Evaluating co-design

We need to evaluate co-design to determine whether we have achieved our objectives. Generally we are doing co-design to create better healthcare together, so your evaluation should aim to answer these two key questions:

Did we achieve a positive change or create better healthcare?
Did we use a collaborative co-design process to work together?

When should we start planning the evaluation?

At the very beginning! This is an important topic of discussion in the “Engage and Align” step of the co-design process.

Ask your team members questions like: “If this project was successful…”

What would that look like?
What would it feel like?
What would the data tell us?
What would people be saying about it?

Asking and discussing these questions will also help you to confirm the scope and vision for your project. This resource may also be helpful – Outcomes: what does success look like from different perspectives, Auckland Co-design Lab

Another reason for planning your evaluation at the beginning is that we often want to measure whether something has improved. This requires good quality baseline data for you to look back on and compare your improvement against.

What data should we collect?

Evaluation measures will usually fall into one of two categories – these are equally important and you should try to have at least one measure for each.

Outcome measures: did you achieve a positive change or create better healthcare? Measures may include:
- Patient and/or staff experience
- Care delivery (quality, accessibility, efficiency)
- Health literacy/ knowledge
- Health or disease outcomes

Process measures: did you use a collaborative co-design process to work together?
- Experience of the co-design team (i.e. feeling respected, engaged, empowered and equal)
- Building skills and confidence in co-design
- Building relationships that continue beyond the project

Refer to our co-design evaluation guide and resources for more information.

How do we choose what to measure?

A successful outcome may look different for different people or groups. Therefore what you measure, and how you measure it, should be selected and defined collaboratively by the co-design team.

Tip: You don’t have to measure everything! Return to the two key evaluation questions (Did we achieve a positive change or improve something? Did we use a collaborative co-design process to work together?) and decide together about what is most important.

Do we need ethics approval?

It’s always good to discuss this with your research ethics team before you start.

If you stick to answering the two key questions (Did we achieve a positive change or make things better? Did we use a collaborative co-design process to work together?) and use our co-design evaluation guide and resources, you probably won’t need formal ethics review or approval as this does not meet the definition of research. Note: if you want to publish or present your project externally, you will need talk to your ethics team about getting a letter of ethical exemption.
If you want to test whether one intervention is better than another, or want to develop or test theories about the co-design process, this may be research.

Even if you don’t need formal ethics committee review, it is important to consider the values and principles of ethical conduct during your evaluation, i.e.

merit and integrity (high quality, justified by its potential benefit)
justice (ensure inclusivity, minimise burden)
beneficence (the benefit outweighs any potential harm or discomfort)
respect (voluntary participation, due regard for people’s welfare, beliefs, perceptions, privacy, confidentiality and cultural considerations).

We’re not researchers! What if we need help?

Firstly, try not to get overwhelmed with evaluation! If you keep coming back to these two questions (Did we achieve a positive change or make things better? Did we use a collaborative co-design process to work together?), you can’t go too wrong!
Refer to the Metro North Evaluation Framework (link) which covers evaluation in more detail.
There are researchers within Metro North Health and partners who are skilled and interested in co-design. The Metro North Research office (link) may be able to help you identify someone to work with.
The free online book titled “A research handbook for patient and public involvement researchers” has been written for non-researchers who are new to research.

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