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Working Towards Genuine Co-design

Heather Davis and Seleena Sherwell,

Manager CSIC

SMICS

April 2016

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SMICS

Is a joint initiative of Alfred Health, Cabrini

Health, Peninsula Health and Monash Health

We are one of 9 Integrated Cancer Services

Established in 2005

An affiliated member of the MPCCC

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SMICS

2,967 square kilometres

Eleven local government areas

Three Primary Health Networks

1,452,278 people

• 49% male

• 51% female

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Where do our patients come from?

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SMICS

Vision: to facilitate a network of cancer services

in southern Melbourne which offers exceptional

care, an ideal experience and optimal clinical

outcomes for people affected by cancer.

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SMICS Mission

Through collaboration with partner

organisations, facilitate the creation of a cancer

care system in southern Melbourne which is:

• integrated

• leads best practice

• improves clinical outcomes

• and is person centred

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SMICS Consumer Engagement

• The most important component of our work

• We have worked to develop plans, strategies

and frameworks

• We have not really worked with consumers to co-

design our consumer strategy until recently

• SMICS consumers are now developing their own

consumer participation plan in partnership with

SMICS and it will be truly consumer led

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Working towards Experience Based Co-design

• A structured approach that aims to ensure that

health care organisations realise the full potential

of patients – the biggest resource they have for

improving the quality of care.

• By proactively establishing and maintaining

meaningful relationships with patients to

understand their lived experience and utilise it to

improve health services

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Experienced Based Co-design

Join the conversation , Cranwell K, McCann Terence, Polacsek M

When used effectively it enables health

providers to:

• Understand what is currently working well

• See where care and experiences can be

improved

• See where workforce skills need to improve

• Change organisational systems to improve

care and experiences

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Co-design

2010, Waitemata District Health Board

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Engage

Proactively establishing and maintaining meaningful relationships with patients to understand and improve health services (Department of Health: 2008).

• should underpin all improvement work

• should occur throughout the life of any service improvement project

• consumer advocates should be valued members of any steering or reference groups

• the views and experience of consumers are central to any design activities undertaken

• identification of high value touch points provides focus for quality improvement

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Engage with health professionals and consumers to establish goals and how to go about achieving them.

• gather different perspectives before determining your specific goals and what work needs to be done

• also useful for the review of specific services/programs

• data related to service provision and demand may be helpful

• bring people together to focus your efforts and establish your vision

Plan

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Understanding patient experience of services and

identifying improvement ideas.

• learn about peoples experience of service delivery

• understand the experiences people desire

• identify how services might be improved to meet

peoples expectations

Explore

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Develop

Working with patients to turn ideas into improvements that will result in better patient experiences

• development involves being creative with patients to evolve improvements that patients value highly for their effectiveness.

• creativity can be achieved through brainstorming issues and ideas

• accept all ideas

• take into account stakeholder needs

• utilise patient scenarios to explore and develop changes

• have the ideal patient experience in mind

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Decide

Choose what improvements to make and how to make them.

•Involve consumers in decision making to ensure balanced and

effective improvements are made to a service

•Helps build service improvements that offer mutual gains for

patients and the service

•Identify service touch points and which to focus on

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Change

Partner with other stakeholders to turn improvement ideas into action.

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A strong foundation…

2005 – SMICS/HIC Project

• Consumer Participation Strategy • Consumer Advisory Group • Appointment of Consumers to SMICS ten Tumour Groups

and various project steering committees • Consumer register

2008 – Additional Consultation undertaken for each tumour stream

• Identification of areas for improvement • Service improvement work initiated

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What went wrong?

• By 2010 most things had fallen over

• Two consumers sitting on Tumour Groups

• Very few project or steering committees included consumer representation

• 22 consumers on the consumer register but most not actively involved in any of SMICS work

• The CAG was largely operating as a support group.

• Consumer engagement was not considered a priority at an executive level

• One SMICS team member was responsible for consumer participation

• Recruitment of new consumers was at a standstill

• Minimal evaluation of consumer involvement being carried out

• Health professionals reluctant to re-appoint consumers to tumour groups

• CAG operating more like a support group than an advisory committee

• Lack of education opportunities

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What did we do well?

• Continued to recruit to and maintain a consumer register – 44 people of

who approximately 10 are actively involved in SMICS work.

• Consumer led projects – Chan, Joy (tumour group)

• Consumer initiated education to community

• Consumers delivering education

• Consumers on multiple steering groups and project working groups

• A SMICS staff member and several consumers have completed HIC

consumer courses and others have attended various consumer

advocacy training

• Consumers were involved in the development of SMICS vision, mission

and strategic plan

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Moving forward…

•Consumer reference group established to develop the SMICS consumer participation plan 2016-2020 and 2016 work plan

– New recruitment material being developed to ensure interests and skills are known

– TORs for all groups or committees required so expectations are clear for everyone involved

– Clinicians need to be educated so are comfortable and confident engaging with consumers – chairs, etc.

•For first time a consumer will be appointed to our governance committee

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The top 5… (+1)

• Consumers should be involved prior to the commencement of any piece work (but is never too late to engage)

• Involvement should continue for the duration of a project

• Support from the top is imperative

• Buy in from involved health professionals is vital

• Consumer engagement is a team effort

• Lessons learned need to be shared widely

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SMICS

Thank You