What outcomes are associated with developing and implementing co-produced interventions in acute healthcare settings? A rapid evidence synthesis
What outcomes are associated with developing and implementing co-produced interventions in acute healthcare settings? A rapid evidence synthesis
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DOI：
10.1136/bmjopen-2016-014650
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发表时间：
2017-07-01
期刊：
影响因子：
2.9
通讯作者：
Robert, Glenn
中科院分区：
文献类型：
--
作者：
Clarke, David;Jones, Fiona;Robert, Glenn
合作生产的定义是用户自愿或非自愿地参与服务的设计、管理、提供和/或评价。对联合生产作为改善医疗质量的干预措施的兴趣正在增加。在急性医疗保健方面，联合生产被推广为利用患者，护理人员和工作人员的知识来改变他们最关心的事情。然而，很少有人知道的影响，共同生产对病人，工作人员或组织的成果，在这些settings.Aims的目的是确定和评价报告的成果，共同生产作为一种干预措施，以提高服务质量，在急性医疗保健settings.Design快速证据合成。数据来源Medline，Cinahl，Web of Science，Embase，HMIC，科克伦数据库的系统评价，SCIE，Proquest论文和论文，EThOS，OpenGrey;协同设计;设计杂志设计问题：研究选择研究报告患者，工作人员或组织的结果与使用共同生产在急性healthcare setting.Findings 712标题和摘要进行了筛选; 24篇论文进行了全文审查，11篇论文被列入证据合成。一项研究是可行性随机对照试验，三项是过程评价，七项使用描述性定性方法。报告的结果涉及：（a）患者和工作人员参与联合生产流程的价值;（B）流程、实践和临床环境变更的想法;（c）切实的服务变更和对患者体验的影响。只有一项研究包括成本分析;没有一项报告进行了经济评价。没有研究评估的可持续性的任何变化made.Conclusions尽管越来越多的兴趣和宣传合作生产，缺乏严格的评估，在急性医疗环境。未来的研究应评估临床和服务结果，以及合作生产相对于其他形式的质量改进的成本效益。还应考虑对参与者的价值观和行为可能产生的更广泛影响。
Background Co-production is defined as the voluntary or involuntary involvement of users in the design, management, delivery and/or evaluation of services. Interest in co-production as an intervention for improving healthcare quality is increasing. In the acute healthcare context, co-production is promoted as harnessing the knowledge of patients, carers and staff to make changes about which they care most. However, little is known regarding the impact of co-production on patient, staff or organisational outcomes in these settings.Aims To identify and appraise reported outcomes of co-production as an intervention to improve quality of services in acute healthcare settings.Design Rapid evidence synthesis.Data sources Medline, Cinahl, Web of Science, Embase, HMIC, Cochrane Database of Systematic Reviews, SCIE, Proquest Dissertation and Theses, EThOS, OpenGrey; CoDesign; The Design Journal; Design Issues.Study selection Studies reporting patient, staff or organisational outcomes associated with using co-production in an acute healthcare setting.Findings 712 titles and abstracts were screened; 24 papers underwent full-text review, and 11 papers were included in the evidence synthesis. One study was a feasibility randomised controlled trial, three were process evaluations and seven used descriptive qualitative approaches. Reported outcomes related to (a) the value of patient and staff involvement in co-production processes; (b) the generation of ideas for changes to processes, practices and clinical environments; and (c) tangible service changes and impacts on patient experiences. Only one study included cost analysis; none reported an economic evaluation. No studies assessed the sustainability of any changes made.Conclusions Despite increasing interest in and advocacy for co-production, there is a lack of rigorous evaluation in acute healthcare settings. Future studies should evaluate clinical and service outcomes as well as the cost-effectiveness of co-production relative to other forms of quality improvement. Potentially broader impacts on the values and behaviours of participants should also be considered.