Experience based co-design in healthcare services: an analysis of projects barriers and enablers

Abstract Experience Based Co-Design (EBCD) has become a popular way of using experience for healthcare service improvement. Despite its popularity, there are few comparative studies on the use of the approach evaluating its enablers and barriers. Here we analyse the barriers and enablers found in literature and of seven projects that used EBCD in the United Kingdom’s National Health Service (NHS) and identify scenarios that may contribute to project success. Thematic analysis of semi-structured interviews with EBCD project facilitators showed that the main project barriers were human and organizational barriers, and main enablers were the project facilitator role, the use of narratives, full organizational support, pre-intervention actions and the relationship between service and patients. We conclude that EBCD improvement projects are likely to be successful when key enablers are in place and that active management participation in the process facilitates implementing changes.