasi, N., & Mandane, B. (2018) · Pharmacy · doi:10.3390/pharmacy6010013 · Cited by 30
Dixon‐Woods, M., Campbell, A., Chang, T. E., Martin, G. P., Georgiadis, A., Heney, V., Chew, S., Citters, A. D. V., Sabadosa, K. A., & Nelson, E. C. (2020) · Implementation Science · doi:10.1186/s13012-020-0976-1 · Cited by 30
“The founding principle was that, by realizing the principles of co-production [28], a learning system could support patients and clinicians to become confident, competent, and equal partners who can share decisions [30], thus countering the traditional tendency for medical consultations to neglect patients’ views in f…”
BackgroundImplementing and evaluating co-designed change in health
Harrison, R., Shé, É. N., & Debono, D. S. (2022) · Journal of the Royal Society of Medicine · doi:10.1177/01410768211070206 · Cited by 29
“Despite the identification of implementation phases within co-design frameworks, evidence of the value of co-designed interventions once implemented on improving health and care outcomes, however, is less clear.(10,11) With increasing focus on these evaluation gaps, we explore the potential contribution of implementat…”
BackgroundParticipatory Genomic Research: Ethical Issues from the Bottom Up to the Top Down
Aungst, H., Fishman, J. R., & McGowan, M. L. (2017) · Annual Review of Genomics and Human Genetics · doi:10.1146/annurev-genom-091416-035230 · Cited by 29
Entrustment Unpacked: Aligning Purposes, Stakes, and Processes to Enhance Learner Assessment
Kinnear, B., Warm, E. J., Caretta‐Weyer, H. A., Holmboe, E. S., Turner, D. A., van der Vleuten, C. P. M., & Schumacher, D. J. (2021) · Academic Medicine · doi:10.1097/acm.0000000000004108 · Cited by 29
The future of engaging patients and families for patient safety
O'Hara, J. K., & Canfield, C. (2023) · The Lancet · doi:10.1016/s0140-6736(23)01908-6 · Cited by 29
Israilov, S., & Cho, H. J. (2017) · The AMA Journal of Ethic · doi:10.1001/journalofethics.2017.19.11.mhst1-1711 · Cited by 29
Care maps and care plans for children with medical complexity
Adams, S. L., Nicholas, D. B., Mahant, S., Weiser, N., Kanani, R., Boydell, K., & Cohen, E. (2018) · Child Care Health and Development · doi:10.1111/cch.12632 · Cited by 28
Roberts, S., Eaton, S. D., Finch, T. L., Lewis‐Barned, N., Lhussier, M., Oliver, L., Rapley, T., & Temple-Scott, D. (2019) · BMC Family Practice · doi:10.1186/s12875-019-1042-4 · Cited by 29
Doctor@Home: Through a Telemedicine Co-production and Co-learning Journey
Miceli, L., Mas, F. D., Biancuzzi, H., Bednarova, R., Rizzardo, A., Cobianchi, L., & Holmboe, E. S. (2021) · Journal of Cancer Education · doi:10.1007/s13187-020-01945-5 · Cited by 29
Metadata
- Authors
- Batalden, M., Batalden, P., Margolis, P., Seid, M., Armstrong, G., Opipari-Arrigan, L., & Hartung, H.
- Affiliations
- Cambridge Health Alliance (US)
- Dartmouth Institute for Health Policy and Clinical Practice (US)
- Cincinnati Children's Hospital Medical Center (US)
- College of Nursing, University of Colorado, Aurora, Colorado, USA
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- University Hospital Crosshouse (GB)
- Corresponding author
- Batalden, Maren
- Venue
- BMJ Quality & Safety
- Publisher
- BMJ
- Published
- 2015-09-16
- Volume
- 25
- Issue
- 7
- Pages
- 509-517
- ISSN
- 1475-3898 (ISSN-L)
- 2044-5415
- 2044-5423
- PMC
- PMC4941163
- OpenAlex
- W2277370197
- Cited by
- 1,078
- References
- 65
- Citations by year
- 2026: 68 · 2025: 84 · 2024: 149 · 2023: 92 · 2022: 130 · 2021: 139 · 2020: 120 · 2019: 91 · 2018: 94 · 2017: 72 · 2016: 38
- FWCI
- 168.93
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Quality & Safety (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Diva portal (Dalarna University Library) (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK085719)
- Topics
- Social Sciences › Business, Management and Accounting › Marketing › Service and Product Innovation
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Keywords
- patient engagement, patient-centered care, service design, service delivery innovation
- MeSH terms
- Delivery of Health Care, Humans, Patient Participation, Quality Assurance, Health Care, Models, Organizational, Quality Improvement
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