Co-designing interventions in quality improvement initiatives: Notes from the field

Stuart A Green, Wendy Carnegie, Susan Barber, Dionne Matthew, Rachel Matthews


Extending patient involvement beyond co-design to implementation creates new levels of engagement and transparency. This article provides an overview of how improvement initiatives supported by a quality improvement programme have engaged patients in various clinical settings.

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Groene O. Patient centredness and quality improvement efforts in hospitals: Rationale, measurement, implementation. Int J Qual Heal Care [Internet] 2011;23(5):531–7. Available from:

Ocloo J, Matthews R. From tokenism to empowerment: progressing patient and public involvement in healthcare improvement. BMJ Qual Saf [Internet] 2016;25:26–632. Available from:

Bate P, Robert G. Experience-based design: from redesigning the system around the patient to co-designing services with the patient. Qual Saf Health Care [Internet] 2006;15(5):307–10. Available from:

National Institute for Health Research. Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) [Internet]. [cited 2017 Nov 22];Available from:

NIHR CLAHRC for Northwest London. CLAHRC Overview [Internet]. 2008;Available from:

Howe C, Randall K, Chalkley S, Bell D. Supporting improvement in a quality collaborative. Br J Healthc Manag [Internet] 2013;19(9):434–42. Available from:

Doyle C, Howe C, Woodcock T, Myron R, Phekoo K, McNicholas C, et al. Making change last: applying the NHS institute for innovation and improvement sustainability model to healthcare improvement. Implement Sci [Internet] 2013;8(1):127. Available from:

Lennox L, Doyle C, Reed JE, Bell D. What makes a sustainability tool valuable, practical and useful in real-world healthcare practice? A mixed-methods study on the development of the Long Term Success Tool in Northwest London. BMJ Open [Internet] 2017;7(9):e014417. Available from:

Reed JE, McNicholas C, Woodcock T, Issen L, Bell D. Designing quality improvement initiatives: the action effect method, a structured approach to identifying and articulating programme theory. BMJ Qual Saf [Internet] 2014;23(12):1040–8. Available from:

Hayes H, Buckland S, Tarpey M, INVOLVE. Briefing notes for researchers: public involvement in NHS, public health and social care research [Internet]. Eastleigh: 2012. Available from:

Faulkner A, Crepaz-Keay D, Kalathil J, Griffiths R, James N, Perry E, et al. Involvement for influence-National Involvement Standards [Internet]. London: 2015. Available from:

Aljuburi G, Laverty AA, Green SA, Phekoo KJ, Banarsee R, Okoye NVO, et al. Trends in hospital admissions for sickle cell disease in England, 2001/02-2009/10. J Public Health (Oxf) [Internet] 2012 [cited 2013 Mar 11];34(4):570–6. Available from:

Green SA, Aljuburi G, Majeed A, Okoye O, Amobi C, Banarsee R, et al. Characterizing emergency admissions of patients with sickle cell crisis in NHS brent: observational study. JRSM Short Rep [Internet] 2012 [cited 2013 Mar 11];3(6):37. Available from:

Aljuburi G, Okoye O, Majeed A, Knight Y, Green SA, Banarsee R, et al. Views of patients about sickle cell disease management in primary care: a questionnaire-based pilot study. JRSM Short Rep [Internet] 2012 [cited 2013 Mar 11];3(11):78. Available from:

AlJuburi G, Phekoo KJ, Okoye NONO, Anie K, Green SA, Nkohkwo A, et al. Patients’ views on improving sickle cell disease management in primary care: focus group discussion. JRSM Short Rep [Internet] 2013 [cited 2013 Mar 11];3(12):84–84. Available from:

Curcin V, Woodcock TT, Poots AJ, Majeed A, Bell D. Model-driven approach to data collection and reporting for quality improvement. J Biomed Inform [Internet] 201AD;52:151–62. Available from:

Vamos EP, Bottle A, Edmonds ME, Valabhji J, Majeed A, Millett C. Changes in the incidence of lower extremity amputations in individuals with and without diabetes in England between 2004 and 2008. Diabetes Care [Internet] 2010;33(12):2592–7. Available from:

National Institute for Health and Clinical Excellence. Diabetic foot problems : inpatient management of diabetic foot problems Diabetic foot problems [Internet]. London: 2011. Available from:

Puhan MMA, Gimeno-Santos E, Scharplatz M, Troosters T, Walters EH, Steurer J. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease ( Review ). Cochrane Database Syst Rev [Internet] 2011 [cited 2013 Aug 17];Art.No.: C(10):CD005305. Available from:

Hopkinson NS, Englebretsen C, Cooley N, Kennie K, Lim M, Woodcock T, et al. Designing and implementing a COPD discharge care bundle. Thorax [Internet] 2011;67(1):3–6. Available from:

Jones SE, Green SA, Clark AL, Dickson MJ, Nolan A, Moloney C, et al. Pulmonary rehabilitation following hospitalisation for acute exacerbation of COPD: referrals, uptake and adherence. Thorax [Internet] 2013;69(2):thoraxjnl-2013-204227-. Available from:

The Point of Care Foundation. EBCD: Experience-based co-design toolkit [Internet]. 2012 [cited 2017 Nov 23];Available from:

Staley K. ‘Is it worth doing?’ Measuring the impact of patient and public involvement in research. Res Involv Engagem [Internet] 2015;1(1):6. Available from:

Green SA, Evans L, Matthews R, Jayacodi S, Trite J, Manickam A, et al. Service user engagement in quality improvement: applying the national involvement standards. J Ment Heal Training, Educ Pract [Internet] 2016;11(5):279–85. Available from:

Renedo A, Marston CA, Spyridonidis D, Barlow J. Patient and Public Involvement in Healthcare Quality Improvement: How organizations can help patients and professionals to collaborate. Public Manag Rev [Internet] 2015;17(1):17–34. Available from: