How inclusive design can reconnect people with government

By Matt Dallisson, 06/12/2019

What’s not to love about Scandinavia? Not only is the region among the world’s most prosperous, healthy, and educated, but it has also given us cultural gems such as ABBA’s pop ballads and Stieg Larsson’s bestselling crime novels, including The Girl with the Dragon Tattoo.

Scandinavian design, too, has rippled across the world. Danish architect Arne Jacobsen pioneered a new approach to modernist design, centered on making buildings and objects both functional and delightful for their users. Sweden’s IKEA has embraced the philosophy of “democratic design” to develop a constant stream of smart, simple, and affordable products—so becoming the world’s largest furniture retailer.

In keeping with the inclusive ethos permeating Scandinavian society and governments, the region is at the forefront of a new kind of design today: reimagining public spaces and services. Government agencies and private-sector organizations are using design thinking to delve deeply into people’s needs, behaviors, and aspirations and involve them in exploration and experimentation that leads to better solutions.

These experiments are showing that good design, undertaken in collaboration with residents themselves, can deliver better experience and better outcomes—often at lower cost. That has relevance around the world, showing how governments can harness design to foster inclusion and build trust with residents.

Turning a strained neighborhood into a connected community

Consider the example of a lower-income suburb in the south of Stockholm with a large proportion of rental properties. There was high turnover in rentals, and around 10 percent of all apartments in the area were sublet on the black market. That and a lack of attractive public spaces gave the neighborhood a poor reputation that was hard to turn around.

Many rental apartments in the area are owned by real-estate developer Ikano Bostad, which partnered with local authorities to find smart ways to improve residents’ experience of the neighborhood. In the words of Anders Wahlqvist, an Ikano Bostad manager, the goal was simple: “To turn the neighborhood into a place where people actually choose to live.”

The project got off to a shaky start. When facilitators tried to convene a meeting of residents to listen to their concerns about the area and cocreate solutions, very few turned up. That showed just how disengaged and distrustful people were. Streets and public spaces were so poorly designed that residents barely knew their neighbors—let alone felt shared ownership of the neighborhood.

To change that, the project appointed a multidisciplinary design team that conducted a series of “design sprints.” These sprints involved going door to door to understand residents’ greatest sources of dissatisfaction and test improvement ideas. For most residents, the priority was greater social interaction with their neighbors, with goals ranging from making new friends to learning to speak Swedish more proficiently.

Good design, undertaken in collaboration with residents themselves, can deliver better experience and better outcomes—often at lower cost.

The design team realized that building and facilitating spaces and activities for interaction would be crucial in improving residents’ sense of well-being. If residents knew their neighbors, they would be part of a community and feel safer and more comfortable.

Based on that insight, the design team used a collaborative process to design and test a combination of services and activities—each addressing different needs—which together could transform the neighborhood. The goal was to find ways to engage residents by rapidly developing and testing solutions. The following solutions were tested:

Other experiments to foster social interaction included group excursions, a “swapping market,” and plots for cultivating vegetables. To back up all these community-building initiatives, Ikano Bostad committed to working harder to ensure that only properly vetted and contracted tenants occupied its rental apartments. The company acknowledged that short-term renting and black-market subletting contributed to a feeling of insecurity in the neighborhood.

Together, these initiatives had a big impact. In just a few months, the community park became a thriving hub and won a national design award. In Ikano Bostad’s surveys, residents reported significantly greater satisfaction with the neighborhood within six months.

In the words of one resident, “We were thinking of moving from this area, but after the activities this spring, we decided to stay here.” The project resulted in a sharp reduction in turnover and vacancy rates in Ikano Bostad’s rental apartments, so improving the company’s financial position and easily covering the costs of the project. Most of all, the experiment showed that good design, combined with truly listening to people’s needs and aspirations, can help to turn even struggling areas into livable, empowering communities—without major investment of time or resources.

In Ikano Bostad’s surveys, residents reported significantly greater satisfaction with the neighborhood within 6 months.

Ikano Bostad has drawn on the lessons from this initiative to rethink its approach to engaging residents of its rental apartments in other neighborhoods across Sweden. Wherever it operates, the company now focuses intensely on fostering a positive living experience and strengthening neighborhood safety and trust. It has also halved the number of black-market sublets across its rental portfolio. As a result, it has significantly increased the attractiveness of its properties and neighborhoods.

Rethinking patient experience to transform healthcare

Such design approaches can be applied just as effectively to core government services such as healthcare—as another Swedish initiative demonstrates. In western Sweden, the County Council of Värmland found that patient satisfaction had been declining even though health outcomes in the area had been improving steadily. Even if clinical services were excellent, patients often found the hospital experience to be confusing, intimidating, bureaucratic, and time-wasting. The buildings might have been sleek icons of Scandinavian architecture, but that’s where the design excellence ended.

In response, the council launched the Experio Lab Patient Journey, a project that brought together a wide range of stakeholders—from health ministry officials to frontline clinical staff—and immersed them in the end-to-end patient experience. 1

In a series of innovative daylong workshops, participants were asked to role-play patients going through every major area of the healthcare system—and then cocreate ways to make that experience simpler and better. The workshops found that small gestures, such as offering patients a glass of water or asking if they needed to go to the bathroom, could often make a big difference.

One nurse who participated in the workshops captured the sentiment of many in the group: “These journeys have really opened my eyes. After 40 years of working as a nurse, I have realized for the first time how little I have understood what patients see, need, and feel. I’m ashamed it took me this long, but now I can’t stop thinking about all the things we can improve.”

Göran Hägglund, who was then Sweden’s minister for Health and Social Affairs, echoed that sentiment, saying, “This was the most exciting and hands-on example of patient involvement that I have seen.”

The role-play approach has since been applied in numerous other parts of the health service, both in Värmland and in other regions of Sweden. The healthcare system has harnessed design thinking to reassess and reimagine patient experience across its hospitals and other services. One example is the development of a new service for youth with mental-health issues in the city of Karlstad. The service, which translates into English as “howareyou.now,” was notably cocreated with local youth; previously, local mental-health workers had typically engaged with young people only in times of crisis.

Another Experio Lab project aimed to improve chronic-pain management. Team members conducted interviews in patients’ homes and reported a big shift in perspective, feeling much greater empathy for them as individuals rather than problems to be solved. That closer human connection carried through the redesign of the service, and patients today are more empowered to be active partners in their care.

As these examples suggest, the value of design thinking in transforming healthcare is its ability to change the mind-sets of both healthcare professionals and patients. It has helped both sides realize how much agency they have, in turn increasing the resilience and adaptability of the healthcare system.

Putting design into action

As the Scandinavian experience shows, design need not be focused only on aesthetics or functionality. Instead, governments and their partners can embrace and apply design thinking in increasingly strategic, system-oriented ways to society’s toughest challenges. Design thinking is particularly valuable in addressing complex challenges that involve multiple decision makers, have high impact on peoples’ everyday lives, or require behavior change to solve.

A good first step for organizations interested in exploring design is bringing in a designer to help frame the problems to solve. As highlighted in this article, skilled designers can engage users of services in innovative ways—often giving rise to fresh perspectives and revealing that the real issues are quite different from those initially assumed by the service provider.

A second key step in applying design to address complex challenges is to adopt a multidisciplinary approach that involves and engages all key stakeholders early in the process. For example, the Experio Lab projects show it is only when all the contributors in the patient journey gather to look at the whole system that they discover solutions that bridge the gaps between the components in the system.

Design thinking offers exciting opportunities for governments and their partners to embrace an inclusive, creative approach to solving problems that unifies people, technology, and the organization.

 

This content was originally published here.