Delivery by design

Christian Bason is passionate about the role design thinking can play in achieving the best possible outcomes in the public sector. Jo Russell talks to him about his vision.

In many organisations, design is no longer simply the preserve of the creative department, busy conjuring up aesthetic new products. Design thinking is increasingly being adopted as a means to tackle ever-more-complex scenarios – nowhere more so than in the public sector.

Design thinking focuses squarely on the user. If a product can be designed with the end consumer in mind, so the thinking goes, why can’t the same approach be adopted for the way in which processes and services are designed? In this way, the end result could be something simple, intuitive, pleasurable to use and, ultimately, more effective.

“Public sector design is about creating more value for people,” says Christian Bason, CEO at Danish Design Centre, an independent organisation funded by the Danish government that acts as a knowledge centre on design matters for businesses. “Public policies and programmes ought to be run on the basis of how they impact people’s lives, and how they can better achieve citizens’ objectives. Design is an approach to solving problems and developing innovative solutions that is human-centred, experimental and challenging in nature.”

Theory in practice

To illustrate this, Bason uses the example of the Heart Centre at Rigshospitalet, Copenhagen. The
hospital had adopted lean project management to the extent that it was believed that no further waste could be eliminated. Yet more efficiencies were being demanded, together with a better, more meaningful experience for patients. The hospital sought the help of MindLab, the Danish cross-governmental innovation unit.

“We started with the end user, the patient, and framed the project around the question, ‘How might we create a more meaningful patient experience?’ None of the doctors or nurses had considered that to be their job. They thought their job was purely to cure patients,” says Bason, a former director at MindLab.

The first step was to spend time with patients and understand their experience around the ward. The design process combined data collection from the patients with a series of workshops and collaborative sessions with nurses, doctors and external experts.

Qualitative research methods were used, including audio recordings of patients highlighting their concerns and where they saw room for improvement. Hearing these voices prompted changes in the professionals’ view of themselves and their role. In the workshops, questions were raised as to how to redesign to create a more coherent, meaningful patient experience with regard to waiting times, delivering information, noise confusion and space.

“An important element of the process is prototyping,” says Bason. “We asked, ‘If we do something different, how will it work in practice?’ We took the approach that a patient’s time should be prioritised, and then planned a day where the work processes would focus around minimising waiting time for patients, and not optimising workflow for doctors.”

The changes led to significant efficiency improvements and unearthed opportunities for improving medical staff workflow. Annual savings of around £600,000 were generated in addition to improving patient experience and satisfaction levels.

Design imperative

Proven results mean that design methodologies are being embraced in the public sector both in the UK and globally. There is recognition that governments constantly design, whether it is services, forms to fill out, policies or interventions. Designing a simple, intuitive, digital experience is just as important for public services as for the private sector. The hope is that a design-centred approach will engage citizens in new and more innovative ways, while dealing with an increasingly complex stakeholder landscape. And that level of complexity can only increase with the advent of Brexit, believes Bason.

Although not from a design background, Bason explains, “I embrace design because I have seen that the complexity and scale of the challenges governments are facing are so huge that we need new approaches, new ways of engaging citizens and running projects.”

A flexible approach

Then there is the notion of rehearsing the future. Design is about creating something that is not yet here, Bason says.

“It is about prototyping and testing, being curious about whether something will work for people, but being humble enough to get feedback. It is also important to be confident enough to discard something if it doesn’t work, rather than assuming that, because it is being delivered by experts, it must be right. Lots of business programmes and public policies turn out not to work in real-world settings.”

This sort of approach does not come naturally. Project managers are used to managing risk and delivering on deadlines. The lack of control posed by design is challenging, and doing something that has not been done before is inherently risky. The cultural change required will not happen overnight.

Bason’s advice is to “just get started”. The best way to learn is by experience, he believes: “Start by spending time with the end user and take it from there. Consultancies can help, and that will obviously have cost implications on already tight budgets.

“But I can almost guarantee that, if you work with a strong design agency, there will be benefits to both the public purse and citizens as a result,” he concludes.

 Tips on adopting a design-led approach

In his book, Leading Public Design, Christian Bason sets out a number of different approaches required from managers in order to adopt design. The first of these is to challenge assumptions.

“People dive in without challenging the brief they have been given, especially in bureaucratic or top-down organisations,” he says. “That means they may end up looking at the wrong problem or developing the wrong solution. Design requires you to have an inherent curiosity and challenge assumptions while asking new questions.”

The second point is to use the insight from citizens’ experiences as a lever for creating change. A critique of many projects is that, while they may lead to different outcomes or solutions, they do not deliver organisational change.

Openness is also key, Bason says: “Good managers are involved in innovation, searching for new solutions with new ideas, not just delivering the norm. That means the solutions space has to be left open for a long time while new ideas are constantly floated and tested. There is no set endpoint, and managers must be able to navigate the unknown.”

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 Jo Russell is a business writer and editor.