A participatory approach to healthcare service improvement focused on staff behavior change

Healthcare systems are complex social systems wherein improvements related to staff practice and behavior can be difficult to implement. Knowledge and practice can be uneven between various specializations, hierarchical imbalances limit the degree of agency of different professionals, and evidence-based guidelines may be interpreted or implemented according to context-specific factors. When changes are imposed from a top-down perspective, invaluable insight and know-how from frontline staff are usually left out, making it further difficult (if not altogether impractical) to implement interventions. The current paper presents a case study focused on improving urinary tract infection diagnosis and treatment, in the emergency department of a hospital within the National Health Service of England. The empirical research addresses identified gaps in the literature by proposing an original framework for healthcare staff practice and behavior change that integrates participatory design and behavior change methods.