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Abstract

Health and social service programs are often designed from the top down, with people in power making decisions that affect others. Integrating all staff and clients in the co-design process ensures that interventions are culturally competent and tailored to the unique challenges faced by the community. Participants bring firsthand knowledge, allowing for a more accurate assessment of needs and preferences. Additionally, involving marginalized individuals helps build trust between service providers and the community, creating a foundation for sustained collaboration and positive outcomes. Overall, participant inclusion is not only a practical necessity but an ethical imperative in delivering effective and equitable quality improvements.

Co-design typically employs creative and participatory methods, and has been implemented in a variety of health care settings. For example, co-design has been utilized to prototype successful models of youth opioid use treatment services, to improve transitions for patients with complex health needs in hospital and home settings, and to develop a user-friendly application that allows patients to access remote services.1-3

As part of a larger community partnership to increase access to treatment for people with opioid use disorder (OUD), the project team worked with a permanent supportive housing program (PSHP) with a mission to end homelessness for people with serious mental illness and substance use disorders. This urban-based program serves approximately 500 people and has an on-site integrated healthcare clinic. The PSHP offices temporarily closed in October of 2020 after a serious onsite safety event. The primary care services during this time continued to be offered at an affiliated clinical site. In preparation for reopening, the PSHP community sought to cultivate a safer space through utilizing co-design as a vehicle to solicit feedback from program participants and staff.

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