Transforming health care systems through design

Realizing change within the health care industry is notoriously difficult, due in part to the industry’s complex set of problems with inextricable interdependencies (Jones, 2013). The challenge is amplified even further amid the constraints of Mayo Clinic, a historically successful health care institution that has been around for over a century. Recently, design has been gaining a reputation for leading innovation of health care products and services to improve the patient experience (Jones, 2013). There has also been an extension of conventional design thinking methods to include social systems design methods that work to create large-scale transformations within health care systems. A systemic approach to innovation enhances the impact that the design process can have by working to influence strategic parts of the system and the ways in which they interconnect (Mulgan & Leadbeater, 2013). This paper illustrates examples of systemic design practice within Mayo Clinic Center For Innovation and highlights challenges as well as patterns of successful systemic shifts learned empirically

FROM BLIND SIDE TO UPSIDE REDESIGNING OUR RESPONSE TO PATIENTS’ SOCIAL NEEDS

It has been suggested that as much as 50% of population health outcomes can be attributed to social determinants of health (SDOH), the conditions in which people live (O’Hara, 2005). Despite widespread recognition of the importance of SDOH, little has been done to support primary care in effectively responding to the social aspects of patients’ health (Bloch, Broden, & Rozmovits, 2011). Using a variety of design research methods, this study investigated why rural family physicians are not successfully addressing SDOH of low-income patients. This exploration revealed underlying cultural and systemic barriers that inhibit physicians from meeting the social needs of their patients. From this understanding, the Community Health Accelerator (CHA) concept was developed. The CHA is a system innovation that bridges primary care and the community to create significant population health improvements and long-term reductions in health care expenditures

Embodying Design Questions: Playful explorations in critical health and care systems

Design methods are increasingly used in the healthcare context. However, there is a clash between the playful culture of design and the professional culture of healthcare. Amid this culture clash is an opportunity to critically reflect on the benefits and risks of playfulness within critical contexts. This paper investigates the tensions that emerge by unpacking examples of playful design explorations within health and care systems in Sweden and Norway. In doing so, we offer reflections on the implications of using playful explorations as an extended form of caring within such systems

Now and then: Co-designing systems smart enough for the future

What happens when a diverse group of community stakeholders collaborate to design systems change aimed at shifting legacy health and social systems toward becoming people-powered supports that learn and adapt? This presentation uses the case example of the Northwest Toronto Service Collaborative, a cross-sectoral partnership between service providers, youth, and families to implement systems change aimed at improving the appropriateness of supports for children and youth with mental health and addictions needs in Northwest Toronto. Grounded in this example, presenters will explore the emerging practices of co-design at a systems-level, creating cross-sectoral design communities, designing systems with adaptive capacity, and moving beyond sustainability toward emergence

Navigating the tensions of integrating lived experience in participatory healthcare design

Despite growing interest in participatory approaches to healthcare design, the integration of people's lived experience-direct, first-hand understanding of a certain condition, situation, or identity-remains a key challenge to meaningful participation. Through an interview study with 23 patients, designers, family caregivers, and healthcare professionals involved in participatory healthcare design initiatives, the authors identify underlying tensions associated with leveraging lived experiences in healthcare design and investigate how existing strategies for integrating lived experience relate to these tensions. In doing so, this research offers insights for practitioners regarding ways of strategically navigating tensions when integrating people's lived experience through design in complex healthcare contexts.info:eu-repo/semantics/acceptedVersio

Designerly approaches for shaping social structures: catalysing intentional change in social systems

With growing interest in systemic design, there is a demand for designerly approaches that can aid practitioners in catalysing intentional social systems change. As social structures have been recognized as a critical leverage point for systems change, this paper conducts an exploratory analysis of how designerly approaches can be developed to intentionally shape social structures. By combining theory and ‘research through design’ experiments, this paper presents a portfolio of experimental designerly approaches for shaping social structures and identifies four key design principles to guide systemic design practitioners in doing this work. This research contributes to the open, pluralistic and evolving methodology of systemic design by showing alternatives to system mapping that can help practitioners address the invisible structure of systems and re- entangle themselves in the systems they seek to change

Designing as Negotiating Across Logic Multiplicity: The case of mental healthcare transformation toward co-design and co-production

Designing within complex service systems implies navigating across a plurality of norms and beliefs that multiple stakeholder groups uphold, designers included. Transformational processes may be challenged by minimum, moderate or extensive conflict depending on the centrality or compatibility of competing logics. This article reflects on how the complexity inherent in higher level institutional orders of society can support or inhibit the potential and implementation of co-production in the public sector realm where designers operate. Using the context of public mental healthcare transformation as a backdrop, we identified and reflected on four predominant logics: the logic of state; the logic of market; the logic of profession; and the logic of community. We then developed a tool to support reflexivity – the Layers of Logics Map – that can be used to take “project logics snapshots” to represent the perceived strength of project stakeholder logics at the micro, meso and macro levels and their centrality and compatibility. Three co-design project examples were used to retrospectively test the Layers of Logics Map to reveal the role of competing logics in project challenges or triumphs. While we acknowledge that logics are often highly institutionalized and difficult to become aware of, we value as fundamental the creation of tools to better enable designers to consciously adopt adequate strategies to navigate this complexity

Reshaping Mental Models – Enabling Innovation through Service Design

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