A milestone resource, Ireland’s new Framework for Public Involvement in Clinical Effectiveness Processes brings public participation front and centre in healthcare decision making.
Led by researchers at Dublin City University and developed for the National Clinical Effectiveness Committee in the An Roinn Slȧinte Department of Health, the framework is a landmark resource aimed at improving public participation in the design and development of National Clinical Guidelines and National Clinical Audit processes. It identifies three conditions for effective public involvement: clear purpose, clear structure, and commitment.
Built on the IAP2 Spectrum of Public Participation, the framework spans five levels of involvement (inform, consult, involve, collaborate, empower) and five stages of activities, providing practical directions on their implementation.
The five stages of activities are:
Defining and guiding involvement
On assessing an appropriate level of involvement, the guide suggests looking at overall goals, the public’s extent of influence and when best to consult, as well as necessary resources and relevant timelines. It addresses criteria for public involvement, approaches and potential sources of bias.
Methods for public involvement
Methods are aligned with levels of involvement:
- leaflets, posters, etc to inform the public;
- documents, surveys, interviews, and literature to consult the public;
- focus groups, public meetings and seminars to involve the public in discussion; and,
- enabling membership of groups, committees and advisory panels to collaborate with the public, and co-design and co-leadership to empower the public.
Support and training for involvement
Speaking to diverse communication and practical needs in the community, the guide recommends support and training for involvement with the following measures:
- Literacy checks on public materials at the inform level can be helped by the use of plain language or a glossary of terms.
- Ensuring accessibility in the consult level can mean developing lay versions, summaries, and jargon-busting supplements to help the public unpack complex documents
- At the involve, collaborate, and empower levels, support and training for periodic and sustained involvement can provide skill development, learning, practical and financial support, and informal support to suit a variety of needs. Public mentoring and pairing initiatives can orient participants to new processes and connect them to a peer support system.
Informing and educating via involvement
Outcomes and recommendations can be made available to the public in lay versions of guidelines and audits or through dedicated public events.
Evaluating public involvement
In addition to capturing change brought about by the process, evaluation also addresses closing the loop on how public involvement contributes to decision making. It also provides essential feedback on how the public felt about their role in the process.
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