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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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“42 This approach is particularly valuable when creating sensory technologies, as it ensures that the solutions are tailored to the lived experiences and evolving needs of older adults.”
A Group Concept Mapping Study to Define Humanizing Health Care
Tackett, S. A., Adams, G., Chen, B., & Wright, S. M. (2025) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2025.04.016 · Cited by 1
Lovell, M. R., Warner, K. N., Archer, P., McCabe, R., & Siddall, P. J. (2025) · Patient Education and Counseling · doi:10.1016/j.pec.2025.109297 · Cited by 3
Wearable Sensors, Real-Time Monitoring and Data Assimilation in Healthcare Resonates
Singh, B. (2025) · Advances in medical technologies and clinical practice book series · doi:10.4018/979-8-3693-6094-1.ch011 · Cited by 1
Goodman, D. J., Lamadriz, L., Stokes, K., Adams, M., Martell, H., Robie, K., Morgan, A., & Saunders, E. C. (2025) · Frontiers in Health Services · doi:10.3389/frhs.2025.1640311 · Cited by 1
Lasalvia, A., Bodini, L., Fin, V., & Bonetto, C. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13407-z · Cited by 1
Peters, V. J. T., de Hoog, A. M., van Gameren-Oosterom, H. B. M., de Winter, P., Eulderink, T., & Bok, L. A. (2025) · European Journal of Pediatrics · doi:10.1007/s00431-025-06532-8 · Cited by 1
Healthcare quality in rural Armenia: Focus group perceptions
Manukyan, C., Antonyan, L., Hovhannisyan, M. G., Terzan, L., & Libaridian, L. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-13545-4 · Cited by 2
“While physicians and nurses will contribute to educational reform, a community-based and co-produced approach is fundamental for long-term improvement and trust-building [31, 92–94].”
Ilioudi, M., Steingrímsson, S., Wallström, S., Thunström, A. O., Lindner, P., Ioannou, M., Falk, Ö., & Ali, L. (2025) · JMIR Formative Research · doi:10.2196/75961 · Cited by 1
“Given that the health care system offers services co-created by health care professionals and people seeking help, improving health care services requires considering innovative ways to involve both staff and patients, along with new organizational forms, structures, and community engagement [20].”
Westerink, H. J., van Uden‐Kraan, C. F., Garvelink, M. M., Sprengers, D., Hartman, B. J., van der Wees, P. J., & van der Nat, P. B. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-104161 · Cited by 1
“This will contribute to more meaningful and sustainable patient participation in VBHC initiatives, with the ultimate goal to improve value of care aligning with the patient’s needs and preferences.”
Carter, J., Knights, F., Mackey, K., Deal, A., Hassan, E., Trueba, J., Jayawardhena, N., Alfred, J., Al-Sharabi, I., Ciftci, Y., et al. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-106484 · Cited by 1
Patient and staff experiences with an EHR-Integrated Symptom Management Program (eSyM) in oncology
Cronin, C. M., Barrett, F., Dias, S. L., Paudel, R., Osarogiagbon, R. U., Schrag, D., Wong, S. L., Dizon, D. S., Bian, J. J., Hazard-Jenkins, H. W., et al. (2025) · Supportive Care in Cancer · doi:10.1007/s00520-025-10248-8 · Cited by 1
“This is particularly important because effective symptom management relies on interdependence between patients and care teams; successful healthcare requires such co-productive partnerships [27].”
Mohamed, H., Alanzi, T. M., Salsberg, J., Mohamed, M., & Kelly, D. (2026) · JMIR Cancer · doi:10.2196/77738 · Cited by 2
“Current approaches to DHL intervention design are evolving from viewing patients as merely passive consumers of care to viewing them as active coproducers in their care management [20,21].”
Caregiver Codesigned Simulation Training for Paediatric Intellectual Disability Emergency Care
Pobre, K., Mariano, M., Jani, S., Lapointe, C., Tomsic, G., & Ong, N. (2026) · The Clinical Teacher · doi:10.1111/tct.70376 · Cited by 1
Duncan, T. S., Lind, L., Åslund, L., Dieker, E., & Riggare, S. S. (2026) · Frontiers in Health Services · doi:10.3389/frhs.2026.1765906 · Cited by 1
“In total, the survey included 11 dimensions of healthcare, on both relational and functional aspects of care (2) as well as codesign (28).”
Integrating theory and practice: the core components guide for rigorous quality improvement design
Howard, P. D., Arrieta, J., Leruth, C., Bones, K., Steinfield, R., Figueroa, J. C., Panjwani, S., & Barker, P. (2026) · Frontiers in Health Services · doi:10.3389/frhs.2026.1751580 · Cited by 1
“Acknowledgement and exploration of power dynamics, structural inequities, and historical and current mistrust are also important to this component, as they influence how the system functions and for whom they improve outcomes ( 23–25).”
Nurses’ perspectives on pain management in pediatric care: systematic review and meta-synthesis
Elmobasher, M., Tao, H., Guo, J., AbuQeis, I., Teeti, A. A., Wang, Y., & Fang, M. (2026) · Frontiers in Pediatrics · doi:10.3389/fped.2026.1814470 · Cited by 1
The family caregiver experience in palliative care pathways: a multidimensional framework
Severino, M. C., Galli, C., & Rosis, S. D. (2026) · BMC Health Services Research · doi:10.1186/s12913-026-14531-0 · Cited by 1
“In fact, co-production does not imply transferring responsibility to service users; rather, it involves sharing responsibilities, redefining roles, and enabling individuals to contribute to value creation for themselves and their communities [19].”
Approaches for co-creating oral health programs for adults: A scoping review
Øzhayat, E. B., Qureshi, A., Sava-Roşianu, R., Abuhaloob, L., Rafiei, S., Andruškienė, J., Erch, R., Lamloum, D., Porosencova, T., Bolchis, V., et al. (2026) · Community Dental Health · doi:10.1177/0265539x261474990 · Cited by 1
Using electronic health record audit logs to identify pediatric intensive care unit teams
Nguyen, L. M., Sebok‐Syer, S. S., Jacobson, D., Mariano, K., Grunyk, J., Burk, S., Nourkhalaj, Y., Kirk, K., Profit, J., Rose, C. C., et al. (2026) · JAMIA Open · doi:10.1093/jamiaopen/ooag126 · Cited by 1
“15,11,16 The approach is best suited for research questions about team stability, care coordination, and the relationship between team composition and outcomes—not as a definitive measure of clinical responsibility or decision authority.”
Batalden, M. (2016) · Future Hospital Journal · doi:10.7861/futurehosp.3-3-197 · Cited by 1
Self-citation
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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