a new report published by King’s College London provides an up to date overview of the spread of the approach and lessons learnt to date. Through an online survey and follow-up telephone interviews, the research team found that at least 59 EBCD projects had been implemented in 6 countries worldwide during the period 2005-2013; a further 27 projects were in planning at the time of the survey.
The approach has been implemented in a variety of clinical areas (incl. emergency medicine, drug & alcohol services, a range of cancer services, paediatrics, diabetes care & mental health services), and typically takes between 6-12 months to complete. The free-to-access, online EBCD toolkit was reported to be a helpful resource.
Whilst EBCD was reported to have been very successful in engaging patients and families in quality improvement efforts, several components of the approach were found to have been relatively underused (including non-participant observation and the filming of patient narratives). The co-design phase was found to be a complex social intervention that is challenging to implement and whose impact and outcomes are difficult to evaluate. More rigorous and robust studies of the effectiveness of EBCD (including PhD theses, feasibility trials of co-designed interventions and cluster randomised controlled trials) are now underway.
A new ‘accelerated’ form of EBCD has recently been evaluated in Intensive Care Units and lung cancer services and found that the range and type of improvement activities were similar to standard EBCD projects. The costs of the ‘accelerated’ approach are around 40% of EBCD.
Future work will be exploring the relative cost-effectiveness of these and other forms of co-design approaches to improving healthcare quality as well as building closer collaborations with service design researchers and design practitioners to refine and reinforce the crucially important co-design aspects.
The full report is available at: King's College London