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Experience-Based Co-Design (EBCD)

Experience-Based Co-Design (EBCD) is an approach which actively involves all stakeholders in the design process of a study or research protocol to ensure that the end results will meet their needs. This approach combines principles of participatory research and user experience design to improve patient experiences of healthcare services.

far fa-dollar-sign fa-sm Budget (e.g. personnel, space, equipment) Low Medium High far fa-user-clock Time per interaction I expect to engage stakeholders for... An hour or less Half a day A full day far fa-calendar-check Number of interactions I expect to interact with stakeholders... 1-2 times Appx. 5 times 10+ times Engagement Purposes far fa-scrubber Identify and explore new perspectives or understanding far fa-scrubber Identify which topics are most important to stakeholders far fa-scrubber Expand and diversify stakeholder outreach far fa-scrubber Investigate best ways to successfully implement a study, based on stakeholder insights far fa-scrubber Design strategies for translating research into practice far fa-clock Time Frame

Generally 6-12 months; May take over a year in some instances.

fal fa-tasks-alt Workload LIGHT MEDIUM HEAVY
Appropriate Applications More useful for: far fa-scrubber Generating qualitative insights into the experience of stakeholders far fa-scrubber Design patient-centered research protocol far fa-scrubber Innovation/generating new ideas far fa-scrubber Collaboration far fa-scrubber Engaging a diverse group of stakeholders far fa-scrubber Promoting consensus building far fa-scrubber Testing multiple hypotheses and possible solutions far fa-scrubber Generating ideas far fa-scrubber Generating sustained change Less useful for: far fa-scrubber Quick and easy engagement far fa-scrubber Projects with a limited time frame far fa-scrubber Projects with limited funds far fa-scrubber Generating quantitative data far fa-scrubber May not be useful for engaging stakeholders with differing agendas far fa-scrubber Expecting findings generalizable to the larger population Key Characteristics Resources Needed fas fa-money-bill-waveMoney far fa-scrubber Participant compensation far fa-scrubber Transportation far fa-scrubber Food and drink far fa-scrubber Childcare far fa-scrubber Other costs vary based on specific project requirements fas fa-paperclipMaterials and Resources far fa-scrubber Video camera far fa-scrubber Comfortable and convenient space to hold meetings fas fa-usersPersonnel At least three team members are needed to form an I-CORP team and must fall into the following roles: far fa-scrubber Experienced facilitator far fa-scrubber Staff to attend interviews and various EBCD events far fa-scrubber Video recording and editing expertise How To Set up the project.
  1. Form a steering group, recruit a project facilitator, and develop a step-by-step project plan.
Gather staff experiences through observational fieldwork and in-depth interviews. Gather patient and career experiences through observation and 12-15 filmed narrative-based interviews. Run a staff feedback event.
  1. This is a facilitated meeting in which the group provides feedback about findings from interviews and observations.
  2. This group prioritizes 4-5 key issues to be discussed at the first co-design event.
Run a patient/carer feedback event.
  1. Show the patient film and allow the participants to discuss their responses and reactions.
  2. The facilitator runs an emotional mapping exercise to help patients identify key points of the patient journey that could benefit from improvement.
  3. From the areas of potential improvement identified by the map, the participants narrow down their list to 4-5 priority issues to be discussed at the first co-design event.
Bring staff, patients and carers together in a first co-design event.
  1. Begin the event with the patient/carer film and share the staff and patient/carer priorities with the group.
  2. Spend ~10 minutes discussing the film.
  3. Break up participants into groups of ~8 and allow for 40-50 minutes of unstructured discussion on the list of issues identified during the feedback events so that each group can begin to identify priorities.
  4. Bring all of the groups back together to share what they identified as priorities. Together, narrow the list down to 3-4 target areas.
  5. Invite participants to join the co-design group that will focus on the target area of most interest to them.
Run co-design groups formed around these priorities (typically 4-6 people per group).
  1. Each group needs a facilitator to encourage discussion, help the group develop ideas into concrete actions, and ensure that those actions are followed up.
  2. The group should meet regularly, around every two weeks or monthly, or as often as needed to achieve their outcomes.
Celebration and review event.
  1. This event allows your team to present on what the project has accomplished to date and to celebrate this success.
Adapted from Bate, P. and Robert, G. (2007). Bringing User Experience to Healthcare Improvement: The Concepts, Methods and Practices of Experience-based Design. Oxford: Radcliffe Publishing and The Point of Care Foundation Experience-based co-design toolkit (
Tips Be flexible in your approach - make adaptations to fit your needs and purpose. Shorter, more frequent meetings are a useful way of keeping stakeholders engaged. Offer alternative ways of engaging stakeholders - e.g., providing a Zoom/Skype options for meetings to involve those who cannot attend in person. Variations Accelerated EBCD replaces the individual patient videos with existing videos from an archive. This approach has been found to trigger a similar response in patients while only requiring half the resources of the full approach. Examples References / Other Resources

The Stakeholder Engagement Navigator is a service of the Data Science to Patient Value Initiative at the
University of Colorado Anschutz Medical Campus

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