Applying User-Centered Design to Develop Practical Strategies that Address Overuse in Primary Care

Area of Science:

• Health Services Research
• Patient-Centered Care
• Clinical Quality Improvement

Background:

• Engaging patients and clinicians is crucial for enhancing care delivery in complex healthcare settings.
• De-intensifying non-beneficial care is a key strategy for improving quality and reducing healthcare costs.

Purpose of the Study:

• To assess an innovative user-centered design approach for improving clinical care quality.
• To focus on de-intensifying non-beneficial care in specific clinical areas: diabetes treatment, carotid artery stenosis screening, and colorectal cancer screening.

Main Methods:

• Utilized a user-centered design approach involving patient and patient-clinician charrettes (intensive collaborative workshops).
• Employed inductive coding to analyze themes from de-intensification ideas, facilitator notes, and audio recordings.
• Participant surveys were also part of the methodology.

Main Results:

• Thirty-five patients generated 134 de-intensification ideas, prioritizing 32, which were refined into six patient-generated principles.
• A subsequent patient-clinician charrette involved 9 patients and 7 clinicians, producing 63 potential de-intensification solutions.
• Six of these solutions were developed into detailed, multi-faceted, operationalized de-intensification strategies.

Conclusions:

• The co-design charrette process effectively engaged patients and clinicians in prioritizing and operationalizing de-intensification strategies.
• The developed strategies were detailed, multi-faceted, and based on feasibility and practical considerations.
• This charrette-based process shows promise for engaging stakeholders in developing complex strategies to improve healthcare delivery.