Co-designing organisational change

Co-designing with users is gaining momentum and being applied in many different situations. Participatory Action Research is familiar to academics and now the concepts are underpinning collaborative methods in different fields of endeavour. Co-designing organisational change is a good way to bring everyone on board.

Hospitals are large bureaucratic enterprises comprising staff from varied backgrounds and skill sets. Add in the diversity of patients and visitors and we can see the difficulty of pleasing most, let alone all stakeholders.

A CT scanner with two medical staff one each side of the patient undergoing the scan process. The image has a blue hue.

Organisational change is a complex process that requires all parties to agree to change. To overcome some of this complexity, Australian researchers used arts-based research methods and arts-based knowledge translation. Their paper outlines the steps in the process and includes some of the participants’ drawings. Workshops, photovoice, photography and digital narratives all had a part to play.

From the conclusion

Both the co-design workshop and visual methods provided opportunities to connect people in an honest and respectful dialogue. System change must engage, educate, support and connect people. Transforming a system is really about transforming relationships between people who make up the system.

Too often organisations, groups, and individuals work on the same problem but work in isolation from each other. Bringing people together is the way to create a positive impact for change.

The arts-based design thinking processes provided a visual mechanism to explore creative solutions. It provided a place for clinicians and consumers to connect and discuss the proposed change strategies. The visual methods enabled time for reflection and then new conversations about care practices emerged.

From the abstract

This chapter tells the story of a complex organisational change to a healthcare service. It is about splitting rehabilitation functions across two hospitals in the same region. The design project was to help healthcare providers from both hospitals reach an understanding of the strengths that each hospital provided to its patients. One was a large metropolitan hospital, and the other a small hospital in a rural area.

Arts-based design methods were used. They included workshops, journey maps, and photovoice experiences from both providers and consumers. The team were able to help the rehabilitation service providers see the value of the organisational change and the potential benefits in the new service.

Co-design in healthcare

Health care is a service and like any service, you want the best for your customers. Customer feedback is common with most services, but knowing the problems after the event is not very effective. The first step is setting up a process that is going to get the most useful design decisions. That means co-designing from the very beginning including co-designing the research method.

Entrance to the emergency section of a hospital.. Co-design in health care.

An inclusive design approach means listening

A Canadian study documents the process of using an inclusive design approach to design the study. As a report of the process the paper necessarily includes many stories from participants. These stories are rich in information not limited by survey or interview formats and questions. It is up to the listener or researcher to guide these experiences into practical solutions.

The methods in this study are applicable to any public service, such as transport or education.

Storytelling and research design

Storytelling often goes beyond describing the immediate barriers and difficulties in using a service to reveal the impact on a person’s life.

“The inclusive design approach to the study was not rigid because inclusive design is about diversity, variability and complexity.”

A young man enters the therapy room. He is using Canadian crutches. He is shaking hands with the therapist

Design exercises

The study reports on three options for design exercises:

Option One: co-designers talk about any part of the health care service that needs re-design. Then the group imagines a future where the barrier no longer exists.

Option Two: co-designers discuss their own or another’s experience during the Covid-19 pandemic.

Option 3: co-designers use the research centre’s “virtuous tornado” exercise. The virtuous tornado is a diagram with three circles, In the centre is the statement, “Like and Use”. The next ring has the statement “Don’t like or have difficulty using”. The outer ring has the statement “Can’t Use”. See the diagram below.

Three rings of a circle indicating the three statements.

Figure 1 from the report with the three options for activities

The title of the article is, Co-Design as Applied to Accessibility in Health Care, and comes from researchers based in Canada.