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EMBEDDING DESIGN IN
LARGE ORGANIZATIONS
Reflections from the field


---
Aalto Studying and Improving Design Practice Symposium
6th of September 2012
Juha Kronqvist
Aalto University School of Arts, Design and Architecture




                                                           1
THE
FORGOTTEN
CUSTOMER?




            2
THE
FORGOTTEN
CUSTOMER?




            3
“IMPROVING
                                                                                HEALTHCARE
                                                                                 IS A WICKED
Reframing Health to Embrace Design
      of Our Own Well-being
       Cover Story by Hugh Dubberly, Rajiv Mehta,
           Shelley Evenson, and Paul Pangaro
                                                                                   PROBLEM”
                                                                           No consensus on the problem
                                                                           No “stopping rule”
                                                                           No clear-cut formula for judging solutions
                                                                           Every solution is a “one-shot operation”
                                                                           No clear-cut list of alternative solutions
                                                                           Each person’s situation is unique
                                                                                                    – after Horst Rittel
                                                         Association for
                                                    Computing Machinery




                                                                                                                           4
FROM…


 HEALTH-CARE   HEALTH-MANAGEMENT




                                   5
TO…




      6
“Reframing health as self-management
   parallels similar trends in … design
       practice, where we increasingly
      recognize that users manage (or
      design) their own experiences.”
                            – Dubberly, 2011




                                               7
WHAT IS                               “The process of inventing physical things which
                                      display new physical order, organization, form, in

DESIGN?                               response to function.” ~ Alexander, 1964


                                           “Design is a conscious and intuitive
                                           effort to impose meaningful order….
                                           Design is both the underlying matrix of
“Design is devising courses of
                                           order and the tool that creates it.” ~
action aimed at changing existing
                                           Victor Papanek, 1971
situations into preferred ones.” ~
Herbert Simon, 1969

                                                        “Design is the human power of conceiving,
                                                        planning, and making products that serve
                                                        human beings in the accomplishment of
  “No longer associated simply with objects             their individual and collective purposes.” ~
  and appearances, design is increasingly               Richard Buchanan, 2001
  understood in a much wider sense as the
  human capacity to plan and produce desired
  outcomes.” ~ Bruce Mau, 2007

                                      “Design thinking is a human-centered approach to
                                      innovation that draws from the designer’s toolkit to
                                      integrate the needs of people, the possibilities of
                                      technology, and the requirements for business success.” ~
                                      Tim Brown, 2009

                                                                                                       8
DESIGN AS
REFLECTIVE
PRACTICE             Contrasts the rational problem-solving approach to
DONALD SCHÖN, 1983   design
                     Reflection-in-action
                     Partly conscious thinking again (during action)
                     about the problem we have encountered. Difficult to
                     verbalise.
                     Reflection-on-action
                     Thinking about what was achieved and how it was
                     done. Often documented.
                     Conversations-with-material
                     Discovering of consequences and implications
                     through doing, appreciated and evaluated.



                                                                          9
Rylander 2009




                10
PIRKANMAA HOSPITAL DISTRICT

         7118
                amount of employees of
                whom 62,2% nurses, 11,7%
                doctors and services 16,2%


          653 milj.€        budget for
                            the year 2011



           179 565
                          patients treated
                          in the whole
                          hospital district




                                              11
PROMISE OF A QUALITY SERVICE EXPERIENCE
The patient and their next of kin receive a good treatment
experience… The quality of treatment is based on trust and
listening to the patient. The patient and their next of kin are
involved in planning, excecuting and evaluating the
treatment, based on their capabilities. The staff supports the
patients’ abilities for treating and preventing illnesses and in
rehabilitation.
– Pirkanmaa Hospital District Strategy 2012-2016




                                                                   12
HOW?

       13
CULTURE & CAPABILITY




                       14
CUMULATIVE                                        after: Engine 2009

CYCLES        BUILD



MODEL                      2.




                                                                 SUSTAIN
                      Discovering       3. Building
                       value and       capability and
                      establishing       structure
                        process
      MODEL




                      1. Pilots          4. Change
                  introduce new      through capability
                      thinking         dissemination




                                                                           15
EMBEDDING
A DESIGN
CULTURE
            Design readiness
            Common vocabulary and language
            Dissemination of design thinking and
            processes
            Getting and keeping management on-
            board
            Re-interpretation and development of
            tools and methods
            Functional learning and delivering value
                                       Bailey, 2012



                                                       16
1. PILOT
  SERVICE DESIGN WITH
  CANCER PATIENTS


  1. Mapping the patient journey
  2. Interviewing staff
  3. Preliminary work flow
  4. Patient interviews
  5. Interpreting results
  6. Co-design workshop




                                   17
2. PILOT




  https://vimeo.com/juhak/cardboardhospital


                                              18
IN-HOUSE
DESIGN
TEAM




           19
REFLECTION

             Resource constraints
             Pace of change
             Role of artifacts
             Object of work
             Resourcing implementation




