Kristin Støren Wigum
Design as a political request
Innovation in Care
Dialogue in System Oriented Design
The health sector in Norway is mainly developed as a common good and public service. These service systems are developed as a response to political decision making and their solution strategies, and the municipality administration is in charge of delivering the public services as requested.
The society demography will change dramatically the next twenty years in the western countries, the population above 80 years old will increase by 50% compared to 2016. This challenge demands for innovative thinking in care structures (Ehrenfeld 2008), political discussions and a prepared administration (Digmann et al, 2012). Is the organisational structure of public administration actually built to handle these type of development processes? The Norwegian Official Report (Hagen, NOU 2011:11) Innovation in the Care Services, from Ministry of Health and Care Services, predicts that future solutions within care for the elderly will find place in co-operations and partnerships between businesses, public institutions, and volunteer organisations.
The N3 method (Innoco, Sintef, 2014) was developed to help the municipalities in innovative design processes in Norway. This method points to five fundaments (Carlson/Wilmot 2006) for innovation to succeed: 1. Identification of real needs, 2. Solutions that actually meet the needs, 3. A Champion who brings the vision forward, 4. A productive multidisciplinary team built by the champion, 5. Anchored process to stakeholders and the organisations involved. The N3 method underline that if one of these fundaments equal “0” then the innovation process equals zero.
Designing solutions for the public is materializing the visions of the politicians who have been elected by the people. It is therefore a large responsibility. The expenses are common, as well as the use of the time and effort by the employees. In almost ten years The Foundation Joy of Life for the Elderly has worked as an ideal organization with development for municipalities in Norway. The two case studies, the designing and implementation of: A. a new certification system that revitalize the nursing homes in Norway, and B. a service concept offered elderly living at home meeting other elderly and young people weekly, avoiding loneliness and passivity, are both political requests. They have the same partners, and are run through the same processes, however, turn out very differently in terms of success, so far. The author has participated in both case studies as a system and product designer.
This paper will compare the two projects. How are the designer and the design team depending on co-design in developing the services? The intended effect of co-design is shared responsibility for the final solution, as well as shared ownership to the results. It may seem that the individual motivation for participation in co-designing is closely related to what degree one is the “owner” of the real problem or need. If the design task is too general it is hard to create a clear ownership in the project, and at the same time the experience shows that the participants in the co-designing is not indifferent. The success is depending on the participants seeing a clear benefit and relation to their daily tasks in joining the process. And finally, radical ideas are not necessarily hard to find, however, a new service is not completed as a design project until it has been successfully implemented. A system perspective is therefore crucial (Jones, 2013).
The co-design methodology may be compared to dialogue-methodology (Hannevig,Parker 2014). It challenges and expands everyone’s individual view. Maybe an extended dialogue within the municipality can bring an awareness of ownership to the larger design tasks? The future care for the elderly requires that employees and leaders in municipality administration see themselves in a larger context and make the organisational structure more flexible to meet the politicians requests across sectors, owning the challenges together.
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