Design principles & methods in government

From visualisation to policy development: levels and impact of design use in the public sector, USA & Japan

Winston Churchill Memorial Trust, Travelling Fellowship Report 2013/14

Camilla Buchanan

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About I am a Policy Advisor at the Design Council in the UK where my work is about identifying and explaining how design principles and methods can be of value to government, in both service delivery and the newer area of design and policy making. Understanding the relevance of approaches from design for public sector challenges is an area of real interest for me. My aims in applying for the Winston Churchill Memorial Trust Fellowship were to improve my knowledge of how and where design methods are being used beyond the design sector on wider policy and service-delivery issues in government, to meet the people leading this work internationally, and to bring insights back to my work in the UK. My background is in public policy and my first job was at the British Council in London. I then worked at the Cultural Policy Unit at the European Commission in Brussels before coming back to London to help set up the Craft Council's first policy strategy. I studied at the London School of Economics and University of Bristol. Acknowledgement The Fellowship was a pivotal experience for me. It has hugely expanded my knowledge of new areas for design. It has also created numerous new opportunities, contacts and friends. I am incredibly grateful to the Winston Churchill Memorial Trust for what has been an amazing personal and career opportunity and for their generosity, flexibility and support throughout the process. Research for the Fellowship was through interviews, conversations and site visits; views in the Fellowship Report are my own. Countries Japan, August 2013 USA, November 2013 Cover: Participant at workshop in The Lab @ OMP for workshop during the Fellowship.

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Abstract An emerging hallmark of designers and the design sector today is the ability to apply design methods, many of which originate in product design, to a wider set of problems in business and society. Many businesses are now using design approaches strategically, for example to understand customers better. Similarly, in the public sector much design-led work has taken place to bring user insights into the development of public services. In the UK interest in how these approaches can aid policy development is now increasing. But knowledge of how and where design adds value to more structural public sector challenges is still limited. The Fellowship aimed to learn from leading international examples where design is being used as a strategic tool in governments, and by organisations outside of government to tackle complex social issues. Many of these methods and approaches have been pioneered by organisations based in the USA, the main country of research. The Fellowship also looked at how design is being used in Japan in response to complex social challenges associated with a rapidly ageing population.

Design schools in the USA

Quick sketch by Charlie Cannon, EPIC Decade/ Rhode Island School of Design

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Contents SECTION 1: Introduction p5 SECTION 2: New areas for design p7 SECTION 3: Design in government, USA p9 SECTION 4: Case Study: Japan, ageing population p22 SECTION 5: Insights & Recommendations p28

Questions for further research p31 Conclusion p30 Appendix 1: Outline of Itinerary p32 Appendix 2: Outcomes of the Fellowship p35

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SECTION 1 Introduction Context for the Fellowship Design is not just an object or aesthetic output at the end of a process, such as a product or web interface. It is also an approach with associated principles and methods for understanding problems and rapidly generating, testing and implementing new ideas. There has been dramatic recent expansion in the application of design methods to problems in business and society and interest in where design can add value has grown significantly. Design methods are varied but in essence involve a user-centred approach, clear visual commutations, integrated approaches to cross disciplinary boundaries and extensive testing (see Section 2). One of the emerging areas for design in the UK is its application to ways of working, the creation of services and systems and to policy development in government. But the use of design methods in government is still relatively new, particularly regarding policy development. Although there is significant interest, knowledge of how and when it adds value is limited and very few real policy projects have used design. As interest grows more evidence of impact is needed, along with clear examples. Lessons on how to articulate this work, the types of space required for it to take place, gaining endorsement from leadership and ways to support the use of new methods introduced in training session are also needed. Aims and Objectives This Winston Churchill Memorial Trust Fellowship looked at how design is being used in two different international contexts to tackle complex problems in government and society. The objective was to improve understanding of how design can provide new approaches in government, especially the policy development process. Design-led solutions for older people in Japan were researched in August 2013; the use of design in the public sector was researched in the USA in November 2013. Structure of the Fellowship Report First, the report outlines how design can be understood as a process, with associated methods and principles that are increasingly being used to tackle challenges in business and the public sector. (Section 2) Second, the report covers insights from the USA, which was the longer part of the Fellowship. It sets out examples of where design is being used in government and insights from other pioneering work where design is being used to tackle highly complex social challenges. (Section 3) Third, the report looks at design in the context of a particular social challenge, ageing population, through examples from Japan where the design process is involved in the development of new products and business models. The visit to Japan took more of a case study approach, looking at dramatic demographic change; the consequences of which is often the remit of governments but also entail wider societal and business responses. (Section 4) Finally, key insights and recommendations from the Fellowship about the use of design in government are made. (Section 5)

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Research questions were: - How is design being used in the public sector in the USA? - Beyond the public sector, where is design being used to tackle complex

social challenges in the USA and what kinds of organisations are leading this work?

- What are the examples of design methods being used to respond to challenges associated with an ageing population in Japan?

- What are the insights on the value of design work in the public sector and how can it be supported?