                                         20
REFLECTION

             Resource constraints
             Often development work is done on the
             side of main work tasks, which leaves
             little time for analysis or reflection.
             Pace of change
             Role of artifacts
             Object of work
             Resourcing implementation




                                                       21
REFLECTION

             Resource constraints
             Pace of change
             Big organisations move slowly and the
             results of activities can be seen in time.
             Still, renewal needs positive feedback.
             Role of artifacts
             Object of work
             Resourcing implementation




                                                          22
REFLECTION

             Resource constraints
             Pace of change
             Role of artifacts
             Design artifacts have a role in more
             traditional fields, but need to be adjusted
             to new contexts. Also, organisations
             need to learn how to utilize them.
             Object of work
             Resourcing implementation




                                                           23
REFLECTION

             Resource constraints
             Pace of change
             Role of artifacts
             Object of work
             Patients are traditionally situated in a
             passive role. New patient-centric ideas
             are easily discarded or rejected.
             Resourcing implementation




                                                        24
REFLECTION
 OSASTOLTA ARKEEN

 Päivä 1. – Jalkeille
 Hei, ensimmäisenä päivänä phasellus                                     Resource constraints
 magna nulla, rhoncus at consequat
 ultrices, pulvinar in lacus. Integer
 et aliquet sapien. Proin congue
 pellentesque augue non eleifend.
                                                                         Pace of change
 kuntoutus osastolla                                                     Role of artifacts
 1) Integer et aliquet sapien. Proin   3) Integer et aliquet sapien.

                                                                         Object of work
    congue pellentesque augue non         Proin congue pellentesque
    eleifend                              augue non ongue sine
                                          pellentesque augue non
 2) Et aliquet con sapien. Proin          eleifend
    congue pellentesque augue non
    eleifend                           4) Integer et aliquet sapien.
                                                                         Resourcing implementation
 omatoimiset harjoitukset
 1) Integer et aliquet sapien. Proin
    congue pellentesque augue non
                                                                         Service designers need to learn from
    eleifend sapien. Proin congue
    pellentesque.                                                        other fields in how to resource and
                                       2) Et aliquet con sapien. Proin
                                          congue pellentesque augue
                                                                         implement the created concepts in
                                          non eleifend. Proin congue
                                          pellentesque augue non.        collaboration with the staff.




                                                                                                                25
THANK YOU!

QUESTIONS? COMMENTS?



  juha.kronqvist@aalto.fi
  www.juhakronqvist.fi
  @juhak




                            26

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Embedding Design in Large Organizations

