title: Improving healthcare through the use of co-design.
abstract: OBJECTIVE
  This paper describes how co-design methods can be used to improve patient experiences and services within healthcare organisations. Using the Patient Co-design of Breast Service Project as an example, we describe how patient experiences were captured and understood, the improvements made and implications for future work.
  
  
  METHODS
  We used a six-step process: engage, plan, explore, develop, decide and change. Tools and techniques employed were based on service design approaches. These included patient journey mapping, experience-based surveys and co-design workshops.
  
  
  RESULTS
  Information, communication, navigation and co-ordination, and environment emerged as key themes for the Breast Service. And as a result, a suite of improvements were made. Key methodological learnings included using co-design alongside traditional quality improvement methodologies, engaging with patients early, the importance of staff buy-in and the necessity of trying things outside one's comfort zone.
  
  
  CONCLUSIONS
  Use of co-design within the Breast Service has resulted in tangible improvements and has demonstrated the value of engaging patients and focussing on their experiences. It is recommended that: evaluation phases are factored into future co-design work, further research is conducted on sustainability and funding and support is given to allow co-design to become more widespread throughout New Zealand.
authors.affiliation: Auckland District Health Board, Auckland, New Zealand. hboyd@adhb.govt.nz
authors.forename: Hilary
authors.initials: H
authors.lastname: Boyd
authors.forename: Stephen
authors.initials: S
authors.lastname: McKernon
authors.forename: Bernie
authors.initials: B
authors.lastname: Mullin
authors.forename: Andrew
authors.initials: A
authors.lastname: Old
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D003695:Delivery of Health Care / Q000458:organization & administration*; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D009520:New Zealand; D010353:Patient Education as Topic; D010358:Patient Participation; D017064:Process Assessment, Health Care; D058996:Quality Improvement; D011795:Surveys and Questionnaires