Methods The principal research method was guided conversations. In Japan these were with, international government bodies, local government, researchers, healthcare practitioners, corporates and not-for-profit organisations. In the USA meetings were with federal government, not-for-profit organisations, design agencies, academics and design membership organisations. Interviews were supported by academic and grey literature. There were also numerous sight visits, for example to the Institute of Gerontology in Tokyo, a practicing hospital; d.school, a cross-departmental design unit at Stanford University; the Institute of Human Centred Design a not-for-profit organisation in Boston; and Smart Design a design innovation consultancy in New York.

Smart Design

View from office in NYC

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SECTION 2 New areas for design This section explains the concept of design as a process, with associated methods and principles, which are increasingly being used to tackle challenges in the private and public sectors. Overview Design is mostly perceived as a tangible output such as a product or visual elements including logos and forms, but design approaches are now being applied to the creation of services and systems in business and the public sector. In business momentum has been created by design consultancies which apply methods, often stemming from the product design process, to wider challenges such as understanding customers and unlocking skills in the workforce. This approach is sometimes referred to as ‘strategic design’ and is particularly well-developed in the USA. Amongst the most high-profile consultancies are IDEO, frog design, Catapult Design, Continuum and Smart Design. Design innovation consultancies in the UK include Livework and Engine Service Design. Other product design business have extracted methods from their product development process and applied them to the wider working culture – for example, at Philips UK Ltd. co-creation workshops have become the norm and trained designers are only involved at certain points in product development. Many non-design businesses have also established design-led innovation units and developed their own design principles, including Barclays, Hyatt Corporation and Nordstrom, Inc. In the public sector, public bodies such as the Design Council in the UK, Mindlab in Denmark and SITRA in Finland have promoted the use of design principles and methods to address public sector challenges. This work is further ahead in Europe and other EU countries than in the USA, but there are excellent, highly transferrable examples particularly in university research centres in the USA. In the UK the majority of design work in government has focussed on service challenges in local authorities, but interest is growing in the application of design methods to broad policy and structural challenges. The major driver for expanding the application of design methods in central government is the Cabinet Office’s Civil Service Reform Plan1 (2012), which has resulted in work by the Policy Profession and new Open Policy Making (OPM) team in the Cabinet Office to introduce new approaches into policy development. The design approach To understand how design can be applied to the development of services and systems it must be seen as a process, with associated principles and methods. Design principles can vary depending on the organisation or challenge but some of the most important are:

- A focus on people or customers, to create solutions which take into account the needs of real people.

- Iterative and collaborative working, to reduce risk in the innovation process through early, frequent testing of solutions as ideas develop.

- Clear visual communication, to help visualise and clarify concepts and possible solutions.

1 http://www.civilservice.gov.uk/wp-content/uploads/2012/06/Civil-Service-Reform-Plan-acc-final.pdf

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These principles are underpinned by design methods, which also vary depending on the context. Many of the methods originate in product and industrial design but are now being used and adapted in less concrete situations. Typical methods include:

- Customer journey mapping: a map of a customer journey over time to identify the ‘pain points’ in a service or product. These can inspire everything from small tweaks to far-reaching innovation projects and are developed with real customers.

- Prototypes: early, low cost testing before ideas are implemented. Prototypes can range from cardboard models to role-playing. Services can also be prototyped as a whole or as individual touch points.

- Personas: fictional characters created to focus on different types of customer and consider their needs. Personas are usually created by synthesising information on real users, and different personas can represent different stakeholder groups.

- Service blueprints: visual maps or diagrams of an entire service or system showing it from end-to-end, but also the steps and interrelations within it. These maps help to identify points where people interact with a service as well as inefficiencies and barriers.

Some useful guides to design methods discovered through research for the Fellowship are:

- Human Centred Design Toolkit, IDEO2 - Taxonomy of Innovation, LUMA Institute3 - Engine, service design methods4 - Helsinki Design Lab, In Studio Recipes for Systemic Change5 - frog design, Collective Action Toolkit6

Emerging areas When design is understood as a process rather than an output, the possibilities for application expand radically. Some of the most exciting challenges for designers are no longer stylistic but rather about the creation of more humanistic, effective experiences.

One of the most important new areas for design is its ability to engage with other sectors and unlock insights from different disciplines in response to complex problems. Design also offers new methods to policy development, including ways to bring customer insights into the policy development process or to prototype and test policies before they are fully implemented.

This approach is important because a huge amount of problems stem from lack of organisational design and management in the public sector. Although much excellent design work has taken place at the service level in the UK, in many cases systems overhaul is needed and projects that ease delivery pressures may conceal bad systems and policy. The aim of spending the majority of the Fellowship in the USA was to learn more about where design has been applied to complex problems and where these approaches are being pioneered, to gain insights for how it can aid policy development in the UK.

