Author: Fiona Munro

As part of our Hospital to Home Project I involved three Service Design Students from Duncan of Jordanstone College of Art and Design (DJCAD) in the co-design workshop process I ran in Tayside.

This was an extremely useful learning experience for myself and for the students as we gained experience in each other’s approach and knowledge of how to engage older people in a co-production design process.

This is an experience that I enjoyed very much and would highly recommend other organisations to utilise the skills of design students and graduates where possible to help develop service design solutions to put in practice.

Below is feedback from Lorri Smyth – one of the students involved in this process – on her experience of this opportunity to work alongside IRISS.

For the past 12 months I have been studying for a Master of Design for Services at the University of Dundee. Throughout this intense and widely rewarding year, I have had the opportunity to explore and develop innovate responses to challenges experienced within the public sector and various business services. The final three months of this course were dedicated to one single project of our choosing. During this time I’ve been fortunate to be involved in the Hospital to Home project along side fellow students Aishwayra Iyengar and Autumn Wang.

To work with IRISS on this project has been a great opportunity to observe some of the challenges and opportunities of co-design in practice. It certainly isn’t an easy thing to do. However, I strongly believe that involving people in the development of services is vital to tackling the challenges we face today and into the future. One simple quote by Albert Einstein has continued to inspire me throughout this year.

“We can’t solve our problems with the same thinking we used when we created them”

The exciting thing about figuring out new ways of thinking, is that there is no set way of doing things. There are no fixed rules, and a limited number people to learn from. It also requires the bravery to embrace change, try things out, make mistakes and try again. There is no set way of integrating co-design into a project, and to be at the forefront of experimenting with these new ways of working has been truly challenging and rewarding.

Working on this project with IRISS has given me the opportunity to see how co-design can be used in different ways. We did not involve people in our project in the same ways that IRISS have, through a workshops. We were also working over a much shorter timescale. Instead, we spoke with people in groups and one to one, to hear their stories. We took these stories back to our studio and developed some ideas. We then involved people during the rapid prototyping and testing of these ideas, incorporating peoples feedback directly into our designs.

From what I have experienced during my time with IRISS and through conducting our independent project, I sense a real enthusiasm and an appetite from people to be involved in the design process. From what I have learned from being part of these projects I will continue experiment with new ways of harnessing creative energies towards generating innovative solutions. It is vital that we enable people to share their thoughts, feelings and creative ideas in ways that are enjoyable, valuable and productive for everyone involved.

I look forward to seeing what the Hospital to Home co-design group produce at the end of their time with the project. We have heard some great insights from people during our time in the workshops that could lead to exciting developments. I’d like to wish the group the very best of luck during their last sessions.

I would like to thank Fiona Munro and her colleagues at IRISS for giving our team this excellent opportunity to be involved in the Hospital to Home project. We have enjoyed our time with the project and look forward to seeing how it progresses.

If you would like to learn more about the project Aishwarya and I have developed please visit our webpage. Here you can view our final prototype and read the full report to accompany the project. 

www.designforconversations.com

 

As part of our Hospital to Home Project I involved three Service Design Students from Duncan of Jordanstone College of Art and Design (DJCAD) in the co-design workshop process I ran in Tayside (Read their reflections here).

During this time they have been working with IRISS with the aim of developing outcomes for their final submission.

Two of the students (Lorri Smyth and Aishwarya Lyengar) have developed a new tool that aims to enable improved communication between older people and the people who matter to them.

They evidenced that they had gathered insights from older people, highlighting that they (older people) did not share relevant information with their family or carers regarding their health needs and day to day wants and needs. Instead older people tend to have informal conversations about these subjects with their friends, who may or may not have a caring role in their life. The aim of this tool is to engage older people and encourage them to communicate more with those who are most relevant to their care.

Their outcome was well received by the working group with many members asking how the tool could be embedded into their professional role in practice or how they could use one with their own families. Lorri and Ash are now working together to take this idea forward in Tayside.

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The third student working with the working group was Autumn Wang. Autumn focused her time with the group on establishing a tool and system that offers support for planning and facilitating design-led workshops.

Her work identified that conducting workshops requires elaborate planning and preparation. This created a niche opportunity to explore how workshop planning and facilitation could be better guided and simplified for people who need assistance in preparation for workshops. Autumn took a Service Design approach to create a complete package called ‘Workshop Whitebox’ that offers both a guide and a checklist for beginners wishing to run workshops. http://workshopwhitebox.weebly.com).

Mindfulness is everywhere – in books, magazines, journals and TV programmes as the latest way to combat the inevitable day-to-day stresses that modern life has to offer.

