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Title: The Participatory Zeitgeist: an explanatory theoretical model of change in an era of coproduction and codesign in healthcare improvement
Contributor(s): Palmer, Victoria Jane (author); Weavell, Wayne (author); Callander, Rosemary (author); Piper, Donella  (author)orcid ; Richard, Lauralie (author); Maher, Lynne (author); Boyd, Hilary (author); Herrman, Helen (author); Furler, John (author); Gunn, Jane (author); Iedema, Rick (author); Robert, Glenn (author)
Publication Date: 2019
Early Online Version: 2018-06-28
Open Access: Yes
DOI: 10.1136/medhum-2017-011398Open Access Link
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Abstract: Healthcare systems redesign and service improvement approaches are adopting participatory tools, techniques and mindsets. Participatory methods increasingly used in healthcare improvement coalesce around the concept of coproduction, and related practices of cocreation, codesign and coinnovation. These participatory methods have become the new Zeitgeist-the spirit of our times in quality improvement. The rationale for this new spirit of participation relates to voice and engagement (those with lived experience should be engaged in processes of development, redesign and improvements), empowerment (engagement in codesign and coproduction has positive individual and societal benefits) and advancement (quality of life and other health outcomes and experiences of services for everyone involved should improve as a result). This paper introduces Mental Health Experience Co-design (MH ECO), a peer designed and led adapted form of Experience-based Co-design (EBCD) developed in Australia. MH ECO is said to facilitate empowerment, foster trust, develop autonomy, self-determination and choice for people living with mental illnesses and their carers, including staff at mental health services. Little information exists about the underlying mechanisms of change; the entities, processes and structures that underpin MH ECO and similar EBCD studies. To address this, we identified eight possible mechanisms from an assessment of the activities and outcomes of MH ECO and a review of existing published evaluations. The eight mechanisms, recognition, dialogue, cooperation, accountability, mobilisation, enactment, creativity and attainment, are discussed within an 'explanatory theoretical model of change' that details these and ideal relational transitions that might be observed or not with MH ECO or other EBCD studies. We critically appraise the sociocultural and political movement in coproduction and draw on interdisciplinary theories from the humanities-narrative theory, dialogical ethics, cooperative and empowerment theory. The model advances theoretical thinking in coproduction beyond motivations and towards identifying underlying processes and entities that might impact on process and outcome.
Publication Type: Journal Article
Source of Publication: Medical Humanities, v.45, p. 247-257
Publisher: BMJ Group
Place of Publication: United Kingdom
ISSN: 1473-4265
Fields of Research (FoR) 2008: 150303 Corporate Governance and Stakeholder Engagement
160508 Health Policy
Fields of Research (FoR) 2020: 350701 Corporate governance
350717 Stakeholder engagement
440706 Health policy
Socio-Economic Objective (SEO) 2008: 970111 Expanding Knowledge in the Medical and Health Sciences
920208 Health Policy Evaluation
920204 Evaluation of Health Outcomes
Socio-Economic Objective (SEO) 2020: 200205 Health policy evaluation
280103 Expanding knowledge in the biomedical and clinical science
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article
UNE Business School

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