Evidence map›Paper›PMID 40055700›Full record

ArticleBMC health services research2025

Integrating patient and public involvement into co-design of healthcare improvement: a case study in maternity care.

Bothaina Attal, Joann Leeding, Jan W van der Scheer, Zenab Barry, Emma Crookes, Sandra Igwe, Nicky Lyons, Susanna Stanford, Mary Dixon-Woods, Lisa Hinton

Abstract read
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In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Bothaina AttalTHIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-3650-7415
Joann LeedingAlzheimer's Research UK, Cambridge, UK.ORCID http://orcid.org/0000-0002-6093-8709
Jan W van der ScheerTHIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-4368-0355
Zenab BarryDepartment of Women and Children'S Health, Maternal and Perinatal Systems Policy (MAPS) Research Group, NIHR ARC South London Maternal & Perinatal Mental Health, King's College London; DREaMED Programme, Oxford University Hospitals NHS Foundation Trust, Cambridge, UK.ORCID http://orcid.org/0000-0002-4513-7727
Emma CrookesWomen's Network, Royal College of Obstetrics and Gynaecology; National Service User Voice Representatives, Maternity and Neonatal Programme, NHS England, London, UK.
Sandra IgweThe Motherhood Group, London, UK.
Nicky LyonsCampaign for Safer Births, London, UK.
Susanna Stanford, London, UK.
Mary Dixon-WoodsTHIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-5915-0041
Lisa HintonNuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford Nuffield, Woodstock Road, Oxford, OX2 6GG, UK. lisa.hinton@phc.ox.ac.uk.ORCID http://orcid.org/0000-0002-6082-3151

Funding

Mary Dixon-Woods was an NIHR Senior Investigator during conduct of the study. NF-SI-0617-10026THIS Institute is funded by the Health Foundation RHZF/001 - RG88620
6 · The paper itself

Abstract

backgroundDespite recognition of the importance of patient and public involvement (PPI) in healthcare improvement, compelling examples of "what good looks like" for PPI in co-design of improvement efforts, how it might be done, and formalisation of methods and reporting are lacking. In this article, we sought to address these gaps through a case study to illustrate a principled approach to integrating PPI into the co-design of healthcare improvement.

methodsThe case study aimed to involve maternity service users in the co-design of clinical resources for a maternity improvement programme, using a four-stage approach: 1) establishing guiding principles for PPI in the programme, 2) structuring PPI for the programme, 3) co-designing improvements with PPI, and 4) seeking feedback on PPI in the co-design process.

resultsPartnership-focused frameworks and other literature on PPI and co-design informed the guiding principles. The structure included a five-member PPI group who provided continuous input, and an additional 15-member PPI group who met twice to discuss experiences of obstetric emergency. PPI in the co-design processes shaped the development of the resources in multiple ways, such as strengthening the prominence given to listening to those in labour and their birth partners, ensuring inclusivity of visuals and language, and developing communication principles informing all resources. Feedback suggested that PPI members felt valued, listened to, and supported to provide unanticipated contributions.

conclusionsThe case study demonstrated how a principled approach to PPI enabled service users to play a key role in co-design of clinical resources aimed at improving the quality and safety of maternity care in the UK. Further case studies, across different clinical areas and with varying levels of resources, are needed to validate this approach.

Indexed as

Community ParticipationMaternal Health ServicesPatient ParticipationQuality ImprovementFemaleHumansOrganizational Case StudiesPregnancyHealthcare quality improvementObstetrics and gynaecologyPatient safetyQuality improvement methodologies

Identifiers

PMID40055700
PMCPMC11889828

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.