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

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 organizational 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; Design Journal; Design Issues. Study selection: studies reporting patient, staff or organisational outcomes associated with using co- co-production in an acute healthcare setting Findings: 712 titles and abstracts were screened, 24 papers underwent full text review; 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.