Co-Design and Implementation Effectiveness

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About the node

The Co-design and Implementation Effectiveness node supports health and social services to use participatory and collaboratives approaches for research, intervention co-design, and monitoring and evaluation to improve services, systems, and outcomes.

What is co-design?

Co-design is an iterative and participatory process that brings people together to address health and social care issues, design solutions, and improve outcomes for those who need them most (Bate & Robert, 2007; McKercher, 2020; Sanders & Stappers, 2008).

Co-design can be used for different types of projects such as:

  • Designing and undertaking research to improve knowledge and understanding.
  • Designing and implementing interventions to improve services and systems.
  • Monitoring and evaluating interventions to improve outcomes.

People with lived experience are central to the co-design process. Their knowledge and expertise are essential for understanding the impacts of health or social care issues and innovating potential solutions. Co-design also engages with practitioners, policymakers, specialists, and other key stakeholders depending on the scope and nature of the project.

Co-design is not a consultation or one-off event – it is an iterative process of genuinely bringing people together to share ideas, generate solutions, test and refine innovations, and collectively work toward achieving positive outcomes.

What is implementation effectiveness?

We use the term ‘implementation effectiveness’ to describe how we connect co-design with implementation science concepts to support collaborative planning and uptake of evidence-based interventions and research in particular contexts and settings.

Implementation effectiveness is about using co-design to develop strategies that ensure interventions:

  • reach the people who need them most.
  • effectively address the identified health and/or social care needs.
  • are appropriate for their context and setting.
  • are acceptable and feasible for practitioners to use.
  • can be maintained and sustained as part of routine practice and policy.

These outcomes can be greatly improved by integrating co-design with research and evaluation to bring people with lived experience and key stakeholders together for positive change and mutual benefit.

What does this node offer?

Co-design is not a one-size-fits-all approach; however, we are generally guided by Experience-Based Co-Design (EBCD) as it outlines a well-established and evidence-based model to support co-design and implementation activities activities (Bate & Robert, 2007; Dawda & Knight, 2017).

EBCD includes five key stages:

  1. Set up for success – planning, visioning, and initiating the co-design process.
  2. Gather information – using research methods to understand the key issues, such as interviews, focus groups, and observations.
  3. Understand the experience – presenting research results to key stakeholder groups both separately and together.
  4. Improve the experience – bringing stakeholders together to use the research results to design and implement solutions using creative and participatory approaches.
  5. Monitoring and maintaining the experience – using evaluation methods to understand how well an intervention was implemented and discover the improvements needed to generate positive outcomes.

We can work flexibly with you across some or all of these stages to establish an approach that is most suitable for your needs and context. For example, stages one to three are best for co-designing a new intervention and/or planning and conducting a research project. Stages four and five focus on the implementation, monitoring and evaluation of an intervention. In these later stages we draw on established implementation science and evaluation frameworks, such as CFIR and RE-AIM. We tailor frameworks to ensure that our methods and activities are aligned with your project needs and promote equity and social justice.

For example:

  • If your service addresses a health issue that is under-researched in a rural context, we can work with practitioners and people with lived experience in selected geographic areas to design and execute a research project that generates rich insights about the issue and potential solutions for supporting people’s related needs.
  • If you have an idea for a new health technology (e.g., app or website) but are not sure how to design and implement it to reach people from migrant and refugee backgrounds, we can work with you to bring people together in co-design activities that creatively produces solutions for this type of intervention.
  • If you want to know if your intervention (whether co-designed with us or previously implemented) was implemented effectively and is producing desired outcomes for your particular setting and context, we can help design an evaluation plan that engages practitioners, people with lived experience and specialists to find out what works and what can be improved.

These are only examples, of course, and we can work with your project in a myriad of waysto produce the results you wish to achieve.

What can I expect from my consultation with this node?

During your initial consultation, we work with you to identify your need for co-designing and implementing an intervention, undertaking a research project, and/or evaluating new or existing initiatives.

We ask about the project’s intended deliverables and outcomes, context, timelines, personnel, and budget. We will then complete an agreement outlining our involvement, which we will ask you to review and sign prior to commencing work.