2 http://www.ideo.com/work/human-centered-design-toolkit/

3 http://hbr.org/2014/01/a-taxonomy-of-innovation/ar/1

4 http://enginegroup.co.uk/approach/

5 http://helsinkidesignlab.org/instudio/

6 http://www.frogdesign.com/work/frog-collective-action-toolkit.html

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SECTION 3: USA, November 2013 Summary of findings: In the past five years the status of design in the private sector in the USA has changed dramatically, and design methods are now increasingly embedded in business through innovation units and companies that are developing their own design principles. Use of design in government, federal and state, is still limited compared to the UK and other EU countries. There is no equivalent to the Design Council or ecology of smaller design agencies working on service challenges in government; however, there is a growing community of interest in design in government, particularly in academic and not-for-profit sectors. Some of the leading examples of the use of design methods studied for the Fellowship were of design application to large scale, ‘super-wicked’ problems. In these cases thinking is based on design but was applied to complex challenges, and had evolved as a means to unlock methods and insights from different disciplines. Whilst many of these examples are in university research centres they show how design approaches can provide a new framework to tackle the types of ‘super-wicked’ problems faced by policy makers. Key proponents include:

- ChangeLabs at Stanford University - Transdisciplinary Design work, at Parsons New School of Design - Business Innovation Factory, Providence, Rhode Island

USA detail of organisations visited This section presents insights from organisations visited in the USA. Examples have been grouped under four headings, indicating the different levels at which design work is taking place in government. Work ranged from the design of print material to the use of design as a strategic approach to tackling highly complex social challenges. Headings are:

- Communicating government policy and processes - Training for civil servants - Design of the customer interface - Design for complex challenges and systems

Communicating government policy and processes Design methods tend to rely on clear visualisations of problems and potential solutions; this can have a powerful impact in cultures otherwise dominated by text. There were several examples in the research of information design being used to increase civic participation in public policy, through simple tools and visualisations of policies and government processes. Approaches included graphic design, data visualisation and illustration. In the following examples information design is used as a tool to represent complex government processes to engage citizens. Centre for Urban Pedagogy (CUP), New York CUP is a small not-for-profit organisation founded in 2002 and based in New York. It aims to give underrepresented people a voice and to encourage wider civic participation in public policy. CUP projects involve designers, communities and policymakers and recent issues represented include the juvenile justice system, voting districts and street vending.

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‘What is Zoning?’7 For example, is a toolkit, including a guidebook and board game, to help communities understand land use zones and how they could be affected by proposed changes. Another project, ‘Government in Plain Sight’8 created with the Academy of Urban Planning and a 9th grade history class is a series of activities for teachers and students to highlight where the state is present in everyday life, in common objects or streetscapes for example. http://welcometocup.org/

7 http://welcometocup.org/Projects/EnvisioningDevelopment/WhatIsZoning 8 http://welcometocup.org/Projects/CityStudies/GovernmentInPlainSight

Centre for Urban Pedagogy,

‘What is Zoning?’ Toolkit

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American Institute for Graphic Arts (AIGA), nationwide The AIGA is a professional membership body for graphic design founded in 1914. It has 26,000 members and 67 chapters in the USA. Activities include advocacy, CPD and awareness-raising, competitions and events. The AIGA has a long-running ‘Design Policy Advocacy’9 campaign to improve the quality and clarity of information design in federal, state and local government interfaces with the public. The campaign also has a strategic ambition, to increase awareness and use of design approaches in government, such as service design. Most work to date has been information design of government forms and other ‘touch points’ with the public. The ‘Design for Democracy’ 10 strand for example is a campaign to encourage voting and to set the design standard for election materials. http://www.aiga.org/ Training The research also covered two different organisations providing training in design methods to civil servants. These organisations aimed to increase awareness of design, augment civil servant skillsets with new methods and improve capability in the public sector to commission design work. Training was thought to have the most impact when it was in partnership with internal innovation teams and was accompanied by a plan for roll out with periodic support. The complexity and cost of the procurement process was cited by these organisations as one of the main barriers to working with government. Another barrier mentioned was the tendency of government agencies to commission only high-profile consultancies, such as IDEO.

9 http://www.aiga.org/aiga-design-policy-advocacy/ 10 http://www.aiga.org/design-for-democracy/

AIGA

Design for Democracy

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LUMA Institute The LUMA Institute is an educational company in Pittsburgh that teaches a Human Centred Design toolkit internationally, through workshops, online resources and consultancy services. It has developed a ‘Taxonomy of Innovation’, a set of 36 design tools most of which are in common use. The framework is split into three broad categories ‘Looking’, ‘Understanding’, ‘Making’, referring to different stages of the design process as defined by LUMA. Each category contains sub categories and four accompanying tools. The hierarchical model is designed to make the selection of appropriate tools easier and to guide people through their use. The framework was described as ‘agnostic’ because the emphasis is on how methods are stitched together in different contexts, meaning it can be applied to a wide range of problems. An interactive model of the framework was featured in Harvard Business Review in January 201411. In the context of policy development, the framework was seen as particularly useful for ‘problem framing’ to better understand the issue around which policy is being created. http://www.luma-institute.com/

11 http://hbr.org/2014/01/a-taxonomy-of-innovation/ar/1

LUMA Institute

Taxonomy of Innovation, as featured in Harvard Business Review

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The Lab @ the Office of Personnel Management, Washington DC The Lab is the only design-led innovation unit in US Federal Government. It was established by the Office of Personnel Management (OPM) in 2012 which is the US federal government department responsible for staff training, recruitment and development. It is led by Abby Wilson and is a distinct space within the department where civil servants from across government can meet, resembling a start up more than a federal government office. Methods used at The Lab originate in product design and the LUMA Institute was commissioned to develop these. The methods focus on keeping people at the centre of the problem-solving process and include ethnographic observations and customer journey mapping. For a problem to be considered by The Lab it asks:

- Is the problem real, pervasive and long-standing? - Are the stakeholders coming to The Lab with the problem committed to

solving it? - What kind of impact will solving the problem make?12

Projects have included ways to increase participation during open season, when federal employees can change healthcare plans and integrating veterans into the federal workforce. During the Fellowship, The Lab convened 20 civil servants from across departments to discuss their experience using design and hear about UK examples. There was very clear interest from participants in design approaches and a number of projects had taken place, for example in the State Department. However, The Lab was seen as an exceptional space and participants felt that internal support across government, evidence of impact and sources of advice were all lacking. Participants also commented on the absence of an external organisation advocating the use of design in the US government.

