What outcomes are associated with developing and implementing co-produced interventions in acute healthcare settings? A rapid evidence synthesis

David Clarke, Fiona Jones, Ruth Harris, Glenn Robert

Research output: Contribution to journalArticlepeer-review

104 Citations (Scopus)
183 Downloads (Pure)


Background: Co-production is defined as the voluntary or involuntary involvement of users in the design, management, delivery and/or evaluation of services. Interest in co-production as an intervention for improving healthcare quality is increasing. In the acute healthcare context, co-production is promoted as harnessing the knowledge of patients, carers and staff to make changes about which they care most. However, little is known regarding the impact of co-production on patient, staff or organisational outcomes in these settings.

Aims: To identify and appraise reported outcomes of co-production as an intervention to improve quality of services in acute healthcare settings.

Design: Rapid evidence synthesis.

Data sources: Medline, Cinahl, Web of Science, Embase, HMIC, Cochrane Database of Systematic Reviews, SCIE, Proquest Dissertation and Theses, EThOS, OpenGrey; CoDesign; The Design Journal; Design Issues.

Study selection: Studies reporting patient, staff or organisational outcomes associated with using co-production in an acute healthcare setting.

Findings: 712 titles and abstracts were screened; 24 papers underwent full-text review, and 11 papers were included in the evidence synthesis. One study was a feasibility randomised controlled trial, three were process evaluations and seven used descriptive qualitative approaches. Reported outcomes related to (a) the value of patient and staff involvement in co-production processes; (b) the generation of ideas for changes to processes, practices and clinical environments; and (c) tangible service changes and impacts on patient experiences. Only one study included cost analysis; none reported an economic evaluation. No studies assessed the sustainability of any changes made.

Conclusions: Despite increasing interest in and advocacy for co-production, there is a lack of rigorous evaluation in acute healthcare settings. Future studies should evaluate clinical and service outcomes as well as the cost-effectiveness of co-production relative to other forms of quality improvement. Potentially broader impacts on the values and behaviours of participants should also be considered.
Original languageEnglish
Article numbere014650
Number of pages11
JournalBMJ Open
Issue number7
Early online date11 Jul 2017
Publication statusE-pub ahead of print - 11 Jul 2017


  • Co-production
  • Co-design
  • Evidence synthesis
  • Acute healthcare


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