The Medical journal of Australia
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The role of culture in palliative care for Aboriginal and Torres Strait Islander peoples builds on over 60 000 years of history and includes meaningful practices to support a good "finishing up". The Gwandalan National Palliative Care Project aims to build capacity in those who deliver palliative care to embed culturally responsive care in all end-of-life settings. Community consultation, value co-creation and user-centred design ensured that diverse Aboriginal and Torres Strait Islander perspectives informed the Gwandalan curriculum. Emerging communities of practice serve as yarning circles where barriers to and enablers of service delivery can be shared and addressed collaboratively.
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Value co-creation focuses on creating value with and for multiple stakeholders - through purposeful engagement, facilitated processes and enriched experiences - to co-design new products and services. User-centred design enables multidisciplinary teams to design and develop or adapt resources from the end user's perspective. Combining value co-creation and user-centred design offers an effective, efficient, user-friendly and satisfying experience for all participants, and can result in co-created, tailored and fit-for-purpose resources. ⋯ Over the past 6 years, the Education and Innovation Department at Australian General Practice Accreditation Limited has used these methods to co-create education and training programs to build workforce capacity and support implementation of many person-centred integrated care programs. In this article, we present examples of how Australian General Practice Accreditation Limited used value co-creation and user-centred design to develop and deliver education programs in primary health care, and offer insights into how program developers can use these methods to co-create any health care product, service or resource to better address end user needs and preferences. As we strive to strengthen the role of consumers as active partners in care and improve service delivery, patient outcomes and patient experiences in Australia, it is timely to explore how we can use value co-creation and user-centred design at all levels of the system to jointly create better value for all stakeholders.
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In this article, we propose that value is a multidimensional construct, highlighting the need for a multi-actor service ecosystem perspective of value in primary care clinics. We argue that different actors in the service ecosystem - for example, patients, their family members and carers, medical practitioners, practice managers, nurses, allied health workers, receptionists and practice owners - may value different aspects of health service delivery more highly than others. We describe ways in which value is perceived among actors in primary care, and highlight the need for a greater focus on a broader view of value involving the various stakeholders to realise better outcomes.