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http://www.federalnewsradio.com/520/3004758/OPMs-innovation-lab-spurs-new-way-of-problem-solving

The Lab @ OPM

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Design of the customer interface There were examples of design-led innovation applied to frontline services, including public services such as education, transport and privately provided healthcare. This work focussed on the public interface with government systems such as the high school admissions process. One of the criticisms of design work in government is that it has worked on overly-discreet service challenges, potentially concealing bad systems and policies which sit behind frontline services13. In these examples, service innovation projects were being used to improve the people’s experience of the interface with government, but the organisations also had ambitions to influence wider culture and policy change. The Public Policy Lab, New York To their knowledge, the Public Policy Lab directed by Chelsea Mauldin in New York is the only not-for-profit in the US working on public service redesign and development. Their work falls into three broad areas, delivery of service redesign in public bodies, research and a fellowship programme for service designers. The service redesign projects are run in partnership with public bodies and focus on specific delivery challenges. But The Public Policy Lab has a strategic ambition in its work at the service level, and front line service projects are seen as the fastest way to influence wider culture change by up skilling staff in design methods and revealing insights about people who use their services. A recent project with the New York City Department and Office of Student Enrolment investigated how to improve the admissions experience to public high school programmes. Research involved interviews with dozens of policymakers, school staff, parents, and 8th and 9th graders and proposed more than 30 opportunities to design services that respond to the needs of different stakeholder groups. There is an excellent explanation of the project process in the accompanying publication Understanding the School Choice Experience14. http://publicpolicylab.org/

13 http://www.nesta.org.uk/publications/design-public-and-social-innovation 14 http://publicpolicylab.us7.list-manage1.com/track/click?u=5ca538c2f43b24e1124effbf8&id=a89d488e79&e=ee3ff38a6f

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Designmatters, Arts Centre Pasadena. Los Angeles Designmatters is a cross-university unit co-founded by Mariana Amutullo and based in the Arts Centre Pasadena, one of the leading design schools in the USA. It undertakes research, teaching and fellowships for students and runs real world projects in partnership with external organisations. The projects often result in tangible outputs such as communications material or products but have a wider social ambition. “Where’s Daryl?” for example is an educational toolkit with eight lesson plans, to help teachers facilitate conversations about guns with students though a fictional character, ‘Daryl’. One of the real benefits of the project is its potential to be scaled up nationally and the program won an Ideas That Matter award from Sappi Fine Paper North America, which allowed for implementation across ten schools in the district in April and May 201315.This is important because one of the major criticisms of design work in the public sector is its focus on small-scale discreet solutions, making ideas and impact difficult to scale up and transfer. http://www.designmattersatartcenter.org/

15 http://www.designmattersatartcenter.org/proj/lausd-wheres-daryl-educational-program/

Arts Centre Pasadena

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Institute for Human Centred Design, Boston The Institute for Human Centred Design in Boston is a long-standing not-for-profit promoting universal, inclusive design. It runs a wide range of activities from education, research, consultancy and design services, government-funded technical assistance and workshops. The organisation also has a User/Expert Lab, which is a group of over 200 people representing different ages and needs which the Institute can draw upon to work with clients to test new products and services. The Institute centres on the philosophy that disability is a ‘contextual phenomenon’, meaning the environment in which we are situated defines our ability. It sees a fundamental role for design in shaping environments around human need, be they digital, spatial or social. The raft of projects delivered in more than 35 years by the Institute includes service projects. For example, the Institute worked with the public welfare agency in Connecticut in 2006; it was a fraught environment in which both staff and users were under extreme pressure and a majority of clients had mental health diagnoses or learning difficulties. All of the agencies’ communications were postal and most clients received more than one communication daily, often running to 35 pages long, staff absenteeism was incredibly high and many users had a ‘diminished sense of self’ when interacting with the service. These insights were revealed through extensive ethnographic and contextual inquiry undertaken by the Institute. They are an example of how challenging the situation in some frontline contexts is and the need for mechanisms which look at entire organisational structures, how people interact with these and the quality of their interactions. http://humancentereddesign.org/

Institute of Human Centred Design Carousel, Rose Fitzgerald Kennedy Greenway, Boston

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Design for complex systems and challenges The final set of examples from the research show some of the most complex and emergent areas for design. These examples demonstrate a marked shift in design from the creation of discreet outputs such as products or communications material, to work on complex social and economic problems where the subject and results of the design process are not necessarily tangible outputs but could be platforms, organisational cultures or systems. In these examples the role of the designer is less about materialising an individual vision; instead designers and non-designers are using methods from design to address complex problems. Collaboration between different disciplines is key to this way of working and the designer is more of an expert facilitator than craftsman; using methods such as personas and systems blueprints, to bring together diverse interest groups and disciplines to work on problems which are so complex than no single disciplinary approach can be used to tackle them. There is an extremely useful description of this shift in some areas of the design sector in The Journal of Design Strategies with an introduction by Joel Towers, Executive Dean, Parsons, and The New School for Design:

“In fields as diverse as education and disaster relief, designers are contributing not just to the conception and development of innovative new products, scenarios, and systems, but also to the effective planning and management of the development processes themselves. Indeed, an emerging hallmark of designers today is precisely their ability to engage productively with a wide range of other sources of knowledge and expertise. In a world beset by intractable problems whose complexity defies resolution within the terms of any single professional perspective, collaboration across disciplines is itself becoming a sine qua non of effective action”.

