Participatory design for behaviour change: An integrative approach to healthcare quality improvement

Behaviour insights have been extensively applied to public policy and service design. The potential for an expanded use of behaviour change to healthcare quality improvement has been underlined in the England’s National Health Service Five-Year Forward View report, in which staff behaviour is connected to the quality of care delivered to patients and better clinical practice (NHS, 2014). Improving the quality of healthcare service delivery involves adopting improvement cycles that are conducted by multiple agents through systematic processes of change and evaluation (Scoville et al., 2016). Despite the recognition that some of the recurring challenges to improve healthcare services are behavioural in essence, there is insufficient evidence about how behavioural insights can be successfully applied to quality improvement in healthcare. Simultaneously, the discussion on how to better engage participants in intervention design, and how to better enable participation are not seen as fundamental components of behaviour change frameworks. This paper presents an integrative approach, stemming from comprehensive literature review and an ongoing case study, in which participatory design is used as the conduit to activate stakeholder engagement in the application of a behaviour change framework, aiming to improve the processes of diagnosing and managing urinary tract infection in the emergency department of a hospital in England. Preliminary findings show positive results regarding the combined use of participatory design and behaviour change tools in the development of a shared-vision of the challenges in question, and the collaborative establishment of priorities of action, potential solution routes and evaluation strategies.