title: Utilizing experience-based co-design to improve the experience of patients accessing emergency departments in New South Wales public hospitals: an evaluation study.
abstract: BACKGROUND
  This paper presents the findings of three multisite evaluations of Experience-Based Co-design (EBCD) programmes conducted in Emergency Departments (EDs) and associated departments in seven public hospitals in New South Wales, Australia.
  
  
  METHODS
  Data for the evaluations were derived from: EBCD documentation provided by the participating sites; interviews with 117 key informants; performance data and the policy and academic literature on EBCD.
  
  
  RESULTS
  Respondents described EBCD as a successful and sustainable method of improving the individual patient experience and the overall quality of a health service. Demonstrated successes were reported to lead to aspects of the EBCD approach spreading within services. However, like any quality improvement activity, EBCD was not without its challenges. The principal challenge particular to the EBCD projects outlined here was their deployment in ED settings. Because of their ambulant patient populations, these settings made sustaining consumer engagement for the duration of the project problematic and required tailoring EBCD to accommodate consumers' involvement preferences and constraints.
  
  
  CONCLUSIONS
  The primary strength of EBCD over and above other service development methodologies was reported to be its ability to bring about improvements simultaneously in both the operational efficiency and the inter-personal dynamics of care. However, careful consideration must be given to the constraints inherent in transient patient specialties and what needs to be done to tailor EBCD to suit the particular setting in which it is deployed.
authors.affiliation: School of Health, University of New England, Armidale, Australia. dpiper@une.edu.au
authors.forename: Donella
authors.initials: D
authors.lastname: Piper
authors.forename: Rick
authors.initials: R
authors.lastname: Iedema
authors.forename: Jane
authors.initials: J
authors.lastname: Gray
authors.forename: Raj
authors.initials: R
authors.lastname: Verma
authors.forename: Lee
authors.initials: L
authors.lastname: Holmes
authors.forename: Nicole
authors.initials: N
authors.lastname: Manning
mesh_terms: D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000592:standards; D006779:Hospitals, Public / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D009517:New South Wales; D058996:Quality Improvement / Q000458:organization & administration