Abstract
In recent years, there has been a growing investment in service design to transform healthcare. While existing literature describes several trade-offs related to catalysing change in complex settings, there has been little understanding to date of how practising service designers in healthcare respond to these choices. There is a need to learn more about how these practitioners navigate their positioning, achieve change and influence healthcare organisations. Bringing forward the situated and contextual knowledge of practitioners about their approach is critical for advancing the emerging practice of healthcare service design. This chapter explores and weaves together the narratives of seven practitioners who employ service design within the healthcare context. What is revealed from this exploration is an “in-betweenness”—where practitioners cope with and make use of contradictions through three compound approaches in healthcare service design. We have labelled these approaches as (1) enacting the insider-outsider, (2) creating radical-incremental change, and (3) catalysing top-up dynamics. The dialogue that emerges through this chapter deepens the understanding of how service designers approach their work within the existing dynamics of social and organisational hierarchies while co-creating change with and within healthcare organisations. Through reflection on the composite nature of healthcare service design approaches, this research offers a grounded perspective on service design practice in healthcare and sheds light on possibilities for future research.
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References
Buchanan, R. (2001). Design research and the new learning. Design Issues, 17(4), 3–23. https://doi.org/10.1162/07479360152681056.
Carr, V., Sangiorgi, D., Buscher, M., Cooper, R., & Junginger, S. (2009). Clinicians as service designers? Reflections on current transformation in the UK health services. In Proceedings of the First Nordic Conference on Service Design and Service Innovation (pp. 31–42), 24–26 November 2009. Oslo School of Architecture and Design (Ed.), Oslo.
Clatworthy, S. (2013). Design support at the front end of the new service development (NSD) process. Doctoral dissertation, Oslo School of Architecture and Design, Oslo. Retrieved February 22, 2018, from http://brage.bibsys.no/xmlui/handle/11250/93069
Coakes, E., & Smith, P. (2007). Developing communities of innovation by identifying innovation champions. The Learning Organization, 14(1), 74–85.
Cottam, H., & Leadbeater, C. (2004). Health: Co-creating services. London: Design Council. Retrieved February 22, 2018, from http://www.designcouncil.org.uk/sites/default/files/asset/document/red-paper-health.pdf
del Castillo, J., Nicholas, L., Kahn, H., & Nye, R. (2017). We change the world: What can we learn from global social movements for health? London: Nesta (Ed.). Retrieved February 22, 2018, from https://www.nesta.org.uk/publications/we-change-world-what-can-we-learn-global-social-movements-health
Denzin, N. K., & Lincoln, Y. S. (2011). Introduction: The discipline and practice of qualitative research. In N. K. Denzin & Y. S. Lincoln (Eds.), The SAGE handbook of qualitative research (4th ed., pp. 1–19). Thousand Oaks: SAGE.
Donetto, S., Tsianakas, V., & Robert, G. (2014). Using experience-based co-design to improve the quality of healthcare: Mapping where we are now and establishing future directions. National Nursing Research Unit (Ed.). Retrieved February 22, 2018, from http://79.125.112.176/nursing/research/nnru/publications/Reports/EBCD-Where-are-we-now-Report.pdf
Dorst, K. (2011). The core of ‘design thinking’ and its application. Design Studies, 32(6), 521–532. https://doi.org/10.1016/j.destud.2011.07.006.
Ellis, C. S., & Davis, C. (2008). Emergent methods in autoethnographic research autoethnographic narrative and the multiethnographic turn. In S. N. Hesse-Biber & P. Leavy (Eds.), Handbook of emergent methods (pp. 283–302). New York: Guilford.
Freire, K., & Sangiorgi, D. (2010). Service design & healthcare innovation: From consumption to co-production and co-creation. In Proceedings of ServDes. Second Nordic conference on Service Design and Service Innovation (pp. 1–11), 1–3 December 2010. Linköping University (Ed.), Linköping.
Gubrium, J. F., & Holstein, J. A. (2008). Narrative ethnography. In S. N. Hesse-Biber & P. Leavy (Eds.), Handbook of emergent methods (pp. 241–264). New York: Guilford.