The excellent leading essay in the same journal by Jamer Hunt, Associate Professor of Transdisciplinary Design, School of Design Strategies, explains in detail some of the possibilities (e.g. looking at entire systems or identifying and framing problems) and the challenges (e.g. lack of qualitative and quantitative evidence of impact) of this design-led approach.16 These examples are linked to universities, but are focussed on real-world challenges and centre on the use of design as a tool to transcend disciplinary boundaries. The examples show how design approaches can provide a new lens to tackle the types of super-complex problems faced by policy makers. Parsons New School for Design, School of Design Strategies The School of Design Strategies has established a two-year graduate programme, the MFA Transdisciplinary Design. The degree emphasises cross-disciplinary working to examine problems from multiple perspectives. Some of the key approaches from the degree are:

- Reflective collaboration – working flexibly in multidisciplinary teams to solve highly complex problems

- Complexity modelling – visually modelling complex systems and social structures to yield new insights

- Critical reframing – examining problems and turning them into design opportunities

- Design-led research – articulating a research problem and exploring it through a design process

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http://vizuarna.files.wordpress.com/2013/04/jds-vol5-screen-1.pdf

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- Fitness prototyping – discovering an appropriate resolution of a problem that belongs to no single design field.17

The programme was established by Jamer Hunt and is equipping designers to play a role in working on complex social challenges and organisational structures, such as health-care systems. It is part of wider work in the School of Design Strategies that defines and explores the emerging roles for designers. Work includes the Parsons DESIS Lab 18 (Design for Social Innovation and Sustainability), a research lab looking at service and strategic design part of the international DESIS Network which comprises over 30 design labs in universities around the world. ChangeLabs, Stanford University ChangeLabs is a special lab that undertakes research and works with industry partners on projects relating to large-scale, complex challenges in critical areas such as social inequality, water scarcity and energy resources. Partners can be NGOs, businesses or government bodies and ChangeLabs also pulls in graduate level students from courses across the university to work on live projects. ChangeLabs was founded by Banny Banerjee, Associate Professor Design Group, Mechanical Engineering Department at Stanford University, and is based in the School of Design. The aim is to create a network of similar agencies internationally to develop the kinds of systems required to meet super-complex challenges, for example new leadership and organisational structures or systems for resource management.

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http://www.newschool.edu/parsons/mfa-transdisciplinary-design/ 18

http://www.newschool.edu/desis/

d.school, Stanford University

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The methods used at ChangeLabs originate in design but have evolved to focus on breaking down disciplinary silos and the co-creation of new models using insights from people in different sectors. ChangeLabs describes this approach as an emerging discipline called ‘Scaled Transformations’. ChangeLabs was created in response to the perception that new frameworks, structural innovation and cross disciplinary working are needed to address conditions which are now so broad and complex that no single disciplinary lens can be used to create solutions. The work shows the potential of methods rooted in design to create a common approach for people with different perspectives and to conceptualise frameworks for entirely new systems. http://changelabs.stanford.edu/ Business Innovation Factory, Providence Rhode Island BIF is a not-for-profit based in Providence, Rhode Island which works with clients to develop and test new business models in areas of high social impact including healthcare, education, energy, and entrepreneurship. BIF was established by Saul Kaplan, in part as a reaction to ‘over specialisation’ in design and the frequent use of design to improve the economic performance of current business models, without reflection on social impact. BIF work is based on the belief that systemic change, rather than ‘tweaks’ to systems is needed. BIF runs ‘Experience Labs’ with clients and end users to gather insights from how end users experience systems; it uses these insights to design and prototype new models. The Labs are run in four areas, ‘Entrepreneur’, ‘Patient’, ‘Student’ and ‘Citizen’. The Labs use a toolkit called the ‘BIF genome’ and each Lab is run on a collaborative platform, which engages a wider community of experts. In a recent project BIF partnered with the Children's Medical Centre, in Dallas, Texas through the Patient Experience Lab, to design and test new ways to care for children and families. For the project, the Children’s Wellness Experience Lab19 was created which involved early stage consultation with families using methods such as in depth interviews and self-documenting of health experiences. Early insights showed the complexity of navigating the healthcare system for families, and how families felt that a sense of disempowerment in many cases made it more challenging for them to care for themselves. A key shift for the Centre has been from a focus on reactive care, in the Emergency Room, to preventative solutions with the community. BIF also has links to Rhode Island School of Design (RISD), one of the most renowned design schools in the USA, through Mickey Ackerman, Chief Design Strategist at BIF and former Head of the Industrial Design Department at RISD. http://www.businessinnovationfactory.com/home EPIC Decade, Nexus North Nexus North, a large-scale community transformation project in Fort McMurray in Alberta in Canada, is another initiative with links to the Industrial Design Department in Rhode Island through its Chief Design Officer, Charlie Cannon who is an Associate Professor of Industrial Design at the school.