Once seen as a ‘New Age Fad’, mindfulness is now used by a range of people from health professionals to athletes, teachers to school children and, most recently, in parliament as a means for combatting mental health concerns such as stress and anxiety.

But what does it have to do with creativity?

Researchers are increasingly discovering a massive link between mindfulness practice and the impact it has on creativity as well as the expected human well-being, health, and happiness (Langer, 2005).

Hazel White, Course Director of the Masters of Design for Services Course at the University of Dundee, supports this view:

As part of the Design for Services Programme at the University of Dundee we run a four week Mindful Design Practice module (MDP). Mindfulness practice is a way of rebalancing thoughts and reducing anxiety through meditation practice, which we feel frees our students minds up to be creative in new and challenging situations.

Our masters programme is an intensive one year of study – many students are juggling the responsibilities of family, part-time work or adapting to a new culture and language: a heady mix which does not always foster creativity. 

The mindfulness practice complements the design research and practice element of the module – supporting students as they gather insights from a range of people in new and sometimes challenging environments. The mindfulness practice is led by practitioner Kumanga Andrahennadi supported by David Sanchez in five 90 minute sessions in the design studio at the university and two short (two hour) ‘retreats’ to the Botanic Gardens in Dundee and a local beach. In the sessions the participants were guided through a series of exercises to reduce the number of thoughts in their mind and focus on positive thoughts.

Feedback from the students suggested that the mindfulness practice gave them ‘space’ for their thoughts and many of them reported on the positive impact it had had on keeping them ‘balanced’ throughout their study.

Psychologist Brad Waters (2014) also supports research that suggests mindfulness can help foster creativity stating “I’ve personally found that, regardless of the science, learning how to cultivate mindfulness during my own bouts of creative block has been a welcome discovery.”

However, mindfulness can be daunting to the novice and should be embraced by learning to ‘trust the process’.

It’s not about ‘doing nothing’ or ‘daydreaming’, it’s about learning to focus on the moment you are in right now and removing yourself from all the distracting thoughts in your mind by becoming aware of them. Admittedly daydreaming can help to generate ideas, but being able to clear your mind and focus on the problem you are addressing is much more helpful in establishing a creative solution.

People may argue that you need a busy mind in order to create lots of new ideas. However, Shamash Alidina and Joelle Jane Marshall, authors of ‘Boast Creativity with Mindfulness, suggest that “when you have a calm mind, creativity naturally reveals itself’. They suggest this is for the following three reasons:

When you practice mindfulness:

1. Your normal conscious thoughts start to lose their grip on your awareness.
2. Your more creative, unconscious brain is able to work more effectively and create new connections and ideas.
3. You make a mental space when your conscious mind calms down in which the new ideas are revealed.

The added benefit, they suggest, is that you are able to identify solutions faster, making you a more effective problem solver.

Try it for yourself:

Right now take a moment to become aware of the space around you, the lights, sounds and shadows. Focus on your breathing and what part of your body you feel it most in. Let thoughts come to mind but dismiss them immediately without letting your mind focus on them. Do this for a couple of minutes. Your only focus is being entirely present in the situation you find yourself in now. This is mindfulness. See where it takes you. 

References:

Alidina, S. and Marshall, J. J. (2014) Boost Creativity with Mindfulness

in Mindfulness Workbook For Dummies

Brad Waters, L.C.S.W. (2014) The state-of-the-art in personal development. Psychology today: Design Your Path

Dhiman, S. Mindfulness and the Art of Living Creatively: Cultivating a Creative Life by Minding Our Mind. Journal of Social Change 2012, Volume 4, Issue1, Pages 24–33 Walden University, LLC, Minneapolis, MN DOI: 10.5590/JOSC.2012.04.1.03

Greenberg. J, Reiner. K and Meiran. N (2012) “Mind the Trap”: Mindfulness Practice Reduces Cognitive Rigidity. PLoS ONE 7(5): e36206.

Hofmann, G. (2014) How Mindfulness Can Help Your Creativity

http://psychcentral.com/blog/archives/2013/10/05/how-mindfulness-can-help-your-creativity/

Langer, E. On Becoming an Artist: Reinventing Yourself Through Mindful Creativity. Ballantine Books; 2005.

White, H. (2014) Personal Interview. DJCAD: University of Dundee.

 

 

 

 

 

 

 

 

 

When?

On 23rd April I attended the 3rd National Co-Production Conference to run a workshop about  the Hospital to Home project activity so far and to explore some of the tools and methodology I’ll be applying in our Working Groups – starting early next month and running for 6 months!

Who was there?

To help facilitate the workshop I was joined by three people involved in the project:

1. Lynne Morman: Team Manager, Social Work Department, Ninewells Hospital, Dundee.

You can hear Lynne speak about the pathway from Hospital to Home in Dundee on the project website.

