Table 1 A principled approach to integrating PPI in co-design of a healthcare improvement programme, as applied to a case study
Stage | What is needed |
|---|---|
1. Establish guiding principles for PPI bespoke to the specific improvement programme | • Review existing evidence to help inform PPI principles bespoke to the improvement programme • Consult on the draft principles • Define the principles, ensuring they are customised to the needs and context of the improvement programme |
2. Structure PPI for co-design | • Develop the structures for operationalising the principles, including creating inclusive structures for involvement • Be clear about how PPI contributors are acknowledged and compensated for their time and efforts • Select representative service users for specific roles in the improvement programme, including considering issues of inclusion and diversity • Remain flexible, with a focus on building the relationships that will support involvement throughout the improvement programme |
3. Co-design improvements with PPI | • Allow time to build relationships among those involved in the PPI activities, while fostering a sense of group identity, trust, and mutual respect • Organise meetings with the PPI member(s), not for them, in an open, informal, flexible, and democratic way to support everyone’s authentic contribution • Use a pre-circulated agenda to frame the meetings, with any required readings shared in advance, but retain enough flexibility for new agenda items to emerge • Ensure that expected meeting outcomes or areas of input are not set at the start, but determined dialogically through open conversations with PPI members • Be clear about what is in scope for the improvement programme and what is not • Seek input in a way tailored to the flexible, iterative approach required for co-design of clinical practice resources • Organise exchange between PPI members and clinicians or other stakeholders when needed, while being cognisant of potential power dynamics |
4. Seek feedback on PPI in the co-design process | • Seek feedback with a view to learn what works, and what does not, for future improvement programmes, with a focus on demonstrating transparency and helping to create a learning culture • Use suitable methods to seek feedback, while leveraging available structures and communication routes (e.g. meetings, email) |