In his introduction to “The Power of Coproduction,” Paul Batalden, M.D., describes an ambitious approach to partnership where patients and providers work together to create health.
Batalden’s vision represents a new paradigm—a word dulled through overuse but appropriate here. Although I am well-versed in different ways to improve the patient-provider relationship through better partnership, each time I read or hear Batladen and others talk about coproduction, I slow down and purposefully work to understand something new and complex. The new podcast series will provide welcome stories and lessons that I expect will help to internalize the concepts and bring them to life.
Coproduction is different from traditional approaches to patient engagement. Batalden says, “[coproduction] is not just a matter of being nice or getting the patient involved or saying this is patient centered. It actually involves two parties working together to make the service.” The service is healthcare; more a relationship than a product, organic and changeable over time.
As for the inherent discrepancy in knowledge — we seek physicians’ advice based on their training and expertise, after all — Batalden explains that mutual respect is the foundation of coproduction and experience the common currency:
Each party [patients and clinicians] is respected and trusted. By that I mean that each party brings something to the table.…This work is done through mutual respect in partnership that notices and invites each participant’s unique strengths and expertise.
Health systems that promote and are able to sustain coproduction among—in Batalden’s words—“people we sometimes call patients and people we sometimes call professionals” will improve the health of communities, as well as patients. By acknowledging and validating what each individual offers, coproduction honors all regardless of background, education, age, gender, race, ethnicity or anything else that too often has been the source of prejudice and exclusion. Coproduction requires that patients and family members, too, think and act differently; I trust that respect and patience on all sides will offer benefits that more than pay back the effort involved in participating. Yes, it’s an idealistic vision but rooted in wide-ranging experience of real life.
For readers who may not be familiar with Batalden, he has been an international leader in quality improvement and system transformation for decades, dating back at least to the early 1990s when, together with Don Berwick, M.D., and others, he helped form the Institute for Healthcare Improvement. Batalden is now an emeritus professor at The Geisel School of Medicine at Dartmouth College and involved in multiple projects at the Dartmouth Institute for Health Policy & Clinical Practice. One of his countless contributions to improving the safety and quality of healthcare is the often quoted (and often misattributed) observation: “Every system is perfectly designed to get the results it gets.”
An interview with Maren Batalden, M.D., M.P.H. In addition to being a practicing internist and Chief Quality Officer at Cambridge Health Alliance, Maren Batalden is the daughter of Paul Batalden, who she credits as a mentor and partner in developing approaches to coproduction of healthcare.