2. Lorri Smyth: Masters for Service Design Student, Duncan of Jordanstone College of Art and Design (DJCAD), Dundee.

Lorri is supporting this project until August 2014 as part of her final Masters submission. In this capacity, she – plus two other students from the course – will be helping to facilitate the Working Group workshops (starting 2nd May 2014).

3. Margaret Hume: An informal carer.

Margaret is involved in the project as a participant in the Working Groups.

What did we do?

During this workshop we introduced participants to the overall findings of the Hospital to Home project to date before asking them to participate in a ‘Serious Play‘ activity using LEGO to map the current pathway from Hospital to Home for older people.

For this purpose, the group (36 participants) was split into four small groups with each group being asked to map the services and support currently available to older people within one of four pathways: 1. Straight home; 2. Step Down; 3. Early Supported Discharge; and 4. Straight to a Care Home.

Each group was then asked to use the LEGO to highlight what some of the issues with these services and support might be. They were also asked to identify the people involved in the pathway at each stage. For example, family members, informal carer(s), health and social care practitioners, community services and not forgetting to include the older person being discharged!

Each group was given 30 minutes to complete this task before providing feedback about their activity to the larger group.

The workshop concluded with a discussion about some of the ‘Golden Rules’ for Co-Production.

select the right people

Build and maintain relationships

Discuss expectations early and make sure everyone involved will benefit from the process

Be open and honest

Remember the facilitator is not the expert

Create a positive environment: encourage, involve, listen

What did the participants think?

“Facilitator suggested older people have a life before hospital – this is a key consideration to make co-production successful!”

“I liked the creative approach to stimulating the working group.”

“The main thing about co-production is around getting everyone involved to have an equal voice.”

“The importance of the PERSON is absolutely key.”

Partners in East Renfrewshire, at the instigation of Anne Kidd, chief executive of VAER, are working together to develop a new ‘Home from Hospital’ service as part of a Big Lottery Funded programme called ‘Better by Design’.   Better by Design is a new approach from Big Lottery, aiming to apply the methods and mindsets of design to improve the social impact and sustainability of Scotland’s third sector. Taylor Haig is delivering this programme for Big Lottery in partnership with the Young Foundation.

Lynne Wardle, Director of Taylor Haig, is working with Anne and partners on Home from Hospital.  Here she describes the initiative and what she thinks is particularly exciting about the approach in East Renfrewshire.

When I first spoke with Anne about the Home from Hospital project she was apologetic.  “I’m sorry” she said, “but it’s complicated”.  She went on to describe the many organizations – public sector, voluntary sector and private sector – the local policies, national policies, new initiatives and existing services that connected and related to older people’s journey home from hospital.  “But the good news,” she added, “is that we’re have a mature local partnership and I believe we can make a difference”.  I believe she’s right.

The official narrative of the issues associated with hospital discharge is well rehearsed.  But how do older people experience this situation?  What are their expectations, their hopes and fears relating to hospital admission and the transition home, or to a new or newly adapted home? What about health professionals, social workers, carers, family members, neighbours and friends? Actually, what problem is “Home from Hospital” trying to solve and whose problem is it anyway?  In a complex system there will be many different perspectives on both the problem and the solution.

As with any design-led approach we began with an exploratory phase.  A workshop with stakeholders [practitioners] informed the initial ‘design brief’ and from there we’ve drawn on ethnographies, case studies, desk research and interviews with stakeholders to shape the approach.

Interestingly, when talking with stakeholders it was noticeable that most said very little about “Home from Hospital”.  Instead, they spoke about their realisation that things had to change.  The current systems and services to support older people don’t make sense in the changing world we live in.  Stakeholders experienced a tension between ‘keeping the lights on’ – maintaining performance within the current paradigm – and working in new ways and with new models that haven’t yet got a clear form.  The people in the partnership were restless and thoughtful but also open minded and optimistic – a great basis for a design-led approach!

It is apparent that partners in East Renfrewshire have positive regard for one another and empathy for the day-to-day pressures that can get in the way of innovation and change.   They are also prepared to challenge assumptions and really seek to understand what people want and need and what assets, capabilities and capacity exits in communities that could be reconfigured in service of older people.  They also want to get on and try things, to co-design with older people and prototype services quickly.  Through learning by doing they hope to show not only that it is possible to design improved services for older people, but also it is possible to change the relationship between commissioners and community providers, between professionals and volunteers and between services and people who need support.

In East Renfrewshire, we’re not only developing a service; we’re prototyping a process, a way of working together that can be applied to other challenges and one that we hope will have the potential to sustain system-wide change in the way communities and public services collaborate to make life better for people.

To quote the well-known anthropologist, Margaret Mead, “Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.”