Cited by 1,078Service and Product InnovationMental Health and Patient InvolvementPatient Satisfaction in Healthcare

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Coproduction of healthcare service

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Batalden, Maren, Batalden, Paul, Margolis, Peter, Seid, Michael, Armstrong, Gail, Opipari-Arrigan, Lisa, Hartung, Hans·2016·BMJ Quality & Safety

DOI 10.1136/bmjqs-2015-004315PMC PMC4941163

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Abstract

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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Figure 1 House of Care. Reproduced with permission of The King's Fund. Source: Coulter A, Roberts S, Dixon A (2013). Delivering better services for people with long-term conditions: building the house of care. London: The King's Fund. Available at: http://www.kingsfund.org.uk/publications/delivering-better-services-people-long-term-conditionsCC BY-NC · PubMed Central

Figure 2 Chronic Care Model, developed by The MacColl Institute, © ACP-ASIM Journals and Books, reprinted with permission from ACP-ASIM Journals and Books. First published in: Wagner EH. Chronic disease management: what will it take to improve care for chronic illness? Eff Clin Pract 1998;1:2–4.CC BY-NC · PubMed Central

Figure 3 Conceptual model of healthcare service coproduction.CC BY-NC · PubMed Central

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“This is of significance as it is widely recognised that involving patients in the development and execution of healthcare services helps better address their needs and expectations, and resultantly improves health outcomes, patient satisfaction, and cost-efficiency in services [50].”
‘Reframing Healthcare Services through the Lens of Co-Production’ (RheLaunCh): a study protocol for a mixed methods evaluation of mechanisms by which healthcare and social services impact the health and well-being of patients with COPD and CHF in the USA and The Netherlands
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Tailoring cultural offers to meet the needs of older people during uncertain times: a rapid realist review
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“Tensions may arise due to the relin-quishing of power, conflicting priorities and misunder-standings, alongside the potential need for additional resources and time [76, 77].”
Family–Educator Partnership in the Development of Entrustable Professional Activities in Complex Care
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Values and Ethics
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Understanding the enablers and barriers to implementing a patient-led escalation system: a qualitative study
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Utilizing compassion and collaboration to reduce violence in healthcare settings
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Developing Sexual and Reproductive Health Educational Resources for Young Women with Cystic Fibrosis: A Structured Approach to Stakeholder Engagement
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Co‐production for service improvement: Developing a training programme for mental health professionals to enhance medication adherence in Black, Asian and Minority Ethnic Service Users
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Post Breast Cancer Coaching Path: A Co-production Experience for Women
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“Batalden et al.(23) highlight how this asset‐ focused approach supports an effective patient–clinician partnership and Sutton et al.”
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Co-development of an evidence-based personalised smoking cessation intervention for use in a lung cancer screening context
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Effects of brief family psychoeducation for caregivers of people with schizophrenia in Japan provided by visiting nurses: protocol for a cluster randomised controlled trial
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Innovating access to the nurse-led hepatitis C clinic using co-production
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Getting what is needed, when it's needed: Sharing information, knowledge, and know‐how in a Collaborative Learning Health System
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To a new normal in radiation oncology: looking back and planning forward
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A Multisite Qualitative Analysis of Perceived Roles in Medication Safety: Older Adults’ Perspectives
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“The theoretical model of coproduction of healthcare service proposes that patients participate in civil discourse, co-planning, and co-execution during health service production (13).”
BackgroundMethodInfluential
Aiming to Improve Equity in Pulmonary Health: Cystic Fibrosis
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NHS England Always Events® program: Developing a national model for co-production
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Promoting a sense of security in everyday life—A case study of patients and professionals moving towards co‐production in an atrial fibrillation “learning café”
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Using Evidence to Design Cancer Care Facilities
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“Without that participation, trust and the delivery of safe, value-driven care are undermined.(4) Indeed, financial considerations often are prioritized over patients’ and staffs’ needs, even though each is critical to achieve optimal results.”
Background
Development of the School-Aged Life Impact Burn Recovery Evaluation (SA-LIBRE5–12) Profile: A Conceptual Framework
Rencken, C. A., Rodríguez-Mercedes, S. L., Patel, K. F., Grant, G. G., Kinney, E. M., Sheridan, R. L., Brady, K. J. S., Palmieri, T. L., Warner, P., Fabia, R. B., et al. (2021) · Journal of Burn Care & Research · doi:10.1093/jbcr/irab104 · Cited by 13
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“important to recognize that the client herself is a co-producer of her/his own health outcomes [73].”
Background
Genesis of change: Substance use treatment for forensic patients with mental health concerns
McFadden, D., Prior, K., Miles, H. L., Hemraj, S., & Barrett, E. L. (2021) · Drug and Alcohol Review · doi:10.1111/dar.13344 · Cited by 12
“‘Co-production’ in health care involves clinicians and patients working together to design and deliver services [38].”
Background
Peer‐supported lifestyle interventions on body weight, energy intake, and physical activity in adults: A systematic review and meta‐analysis
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Co-design of an oral health intervention (HABIT) delivered by health visitors for parents of children aged 9–12 months
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BackgroundMethod
Leveraging Patients’ Creative Ideas for Innovation in Health Care
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“33,47 Our results suggest that all patients who experience health care, that is all patients who receive standard patient experience surveys postvisit (or their surrogates), are capable and willing to provide their creative ideas for improvement.”
Nursing Practice, Research and Education in the West
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“Professionals must collaborate well with individuals and families, community health workers, and others involved in cocreating new models of care (Batalden et al., 2016).”
Quality Improvement in Health Care: The Role of Psychologists and Psychology
Bonin, L. (2018) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-018-9542-2 · Cited by 12
“For example, the engagement of patients and families in the coproduction of care (including shared decision making) has been identified as central to high quality patient- and family-centered collaborative care (Barry & Edgman-Levitan, 2012; Batalden et al., 2016).”
Background
What Twitter teaches us about patient-provider communication on pain
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“Research has shown that learning networks improve health outcomes as participants from different areas of health care work toward a common goal [15].”
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“Won’t You Be My Doctor?”: Four Keys to a Satisfying Relationship in an Increasingly Virtual World
Frankel, R. M., & Beckman, H. (2020) · Journal of Patient Experience · doi:10.1177/2374373520957184 · Cited by 12
“Coproduction is a concept that has its origins in behavioral economics and has recently found its way into the literature on quality and safety (3).”
Background
Rapid design and implementation of a virtual pain management programme due to COVID-19: a quality improvement initiative
Williams, D., Booth, G., Cohen, H., Gilbert, A. W., Lucas, A., Mitchell, C., Mittal, G., Patel, H., Peters, T., Phillips, M., et al. (2021) · British Journal of Pain · doi:10.1177/20494637211039252 · Cited by 15
Empowering first-line managers as change leaders towards co-creation culture: the role of facilitated sensemaking
Aflaki, I. N., & Lindh, M. (2021) · Public Money & Management · doi:10.1080/09540962.2021.2007636 · Cited by 18
“…and collective sensemaking argues that service culture transformation requires changes in service ethics, identities and social relations (Batalden et al., 2015; Weick et al., 2005) but it often fails due to insufficient skills in change leadership (Iveroth & Hallencreutz, 2016; Lüscher…”
BackgroundInfluential

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
ORCID: Batalden, Paul
Margolis, Peter
Seid, Michael
Armstrong, Gail
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
DOI: 10.1136/bmjqs-2015-004315
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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