Health system redesign: Changing thoughts, values, and behaviours for the co-production of a safety culture

Purpose: Simultaneous incremental and revolutionary systems change is a norm for many health care organisations. Organisational redesign, incorporating physical redevelopments and technological innovations, drives revolutionary transformations. Redesigning health facilities provides opportunities for improving and sustaining safe, high-quality patient care. There is a need for the creation of knowledge, based on empirical research, to inform how to effectively plan, implement, and evaluate health organisational redesign, underpinned by co-production principles. Findings: Using an Australian case study, we identify and discuss the opportunities and challenges, aligned with safety and quality requirements, to undertake redesign projects. Through an analysis of redesign and governance accountabilities, we identify five key foci for health leaders, and their communities, to plan, implement and evaluate organisational redesign. Conclusion: By rebuilding and engaging with patients and consumers to organise, manage and deliver care, the redesign process allows us to change thoughts, values, and behaviours to achieve better patient outcomes.