  • 1. EMBEDDING DESIGN IN LARGE ORGANIZATIONS Reflections from the field --- Aalto Studying and Improving Design Practice Symposium 6th of September 2012 Juha Kronqvist Aalto University School of Arts, Design and Architecture 1
  • 4. “IMPROVING HEALTHCARE IS A WICKED Reframing Health to Embrace Design of Our Own Well-being Cover Story by Hugh Dubberly, Rajiv Mehta, Shelley Evenson, and Paul Pangaro PROBLEM” No consensus on the problem No “stopping rule” No clear-cut formula for judging solutions Every solution is a “one-shot operation” No clear-cut list of alternative solutions Each person’s situation is unique – after Horst Rittel Association for Computing Machinery 4
  • 5. FROM… HEALTH-CARE HEALTH-MANAGEMENT 5
  • 6. TO… 6
  • 7. “Reframing health as self-management parallels similar trends in … design practice, where we increasingly recognize that users manage (or design) their own experiences.” – Dubberly, 2011 7
  • 8. WHAT IS “The process of inventing physical things which display new physical order, organization, form, in DESIGN? response to function.” ~ Alexander, 1964 “Design is a conscious and intuitive effort to impose meaningful order…. Design is both the underlying matrix of “Design is devising courses of order and the tool that creates it.” ~ action aimed at changing existing Victor Papanek, 1971 situations into preferred ones.” ~ Herbert Simon, 1969 “Design is the human power of conceiving, planning, and making products that serve human beings in the accomplishment of “No longer associated simply with objects their individual and collective purposes.” ~ and appearances, design is increasingly Richard Buchanan, 2001 understood in a much wider sense as the human capacity to plan and produce desired outcomes.” ~ Bruce Mau, 2007 “Design thinking is a human-centered approach to innovation that draws from the designer’s toolkit to integrate the needs of people, the possibilities of technology, and the requirements for business success.” ~ Tim Brown, 2009 8
  • 9. DESIGN AS REFLECTIVE PRACTICE Contrasts the rational problem-solving approach to DONALD SCHÖN, 1983 design Reflection-in-action Partly conscious thinking again (during action) about the problem we have encountered. Difficult to verbalise. Reflection-on-action Thinking about what was achieved and how it was done. Often documented. Conversations-with-material Discovering of consequences and implications through doing, appreciated and evaluated. 9
  • 11. PIRKANMAA HOSPITAL DISTRICT 7118 amount of employees of whom 62,2% nurses, 11,7% doctors and services 16,2% 653 milj.€ budget for the year 2011 179 565 patients treated in the whole hospital district 11
  • 12. PROMISE OF A QUALITY SERVICE EXPERIENCE The patient and their next of kin receive a good treatment experience… The quality of treatment is based on trust and listening to the patient. The patient and their next of kin are involved in planning, excecuting and evaluating the treatment, based on their capabilities. The staff supports the patients’ abilities for treating and preventing illnesses and in rehabilitation. – Pirkanmaa Hospital District Strategy 2012-2016 12
  • 13. HOW? 13
  • 15. CUMULATIVE after: Engine 2009 CYCLES BUILD MODEL 2. SUSTAIN Discovering 3. Building value and capability and establishing structure process MODEL 1. Pilots 4. Change introduce new through capability thinking dissemination 15
  • 16. EMBEDDING A DESIGN CULTURE Design readiness Common vocabulary and language Dissemination of design thinking and processes Getting and keeping management on- board Re-interpretation and development of tools and methods Functional learning and delivering value Bailey, 2012 16
  • 17. 1. PILOT SERVICE DESIGN WITH CANCER PATIENTS 1. Mapping the patient journey 2. Interviewing staff 3. Preliminary work flow 4. Patient interviews 5. Interpreting results 6. Co-design workshop 17
  • 18. 2. PILOT https://vimeo.com/juhak/cardboardhospital 18
  • 20. REFLECTION Resource constraints Pace of change Role of artifacts Object of work Resourcing implementation 20
  • 21. REFLECTION Resource constraints Often development work is done on the side of main work tasks, which leaves little time for analysis or reflection. Pace of change Role of artifacts Object of work Resourcing implementation 21
  • 22. REFLECTION Resource constraints Pace of change Big organisations move slowly and the results of activities can be seen in time. Still, renewal needs positive feedback. Role of artifacts Object of work Resourcing implementation 22
  • 23. REFLECTION Resource constraints Pace of change Role of artifacts Design artifacts have a role in more traditional fields, but need to be adjusted to new contexts. Also, organisations need to learn how to utilize them. Object of work Resourcing implementation 23
  • 24. REFLECTION Resource constraints Pace of change Role of artifacts Object of work Patients are traditionally situated in a passive role. New patient-centric ideas are easily discarded or rejected. Resourcing implementation 24
  • 25. REFLECTION OSASTOLTA ARKEEN Päivä 1. – Jalkeille Hei, ensimmäisenä päivänä phasellus Resource constraints magna nulla, rhoncus at consequat ultrices, pulvinar in lacus. Integer et aliquet sapien. Proin congue pellentesque augue non eleifend. Pace of change kuntoutus osastolla Role of artifacts 1) Integer et aliquet sapien. Proin 3) Integer et aliquet sapien. Object of work congue pellentesque augue non Proin congue pellentesque eleifend augue non ongue sine pellentesque augue non 2) Et aliquet con sapien. Proin eleifend congue pellentesque augue non eleifend 4) Integer et aliquet sapien. Resourcing implementation omatoimiset harjoitukset 1) Integer et aliquet sapien. Proin congue pellentesque augue non Service designers need to learn from eleifend sapien. Proin congue pellentesque. other fields in how to resource and 2) Et aliquet con sapien. Proin congue pellentesque augue implement the created concepts in non eleifend. Proin congue pellentesque augue non. collaboration with the staff. 25
  • 26. THANK YOU! QUESTIONS? COMMENTS? juha.kronqvist@aalto.fi www.juhakronqvist.fi @juhak 26

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  9. i.   Desirability of their consequences.\nii.  Conformity to/violation of implications of earlier moves.\niii.  Their appreciation of new problems or potentials they have created.\n
  10. The differing constructions are rooted in the differing epistemological tradi- tions of the fields of knowledge work and design thinking. In the literature on KIFs, knowledge work is construed as rational, analytical, and disembodied—or intellectual in character. So-called knowledge workers’ sensemaking process is conceptualized as constituted in social interactions, while the roleof interactions with the physical surroundings and various kinds of\nsense information is not well understood, if it is recognized at all. Design firms, on the other hand, proceed from a different epistemological tradition, in which ambiguity is accepted as a natural part of the process, emphasizing reflection in action (Schön, 1983) and practical knowledge (Molander, 1996), thus nurturing different educational and work practices as well as different identities.\n\n
  11. Viroista ja toi- mista hoitajia on 62,2, lääkäreitä 11,7 ja huoltohenkilöstöä 16,2 prosenttia.\n\n
  12. Viroista ja toi- mista hoitajia on 62,2, lääkäreitä 11,7 ja huoltohenkilöstöä 16,2 prosenttia.\n\n
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