Abstract
Background Coproduction is defined as patients and clinicians collaborating equally and reciprocally in healthcare and is a crucial concept for quality improvement (QI) of health services. Learning Health Networks (LHNs) provide insights to integrate coproduction with QI efforts from programmes from various health systems. Objective We describe interventions to develop and maintain patient and family partner (PFP) coproduction, measured by PFP-reported and programme-reported scales. We aim to increase percentage of programmes with PFPs reporting active QI work within their programme, while maintaining satisfaction in PFP-clinician relationships. Methods Conducted in the Cystic Fibrosis Learning Network (CFLN), an LHN comprising over 30 cystic fibrosis (CF) programmes, people with CF, caregivers and clinicians cocreated interventions in readiness awareness, inclusive PFP recruitment, onboarding process, partnership development and leadership opportunities. Interventions were adapted by CFLN programmes and summarised in a change package for existing programmes and the orientation of new ones. We collected monthly assessments for PFP and programme perceptions of coproduction and PFP self-rated competency of QI skills and satisfaction with programme QI efforts. We used control charts to analyse coproduction scales and run charts for PFP self-ratings. Results Between 2018 and 2022, the CFLN expanded to 34 programmes with 52% having ≥1 PFP reporting active QI participation. Clinicians from 76% of programmes reported PFPs were actively participating or leading QI efforts. PFPs reported increased QI skills competency (17%–32%) and consistently high satisfaction and feeling valued in their work. Conclusions Implementing system-level programmatic strategies to engage and sustain partnerships between clinicians and patients and families with CF improved perceptions of coproduction to conduct QI work. Key adaptable strategies for programmes included onboarding and QI training, supporting multiple PFPs simultaneously and developing financial recognition processes. Interventions may be applicable in other health conditions beyond CF seeking to foster the practice of coproduction.
| Original language | English (US) |
|---|---|
| Article number | e002860 |
| Journal | BMJ Open Quality |
| Volume | 13 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jul 27 2024 |
Funding
We would like to acknowledge Erin Moore, Sarah Noyes, Clifford Gammon, Sophia Thurmond, Sophia Stamper, Julia Carney, LaCrecia Thomas, George Dellal, Karen Zeribi and the Operations Team members at the Cincinnati Children's Hospital Medical Center Anderson Center for their contributions to the development and growth of the CF Learning Network. We would also like to thank Dr Bruce Marshall and the Cystic Fibrosis Foundation. This work was funded by the Cystic Fibrosis Foundation (SEID15A0, SEID19AB0). TO was supported by the Cystic Fibrosis Foundation (CFF ONG20A0-KB) and the AHRQ-PCORI funded PEDSnet Scholars Training Programme (5K12HS026393-03), which is a national faculty development programme that trains individuals in the competencies of learning health systems science. There are important limitations to this work. Participating programmes in the CFLN received financial support from the CF Foundation to participate in the Network and practice coproduction. It is unclear how reports of engagement would change without such resources. The self-reported measures of coproduction in the CFLN are subject to reporting bias. PFP responses were also de-identified to promote sharing and transparency for the coproduction improvement process. As such, the duration of an individual PFP reporting was not tracked. However, in a separate study involving interviews with PFPs and clinicians in the CFLN, self-reported measures echoed themes of high-value partnership and shared purpose. We also tested multiple change concepts simultaneously and concurrently with external factors such as the COVID-19 pandemic limiting analysis for singular interventions. We present all tested concepts () to provide organisations an opportunity to adapt to local systems. We recognise that we had more paediatric programmes and a greater representation of family partners compared with adult partners. We were not scoped to assess potential differences in these responses. As the CFLN has expanded in 2024 to 42 sites, including 18 adult programmes, we continue to refine the change package to promote PFP coproduction. This work was funded by the Cystic Fibrosis Foundation (SEID15A0, SEID19AB0). TO was supported by the Cystic Fibrosis Foundation (CFF ONG20A0-KB) and the AHRQ-PCORI funded PEDSnet Scholars Training Programme (5K12HS026393-03), which is a national faculty development programme that trains individuals in the competencies of learning health systems science.
ASJC Scopus subject areas
- Leadership and Management
- Health Policy
- Public Health, Environmental and Occupational Health
