Authentic engagement and co-design are the key ingredients to meaningful change

Engagement and co-design are about partnerships and shared leadership with clients (including patients and residents), family caregivers and healthcare providers as active and equal contributors.  It means that people with lived experience are viewed as experts at the table.  

In recent years there has been a strong emphasis on leveraging principles of engagement, collaboration, co-design and partnership to achieve large scale improvement in healthcare. Driving this forward has been:

  • A growing patient and caregiver movement for an equal voice in informing healthcare system changes.

  • Evidence demonstrating the positive impact of using co-design methodology in improving how patients and families experience care, strengthening the relationship between patients and providers, and enhancing care and service delivery [1][2]

  • Direction from the Ministry of Health requiring “demonstrated history of meaningful patient, family and caregiver engagement” as an essential component for system transformation and expectations for Ontario Health Teams to “uphold the principles of patient partnership, community engagement, and system co-design”.

The Ontario Caregiver Organization believes deeply in the value of engagement and co-design with caregivers.  It’s how we do our work and we recognize the value of co-design within the system of care.  Following are valuable resources to support meaningful engagement of caregivers for health care improvement.


The Engagement and Co-Design Inventory of Resources is a collection of resources and tools that can support individuals, organizations and community coalitions to build capacity in and leverage engagement and co-design approaches.

Whether you are interested in deepening your knowledge and understanding of engagement and co-design, learning the how-to, or looking for resources that are adaptable to your context, this inventory was developed to be your practical guide.

The Lessons from Changing CARE reports series (2018 to 2020) features practical tips for you to use and adapt what The Change Foundation learned through their Changing CARE initiative to help you co-design solutions in your own setting. Leveraging Experience-Based Co-Design (EBCD) methodology, the Changing CARE projects together co-designed and implemented over 60 change ideas (e.g., resources and tools) to better recognize, value, empower and actively partner with family caregivers. The intent of these reports is to share learnings – what worked and what didn’t to support others in their journey of quality improvement using EBCD. Supplementing the reports, several tips are also available. 

The Canadian Foundation for Healthcare Improvement (CFHI) has been leading and championing partnerships with patients, family and caregivers to improve quality across the continuum of care for the past ten years.  Patient Engagement Resource Hub  

[1] Bate, Paul & Robert, Glenn. 2006. Experience-Based Design: From Redesigning the System Around the Patient to Co-designing Services with the Patient. Quality & safety in health care. 15. 307-10. 

[2] Van Citters, A. 2017. Experience-Based Co-Design of Health Care Services. Cambridge, Massachusetts: Institute for Healthcare Improvement.

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