Tackling complex challenges in health and care requires collaborative working with various people. Broadening out the people involved can help to build a more rounded understanding of the issues at hand. Q Lab uses creative and collaborative approaches to bring together diverse perspectives, understand what is known about a topic, uncover new insights and develop and test ideas. Most recently, the Lab explored reducing waits in elective care.
To support the test teams to engage with patients and wider system perspectives, we introduced a “co-researcher” role to the Lab. Co-researchers, with a mix of lived expertise and improvement skills, helped the test teams ‘work out loud’ to develop their ideas, bring external perspective to the projects and supported communication and engagement within and beyond the Lab, such as through sharing updates and insights from the projects. The role was co-produced and iterated with the group of co-researchers throughout the lab.
Practical lessons for meaningful involvement
Our five lessons reflect on conversations with co-researchers and test teams about their role, contribution to the Lab programme, and specific projects. Here, we reflect on what went well, and where things could improve, and share co-researchers tips for others embarking on similar journeys. While our experiences of co-researchers are specific to the Lab, the lessons we share apply to teams working with anyone external to them.
Start well: Get to know people’s strengths
It is important to understand what everyone can contribute. Each of our Co-researchers came with a wealth of personal and professional experiences and expertise.
While early sessions in the programme were dedicated to introductions and team development, we learned that more facilitated relationship-building opportunities would have been helpful and necessary.
Good onboarding can help everyone involved gain a shared understanding of the role, so they can be supported in building a productive working relationship earlier in the process. As a Lab team we reflected that it would’ve been useful to provide test teams with a biography of their paired co-researcher and the skills they bring. Several co-researchers shared that it took months before their key assets and skills came up in a conversation: skills that would have been valuable to the teams’ innovation journey.
Having the initial meeting face-to-face would really help everyone getting to know each other and understand what we can bring to the table. – Sarah Rae
Identify each team members’ strengths and how they can help, early on. Understanding these will support you to recognise the different ways you may be able to work together.
Make the expectations clear for everyone involved, while allowing agility
There are different ways to meaningfully involve external people in improvement and innovation projects. When we set up the co-researcher role, we left the definition open and adaptable. We hoped this would allow flexibility for co-researchers and their test teams to develop a relationship that worked for them. However, being too open had its drawbacks. Without a clear and precise role description, co-researchers and test teams interpreted the role differently.
It could be helpful to work with a coach or someone who could facilitate the conversations early on in our journey – so that we could agree how we best work together. – Astrid Atherley
Clarify roles, including levels of involvement, time required, and expectations for the role from everyone involved.
Manage insider/outsider status
The role of a co-researcher aimed to provide a different perspective to the test teams and their projects. Co-researchers joined their teams at the start of the 9-month Lab programme. The role was for one day a month, so there were constraints around how much the co-researchers could become part of the test team.
There is being an outsider and there’s being on the outside. It is important to understand what’s really going on, to feel that you’re involved and part of the team. This helps you have more ownership and feel more responsibility, ultimately leading to being able to make a more useful contribution. – Katie Clarke-Day
But it was hard to find the right balance. It was important for the co-researchers to feel informed enough about the project, to understand what was happening and what the challenges were. While there may not be one right way of doing this co-researcher involvement should be negotiated through ongoing, intentional conversations.
For me, it would be useful to be included in as many meetings as possible, even if just through recordings. Because of the status, identifying ways to best integrate and include the co-researcher was key to the successful and productive relationship. – Louise Paton
Having clear conversations can help your external participants to understand their involvement and where they can meaningfully contribute to a project.
Create opportunities for peer support and learning
Throughout the programme, co-researchers regularly came together to reflect on and share their experiences, updates and suggestions for making the most of the role. They found it useful to come together as a peer group to learn from each other, share experiences, and regain motivation for the role.
To facilitate peer support, spend time developing the community and creating a safe space that is both positive and productive. For me, having a group of individuals who are going through the same process and the same learning as myself has been incredibly useful. – Cleo White
Create opportunities for peers to connect and learn from each other’s experience.
If opportunities are limited within your organisation or programme, it may be valuable to make links with other networks, like Q’s Co-production online group.
Share the impact of the role
The co-researchers emphasised the importance of capturing and communicating the impact of the role as part of developing their skills.
It is important that you understand what impact you’re having and get feedback on how you are doing. It would be really good to have a feedback loop, and encourage the test teams to think about what impact we’re having and what more we could do. – Sarah Rae
Often, we may not share the impact because we’re waiting for enough or significant evidence, but providing feedback throughout is an important element of meaningful engagement.
Sharing examples where an external participant has made a difference supports their learning throughout the journey, and helps motivate and encourage them to develop in their role.
Find out more about the projects from the co-researchers
Aneurin Bevan University Health Board