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http://childrens.businessinnovationfactory.com/

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The Nexus North project is run by EPIC Decade the charitable arm of the design consultancy, IP.21 Studio. The project aims to develop an ‘ecosystem approach to sustainability’ in Fort McMurray where the population is expected to grow from 10,000 to 90,000 by 2030 because of the expanding oil industry. It was launched in 2012 as a cultural change initiative to help develop sustainable models as the community expands. In the first year the project engaged 68 organisations on issues such as governance, well-being, economic opportunity and natural systems. It is showing an emerging understanding of the relationship between design and large-scale challenges and areas for work have been identified through design methods workshops. http://nexus-north.com/# Conclusion: key insights on use of design in USA The USA has the world’s largest design sector20 and US-based consultancies such as IDEO have pioneered the application of design methods to a wider set of problems in business and society. Companies in the USA, such Nordstrom, Inc. and Hyatt Corporation have led the way in adopting design methods, particularly those which help to reveal customer insights, to shape new services and strategies for their businesses. The USA is also home to the world’s leading design schools and has integrated design teaching into many business and management courses. However, use of design methods in the public sector in the USA was estimated to be 5-10 years behind the UK and other EU countries. There is no strategic directive from national government to use design. Whilst national design membership bodies are well established, they are specific to design-subsectors and there is no publicly funded body focussing on wider applications of the design process. Interest in design methods from civil servants in Federal Government was high but they felt that an external body providing training, delivery and advice was lacking. Despite this, the role of design as a tool for public sector innovation in the USA is changing and there is a whole raft of research centres, labs and not-for-profits leading some of the world’s most advanced thinking on how design methods can be used to tackle super-complex challenges. These approaches are highly relevant to service and policy challenges in the public sector. The examples covered in the Fellowship indicate a number of different levels at which design is being adopted and applied to the public sector. At its most tangible, communications design was being used by CUP and the AIGA as a tool to engage citizens in policies and government processes by making these more legible and through simple interactive games. In these examples, focussing on the public interface with government, such as print materials for voting, was seen as the most effective route to increase awareness of design methods in government. There were also examples of capacity building in design methods with civil servants. This work aimed to up-skill civil servants to create enough awareness for simple methods to be used internally and to make informed decisions about when to commission design experts. To be effective, it was thought that on-going support, for example from internal innovation teams, and plans for the day-to-day application of methods in addition to training were needed.

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International Design Scoreboard, University of Cambridge (http://www.ifm.eng.cam.ac.uk/uploads/Research/CIG/090406int_design_scoreboard.pdf)

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Design was also seen to offer a supremely effective set of tools to redesign government services, particularly by surfacing insights about how real people interact with services and using these to shape new services. The Public Policy Lab in New York is, to their knowledge, the only not-for-profit in the USA focussing on the redesign of front-line services in public bodies. They viewed design as a tool for improving the public interface with government but also for influencing wider policy and culture change by up skilling staff in design methods and revealing insights from real service users to inform their decisions. The final set of examples, show a marked shift in design; at Parsons New School of Design and ChangeLabs new frameworks based on design are being developed to look across whole systems and bring together different disciplines. Recommendations from the Fellowship about the use of design in government are presented in Section 5.

d.school, Stanford University

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SECTION 4: Case Study: Japan, ageing population This section of the report covers the first leg of the fellowship which was to Japan in August 2013, and looks at design in the context social challenges associated with a rapidly ageing population. The visit involved meetings with people from government (Japanese, British and the EU), research, businesses, design and the voluntary sector. Summary of findings The business and technology response to an ageing population in Japan is extremely sophisticated and design has mostly been used at the level of product innovation, leading examples include TOTO LTD, the bathroom manufacturer. Social innovation and voluntary sector responses to ageing in Japan are only just emerging; although there were some excellent examples, particularly the Tokyo Metropolitan Institute of Gerontology and work at the City of Yokohama planning department. Research did cover a collaboration between Fujitsu, The Centre for Global Communications (GLOCOM) at the International University of Japan, and the Dementia Friendship Club (a social enterprise), where design methods are being used facilitates a consortium of businesses and creates new responses to dementia. The emphasis of this work is on active ageing within communities.

