Experience-Based Co-Design of Health Care Services

Innovation Case Study

Van Citters A. Experience-Based Co-Design of Health Care Services. Cambridge, MA: Institute for Healthcare Improvement; 2017. (Available at ihi.org)

Few health care organizations deeply involve patients in improving or redesigning services. Experience-based co-design (EBCD), developed in the UK, brings together narrative-based research with service design methods to improve patient and staff experiences of care.

Patients and staff are filmed, interviewed, and/or observed to understand positive and negative care experiences. These shared experiences catalyze a change process where patients and staff sit side-by-side to design, implement, and test improvements to health care services.

The EBCD method has been used in more than 60 projects in six countries; it has led to improvements in patients’ experiences as well as transformations in health care workforce culture, values, and behaviors.

Implementation Guide

Pelton L, Knihtila M. Experience-Based Co-Design of Health Care Services — Implementation Guide. Boston, Massachusetts: Institute for Healthcare Improvement; 2018. (Available at ihi.org)

The accompanying Implementation Guide provides details on implementing the experience-based co-design (EBCD) innovation based on the experience of US health care systems participating in the International Innovations Network Learning and Action Community, led by The Commonwealth Fund and IHI.


The Commonwealth Fund, in collaboration with IHI, established the International Program for US Health Care System Innovation to identify promising frontline delivery system approaches to health care from abroad that might be transferred to the United States to improve quality of care, control costs, and increase value. The case study presents one of the four selected innovations for which a site visit was conducted, describing the innovation in the local context and discussing considerations for implementing the innovation in the US health care system.

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