Holm, G. (2008). Visual research methods where are we and where are we going? In S. N. Hesse-Biber & P. Leavy (Eds.), Handbook of emergent methods (pp. 325–341). New York: Guilford.
Iedema, R., Merrick, E., Piper, D., Britton, K., Gray, J., Verma, R., et al. (2010). Codesigning as a discursive practice in emergency health services: The architecture of deliberation. The Journal of Applied Behavioral Science, 46(1), 73–91. https://doi.org/10.1177/0021886309357544.
Jones, P. (2013). Design for care: Innovating healthcare experience. New York: Rosenfeld Media.
Kimbell, L. (2009). Design practices in design thinking. In Proceedings of the 8th European Academy of Design Conference. (pp. 249–254), 1–3 April 2009. Aberdeen: The Robert Gordon University (Ed.). Retrieved February 22, 2018, from http://www.lucykimbell.com/stuff/Practicedesignthinking.pdf
Kvale, S. (2008). Doing interviews. London: SAGE.
Locock, L., Robert, G., Boaz, A., Vougioukalou, S., Shuldham, C., Fielden, J., et al. (2014). Testing accelerated experience-based co-design. Health Services and Delivery Research, 2(4). Retrieved February 22, 2018, from https://njl-admin.nihr.ac.uk/document/download/2003318
Luscher, L. S., Lewis, M., & Ingram, A. (2006). The social construction of organizational change paradoxes. Journal of Organizational Change Management, 19(4), 491–502. https://doi.org/10.1108/09534810610676680.
Mager, B., Nisbett, A., Siodmok, A., Katz, A., Mauldin, C., O’Sullivan, D., et al. (2016). Service design impact report: Public sector. Service Design Network (Ed.). Retrieved February 22, 2018, from https://www.service-design-network.org/uploads/sdn-impact-report_public-sector.pdf
Mager, B., Jones, M., Haynes, A., Ferguson, C., Sangiorgi, D., & Gullberg, G. (2017). Service design impact report: Health sector. Service Design Network. Retrieved February 22, 2018, from https://www.service-design-network.org/books-and-reports/impact-report-health-sector
McColl-Kennedy, J. R., Vargo, S. L., Dagger, T. S., Sweeney, J. C., & Van Kasteren, Y. (2012). Health care customer value cocreation practice styles. Journal of Service Research, 15(4), 370–389. https://doi.org/10.1177/1094670512442806.
McDermott, C. M., & O’Connor, G. C. (2002). Managing radical innovation: An overview of emergent strategy issues. Journal of Product Innovation Management, 19(6), 424–438. https://doi.org/10.1016/S0737-6782(02)00174-1.
Mishler, E. G. (1986). Research interviewing: Context and narrative. Cambridge: Harvard University press.
Moritz, S. (2005). Service design – Practical access to an evolving field. MEDes thesis, MA European studies in design. Retrieved February 22, 2018, from http://hci.liacs.nl/files/PracticalAccess2ServiceDesign.pdf
Mulgan, G. (2014a). Design in public and social innovation, what works and what could work better. London: Nesta. Retrieved February 22, 2018, from http://www.nesta.org.uk/sites/default/files/design_in_public_and_social_innovation.pdf
Mulgan, G. (2014b). The radical’s dilemma: An overview of the practice and prospects of social and public labs. London: Nesta. Retrieved February 22, 2018, from https://www.nesta.org.uk/sites/default/files/social_and_public_labs_-_and_the_radicals_dilemma.pdf
NHS Department of Health. (2005). Creating a patient-led NHS – Delivering the NHS improvement plan. London: DH/NHS. Retrieved February 22, 2018, from https://www.plymouth.ac.uk/uploads/production/document/path/1/1921/dh_4106507.pdf
Norman, D. A., & Verganti, R. (2014). Incremental and radical innovation: Design research vs. technology and meaning change. Design Issues, 30(1), 1–19. https://doi.org/10.1162/DESI_a_00250.