‘Ageing’ products on display in Muji, Tokyo

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Overview, ageing population in Japan The population in Japan is both shrinking and ageing. According to projections, by 2055, 40% of people will be aged 65+ and those under 15 will account for 8%. By comparison, people aged 65+ in the UK are expected to comprise 24% of the population by 205521. The Japanese Ministry of Health, Labour and Welfare estimate that the number of people living with dementia in Japan is over 4.6 million. A critical issue for many Japanese cities (for example Yokohama) is the ageing infrastructure and population of the ‘bed towns’ – commuter towns developed in the rapid urbanisation of the 1960s – this has created ‘pockets’ of ageing where people are tragically ‘living and dying alone’. Population ageing is likely to affect satellite towns and rural areas disproportionality. Most people interviewed as part of the research felt that Japan’s response to an ageing population has been technology-led and more ‘soft’ approaches are needed. Research covered two striking examples of community and institutional collaboration, at Tokyo Metropolitan Institute of Gerontology and the City of Yokohama administration, but people working there viewed these projects as unique. Social innovation is in its infancy but the voluntary sector and the number of social enterprises are apparently growing very quickly. A shrinking population and 20 years of economic hardship in Japan have left a significant dent on public sector resources. A common theme was the decline in state resource and family responsibility in a society which has traditionally relied on state provision and extended families for social care. One interviewee spoke of the cultural norm for older people to remain silent about their own lives making it difficult for their living conditions to be acknowledged socially and addressed. Several interviewees also mentioned the ‘Galapagos’ effect – referring to Japan’s relative introspection in technology which has meant that some important global trends have been missed. People did speak about significant shifts in attitudes to ageing in Japan in recent years including the renaming of dementia from ‘chiou’ (bad knowledge or stupid) to ‘ninchi-sho’ (cognitive disorder) in 2004. Another statutory change is the introduction of handrails to prevent falls in domestic staircases in 2000. There have been wider cultural shifts too; dementia is no longer automatically dealt with as medical issue through institutional channels. There are also striking examples of Japan’s technological prowess directed towards understanding and supporting physical and social needs. The best examples encountered in the research are clustered into groups in the following section; care in the round; public and private partnerships; life-enhancing technology, and new business models. Care in the round Tokyo Metropolitan Institute of Gerontology takes an approach that might be called ‘holistic care’ or ‘care in the round’ in the UK. It is a research institute attached to an extremely well-resourced hospital with 200 researchers split between medical and social science research. The medical facilities sit alongside services such as will writing, a gym and major community engagement projects called Silver and Reprints which provide flexible work and volunteering. The Institute is keen to create better

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The Impact of Demographic Change in Japan, British Embassy Tokyo, 2013

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conditions for its patients and community by demonstrating and building evidence rather than campaigning – the ambition of building ‘ikigia’, meaning purpose or fulfilment, guides their social participation work. http://www.tmig.or.jp/

Public and private sector partnerships In response to the ‘bed town’ phenomenon, the City of Yokohama has created a partnership with Tokyu Corporation, which owns much of the rail infrastructure and land in Yokohama. The ‘smart city’ concept is widespread in Japan and Yokohama is trying to become a ‘wise city’ where communities are better understood and empowered to do more for themselves. Early projects include disseminating 1000 iPads with residents to understand more about behaviour such as energy consumption, gaming to develop new services and extensive engagement of people in the planning of community facilities. This ‘New Public Sector’ concept is unusual in Japan but the authority thinks there is significant potential to support the older members of community by co-designing public services. http://jscp.nepc.or.jp/en/yokohama/

‘ Tokyo Metropolitan Institute of Gerontology

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Consumer friendly products TOTO, Japan’s leading manufacturer of intelligent toilets has developed a mobile model of its signature washlett toilet with flexible soil pipe – meaning it can be moved closer to a bed or used to adapt spaces in homes, to create a downstairs toilet for example. TOTO has also created sleek more accessible bathrooms such as the 01 range. http://www.toto.co.jp/en/ The Japanese government is supporting R&D for service robots to help with housework and tasks such as lifting (people and things) and to grow an export sector22. A number of people interviewed mentioned a slightly stranger device called Paro, which is a robotic seal designed to provide a soothing presence in care contexts. Paro was developed by AIST, a Japanese industrial automation company. http://www.parorobots.com/

22 The Impact of Demographic Change in Japan, British Embassy Tokyo, 2013

‘ TOTO washlett control panel, Tokyo

Paro Therapeutic Robot

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New business models In 2011, Fujitsu which is one of Japan’s leading providers of IT services, entered into partnership with the Centre for Global Communications (GLOCOM) at the International University of Japan, and the Dementia Friendship Club a social enterprise. The partners are leading an initiative called the Dementia Project which is a consortium of businesses that are developing new services and business models to create dementia friendly communities23. Their objective was to examine how the private sector can play a greater role in responding to some of the social challenges associated with dementia, particularly how dementia patients can be supported to live independently in the community. The first tranche of activities comprised three workshops with businesses, called Futures Sessions, to generate ideas about how businesses in the consortium could respond to dementia. The partnership developed a framework for the Futures Sessions based on design methodologies including customer journey mapping and participant observation. The British Council joined the partnership in 2012 and launched the ‘Futures’ initiative which aimed to develop a platform enabling social entrepreneurs, government agencies, and businesses to explore the possibility of social innovations while interacting and collaborating across sectors. Work is now moving into a third phase with a wider consortium of businesses which will be developing ideas around eight areas including, public transport, local government and product innovation. This work sits alongside on going awareness-raising work by the consortium including a dementia marathon across Japan. Emerging ideas from the first phase of work include a smart watch and cash machine with retina recognition. Conclusion: key insights on use of design in Japan Design-led responses to ageing in Japan are mostly at the level of product innovation and business such as TOTO and AIST are developing highly sophisticated aspirational products for the older market. The concept of design as a set of methods for tackling complex problems seemed to be less familiar. As part of the Fellowship a workshop was organised by the British Council in Tokyo with the Dementia Friendship Club and 60 participants from business, universities, designers and the voluntary sector. This comprised a presentation of design-led innovation in ageing in the UK and a facilitated session which aimed to generate ideas for how dementia could be supported by cross-sector collaborations. The majority of participants said they were unfamiliar with the concept of design beyond product or aesthetic innovation. Although interest was significant, participant comments following the workshop included:

“Surprised by the wide and deep definition of ‘design’ Design is a process for bringing about social change and solving social issues.”

