Stimulating co-production in healthcare quality improvement: raising the interest of health professionals to collaborate with patients.

There is ample evidence that patients contribute substantially to quality improvement, i.a. by offering perspectives and opportunities for improvement not necessarily noticed by professionals and managers and increasing the patient-centredness of improved care processes. The literature on co-producing quality improvement highlights mostly structural and organisational barriers to patient involvement. However, several studies report about health professionals being sceptical to patient co-production in general and the same attitude might prevent them from engaging in collaboration in quality improvement. The vast literature on professional practice change, including changes informed by new scientific evidence and required by clinical guidelines, show the value of interventions guided by theories from social psychology. In this paper advice is sought from those theories on how to increase the willingness of health professionals to co-produce QI with patients. Based on a synthesis of that analysis the following recommendations are formulated: Showing the benefits of patient involvement to professionals and how those resonate with their professional beliefs and goals will have a positive effect on their attitudes towards co-production. Engaging professional champions to lead QI will create social pressure and establish norms that will attract other professionals to participate. Enabling professionals to actively participate in designing the improvement processes will provide them with a sense of control of their working conditions that will increase their intrinsic motivation. Institutionalising co-produced quality improvement as organisational routines will show professionals that QI is an ordinary day-today activity that will enrich their clinical practice.