Enablers and Barriers to an Experience‐Based Co‐Design Process to Develop Service Improvements in Enhanced Community Care in Ireland: A Qualitative Study

ABSTRACT Background 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. Objective This study aimed to identify enabl...

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Main Authors: Fay O'Donoghue, Máire T O'Donnell, Tomás P. Griffin, Eileen Fahy, Elaine Newell, Ann‐Marie Creaven
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Health Expectations
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Online Access:https://doi.org/10.1111/hex.70206
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author Fay O'Donoghue
Máire T O'Donnell
Tomás P. Griffin
Eileen Fahy
Elaine Newell
Ann‐Marie Creaven
author_facet Fay O'Donoghue
Máire T O'Donnell
Tomás P. Griffin
Eileen Fahy
Elaine Newell
Ann‐Marie Creaven
author_sort Fay O'Donoghue
collection DOAJ
description ABSTRACT Background 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. Objective 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. Design 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. Methods 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. Results 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. Conclusions 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. Patient or Public Contribution 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.
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spelling doaj-art-e79673d7636b4bfc888d29f193f6814a2025-08-20T03:08:28ZengWileyHealth Expectations1369-65131369-76252025-04-01282n/an/a10.1111/hex.70206Enablers and Barriers to an Experience‐Based Co‐Design Process to Develop Service Improvements in Enhanced Community Care in Ireland: A Qualitative StudyFay O'Donoghue0Máire T O'Donnell1Tomás P. Griffin2Eileen Fahy3Elaine Newell4Ann‐Marie Creaven5Department of Psychology University of Limerick Limerick IrelandSchool of Medicine University of Galway Galway IrelandSchool of Medicine University of Galway Galway IrelandCommunity Healthcare West, HSE Galway IrelandCommunity Healthcare West, HSE Galway IrelandDepartment of Psychology University of Limerick Limerick IrelandABSTRACT Background 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. Objective 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. Design 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. Methods 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. Results 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. Conclusions 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. Patient or Public Contribution 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.https://doi.org/10.1111/hex.70206Enhanced Community Careexperience‐based co‐designhealthcareintegrated carepatient experiencequalitative
spellingShingle Fay O'Donoghue
Máire T O'Donnell
Tomás P. Griffin
Eileen Fahy
Elaine Newell
Ann‐Marie Creaven
Enablers and Barriers to an Experience‐Based Co‐Design Process to Develop Service Improvements in Enhanced Community Care in Ireland: A Qualitative Study
Health Expectations
Enhanced Community Care
experience‐based co‐design
healthcare
integrated care
patient experience
qualitative
title Enablers and Barriers to an Experience‐Based Co‐Design Process to Develop Service Improvements in Enhanced Community Care in Ireland: A Qualitative Study
title_full Enablers and Barriers to an Experience‐Based Co‐Design Process to Develop Service Improvements in Enhanced Community Care in Ireland: A Qualitative Study
title_fullStr Enablers and Barriers to an Experience‐Based Co‐Design Process to Develop Service Improvements in Enhanced Community Care in Ireland: A Qualitative Study
title_full_unstemmed Enablers and Barriers to an Experience‐Based Co‐Design Process to Develop Service Improvements in Enhanced Community Care in Ireland: A Qualitative Study
title_short Enablers and Barriers to an Experience‐Based Co‐Design Process to Develop Service Improvements in Enhanced Community Care in Ireland: A Qualitative Study
title_sort enablers and barriers to an experience based co design process to develop service improvements in enhanced community care in ireland a qualitative study
topic Enhanced Community Care
experience‐based co‐design
healthcare
integrated care
patient experience
qualitative
url https://doi.org/10.1111/hex.70206
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