Oliveira, M. D., Magone, J. M., & Pereira, J. A. (2005). Nondecision making and inertia in Portuguese health policy. Journal of Health Politics, Policy and Law, 30(1–2), 211–230. https://doi.org/10.1215/03616878-30-1-2-211.
Polaine, A., Løvlie, L., & Reason, B. (2013). Service design: From insight to implementation. New York: Rosenfeld Media.
Randall, D., & Rouncefield, M. (2016). Ethnography. In: M. Soegaard & R. Friis Dam (Eds.), The encyclopedia of human-computer interaction (2nd Ed., pp. 1–101). Interaction design foundation. Retrieved February 22, 2018, from https://www.interaction-design.org/literature/book/the-encyclopedia-of-human-computer-interaction-2nd-ed/ethnography
Rittel, H., & Webber, M. (1973). Dilemmas in a general theory of planning. Policy Sciences, 4(2), 155–169. https://doi.org/10.1007/BF01405730.
Roth, W. (2005). Auto/biography and auto/ethnography: Finding the generalized other in the self. In W. Roth (Ed.), Auto/biography and auto/ethnography: Praxis of research method (pp. 3–16). Rotterdam: Sense Publishers.
Schweitzer, J., Groeger, L., & Sobel, L. (2016). The design thinking mindset: An assessment of what we know and what we see in practice. Journal of Design, Business and Society, 2(1), 71–94. https://doi.org/10.1386/dbs.2.1.71_1
Sevaldson, B. (2008) Rich design research space. Form Akademisk,1(1), 28–44. Retrieved February 22, 2018, from http://journals.hioa.no/index.php/formakademisk/article/view/119/108
Sharma, S., & Conduit, J. (2016). Cocreation culture in health care organizations. Journal of Service Research, 19(4), 438–457. https://doi.org/10.1177/1094670516666369
Smith, B. (2007). The state of the art in narrative inquiry. Narrative Inquiry, 19(2), 391–398. https://doi.org/10.1075/ni.17.2.13smi
Snook, Design Managers Australia. (2014). Service design principles for working with the public sector. DMA. Retrieved February 22, 2018, from https://issuu.com/wearesnook/docs/dma_article_v6
Spry, T. (2001). Performing autoethnography: An embodied methodological praxis. In N. K. Denzin & Y. S. Lincoln (Eds.), Qualitative inquiry (Vol. 7, pp. 706–732). Thousand Oaks: SAGE. https://doi.org/10.1177/107780040100700605
Stickdorn, M., & Schneider, J. (2011). This is service design thinking. Amsterdam: BIS.
Szücs Johansson, L., Vink, J., & Wetter-Edman, K. (2017). A Trojan horse approach to changing mental health care for young people through service design. Design for Health, 1(2), 245–255. https://doi.org/10.1080/24735132.2017.1387408
Tsekleves, E., & Cooper, R. (2017a). Emerging trends and the way forward in design in healthcare: An expert’s perspective. The Design Journal, 20(1), 2258–2272. https://doi.org/10.1080/14606925.2017.1352742
Tsekleves, E., & Cooper, R. (2017b). Design for Health. New York: Routledge.
Wang, V., Lee, S-Y. D., & Maciejewski, M. L. (2015). Inertia in health care organizations. Health Care Management Review, 40(3), 203–213. https://doi.org/10.1097/HMR.0000000000000024
Acknowledgements
We would like to thank the practitioners involved in this inquiry for their time and openness in sharing their experiences. We would also like to thank Simon Clatworthy, Andrew Morrison, Ted Matthews and William Kempton for their feedback and comments on the text. Funding for this research includes the Centre for Connected Care, the Research Council of Norway and the European Union’s Horizon 2020 Research and Innovation Programme under the Marie Skłodowska-Curie grant agreement No. 642116.
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Romm, J., Vink, J. (2019). Investigating the “In-betweenness” of Service Design Practitioners in Healthcare. In: Pfannstiel, M.A., Rasche, C. (eds) Service Design and Service Thinking in Healthcare and Hospital Management. Springer, Cham. https://doi.org/10.1007/978-3-030-00749-2_8
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