What is EBCD? Using experience-based co-design to design a cancer nutrition care pathway

Ms Jenelle Loeliger1, Ms Sarah Dewar1, A/Prof Nicole Kiss2, Ms Belinda Steer1, Ms Jane  Stewart1, Project Steering Committee1

1Peter MacCallum Cancer Centre, Melbourne, Australia, 2Deakin University, Burwood, Australia

Background: Designing ‘patient-centred’ care that is more in-depth than conventional consultation or feedback processes can be challenging. Experience-based co-design (EBCD) is a type of participatory action research that ensures the patient is integral to the design process itself with a focus on their experiences and making the service ‘better’ for them.

Aims: To develop a cancer nutrition care pathway to guide consistent and evidence-based nutritional care of patients throughout the cancer care continuum, utilising an EBCD approach.

Methods: This study utilised mixed methods within an embedded process focused on EBCD. A survey and focus groups were conducted with patients/carers, in addition to co-design workshops and key stakeholder consultation with patients, carers and multidisciplinary cancer health professionals (HP).

Results: The patient/carer survey (n=165) indicated only 51% (n=84) of respondents had talked to a HP about nutrition despite most (84%) feeling nutrition was important. Support received for nutrition care was rated low by patients/carers. Five focus groups were held (n=20; 16 patients, 4 carers) and 6 major themes emerged.  Two co-design workshops were held with patients, carers and HP who collectively shared experiences (‘touchpoints’) and agreed on key priorities and outcomes to underpin the pathway design and content. The pathway (The CanEAT pathway) was finalised based on the workshop outcomes and further stakeholder consultation.

Conclusions: Active participation and agreed priorities by patients, carers and HP was critical to the co-design of the CanEAT pathway. This study provides an Allied Health example using EBCD methodology to inform targeted healthcare enhancements with meaningful outcomes.


Jenelle is the Head of Nutrition of Speech Pathology at the Peter MacCallum Cancer Centre, a specialist cancer centre in Melbourne. Jenelle is passionate about great cancer care for patients and their families. She provides leadership to the Victorian Cancer Malnutrition Collaborative (VCMC) which focuses efforts on reducing the burden of cancer malnutrition on patients, carers and health services.

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