title: Multiple sclerosis outpatient future groups: improving the quality of participant interaction and ideation tools within service improvement activities.
abstract: BACKGROUND
  Improving the patient experience is a key focus within the National Health Service. This has led us to consider how health services are experienced, from both staff and patient perspectives. Novel service improvement activities bring staff and patients together to use design-led methods to improve how health services are delivered. The Multiple Sclerosis Outpatient Future Group study aimed to explore how analogies and props can be used to facilitate rich interactions between staff and patients within these activities. This paper will consider how these interactions supported participants to share experiences, generate ideas and suggest service improvements.
  
  
  METHODS
  Qualitative explorative study using 'future groups,' a reinterpretation of the recognised focus groups method directed towards exploring future alternatives through employing analogies and physical props to engage participants to speculate about future service interactions and health experiences. Participants were people with multiple sclerosis (PwMS) and outpatient staff: staff nurses, nursing assistants, junior sisters and reception staff.
  
  
  RESULTS
  Use of future groups, analogies and physical props enabled PwMS and outpatient staff to invest their own ideas and feelings in the service improvement activity and envisage alternative health care scenarios. The combination of participants in the groups with their diverse perspectives and knowledge of the service led to a collaborative approach in which staff highlighted potential practical problems and patients ensured ideas were holistic. Service improvements were prototyped and tested in the outpatient clinic.
  
  
  CONCLUSIONS
  Design-led methods such as future groups using analogies and physical props can be used to facilitate interactions between staff and patients in service improvement activities, leading to the generation of meaningful ideas. It is hoped that improving the quality of ideation tools within design-led methods can contribute to developing successful service interventions in service improvement activities.
authors.affiliation: Centre for Neuroscience and Trauma, Blizard Institute, Queen Mary, University of London, Whitechapel, London E1 2AT, UK. a.thomson@qmul.ac.uk.
authors.forename: Alison
authors.initials: A
authors.lastname: Thomson
authors.affiliation: Centre for Primary Care and Public Health Blizard Institute, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK. c.a.rivas@soton.ac.uk.|School of 717 Health Sciences, University of Southampton, Highfield, Building 67, 718, Southampton, SO17 1BJ, UK. c.a.rivas@soton.ac.uk.
authors.forename: Carol
authors.initials: C
authors.lastname: Rivas
authors.affiliation: Centre for Neuroscience and Trauma, Blizard Institute, Queen Mary, University of London, Whitechapel, London E1 2AT, UK. g.giovannoni@qmul.ac.uk.
authors.forename: Gavin
authors.initials: G
authors.lastname: Giovannoni
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D009937:Organizational Objectives; D010045:Outpatients / Q000523:psychology*; D010353:Patient Education as Topic / Q000458:organization & administration*; D010358:Patient Participation / Q000523:psychology*; D036301:Qualitative Research; D058996:Quality Improvement / Q000458:organization & administration*; D012944:Social Support; D013222:State Medicine / Q000458:organization & administration*