23 Draft for FUJITSU SCIENTIFIC & TECHNICAL JOURNAL (FSTJ) published in the October, 2013, “Special Issue: Innovation Design”

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“Up until now I hadn’t thought of design and dementia together.” “Design is about designing an interface between people and technology, or people and people.”

The key insights from Japan about the role of design in addressing social challenges associated with an ageing population were about aspirational product design for the older market and the use of design methodologies to catalyse different stakeholders around a common challenge in workshops. Other leading examples of care in Japan were less linked to design but demonstrated the significant potential of institutional and community collaboration.

Workshop with British Council, Tokyo

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SECTION 5 Insights & Recommendations The final section of the Fellowship Report summarises insights from the research in the USA and Japan on how design is a valuable tool for service and policy development and makes recommendations for supporting and positioning this work. Recommendations for how design adds value to policy development:

1. Human Insights: design methods such as ‘personas’ and ‘customer journey mapping’ with real service users can reveal ‘pain points’ and rich ideas for service improvement. Although end users are often far removed from policy development the requirements and impact for policy decisions can often be better understood with human insights in mind. For example, The Public Policy Lab’s Understanding the School Choice Experience, project revealed more than 30 opportunities for service improvement around user needs.

2. Accelerated ideas generation: the Understanding the School Choice Experience example also shows how a focus on end users, though techniques such as in depth interviews with a range of stakeholders, can generate far more ideas for a service or policy improvement.

3. Visualisation: clear visualisations can be used to make government process more engaging and legible to both citizens and civil servants. Both CUP and the AIGA were using communications design to translate government policies for citizens.

4. Problem framing: problems or challenges can be reframed by using design principles; this is particularly important where consultation with external stakeholders is necessary. The first stage of the LUMA Institute’s Taxonomy of Innovation for example is called ‘Looking’ and comprises methods to gather and interpret ethnographic research.

5. Taking a systemic view whilst retaining detail: methods such as service blueprinting help to map out an entire system or process whilst retaining detail of specific stages and the interactions between stages. Conceptualising entire systems is central to the work of the Business Innovation Factory and ChangeLabs.

6. Breaking down disciplinary silos and collaborative working: design methods can help to create a common approach for diverse stakeholders which often results in new insights that could not have been found through more traditional modes of working. The role of the designer as a facilitator is central to the work at ChangeLabs and the MFA in Transdiciplinary Design; it was seen as vital for the types of ‘super-complex’ problems faced by policy makers which require insights from multiple disciplines.

7. Reducing risk: building evidence for policy decisions is crucial. However, ways to test whether ideas will work in practice are often lacking. Prototyping 24 is a very common design approach and was identified by ChangeLans as a way to reduce risk by testing ideas safely, early, frequently and at low cost and by learning from these trials.

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A term used in design to test an idea or concept very early and at small scale and cost. Prototypes can be simple cardboard models or small trials of a new service or system involving role play.

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Recommendations for how to position and support design work in government:

- Space: distinct places, such as The Lab @ OPM, for staff from different teams and disciplines to convene outside of the normal working environment were thought to be important, particularly at the early stages of using design methods.

- On-going support: whilst district spaces are important at the early or ‘catalytic’ stage, in the experience of the LUMA Institute, on-going plans for support are needed to embed training work, ideally through an internal team and roll out plan.

- Evidence: as interest in design moves up to strategic levels in government,

more focus is needed on how design methods work alongside the types of evidence and factors considered by policy makers, such as large data sets and public opinion. This was thought to be particularly important by the cross-government civil servants convened during the Fellowship at The Lab in Washington DC.

- Clarity on training outcomes: training courses were not attempting to turn civil

servants into designers. They were seen as valuable for building enough capacity to use simple techniques, and crucially to raise awareness of how and when to commission in expertise. The role for the designer in government, as defined by ChangeLabs and the MFA in Transdiciplinary Design, is increasingly that of an expert facilitator.

- Language: terms used by designers such as ‘design-led innovation’ or ‘design

solutions’ can seem vague to people in government, particularly policy makers. The importance of framing design work in the context of shared values and reflecting government language was for example, important in the service design projects at the Institute of Human Centred Design and The Public Policy Lab.

- Visible projects: communications design, and even service design, were seen as routes to increasing the profile of design work in government and ultimately influencing wider culture and policy change. This approach was taken by CUP, AIGA and The Public Policy Lab.

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Conclusion Some of the newest and most exciting challenges for designers today, and for non-designers using design methods are not stylistic; they are about the navigation of complex systems and problems and the creation of simpler, more human-centred experiences and structures. Interest has grown significantly from governments around the world in design as a methodology for connecting new ideas with real people’s needs, reducing risk and shaping complex systems. Despite this, knowledge and evidence of how design adds value to different processes in government is still emerging, particularly in newer areas such as policy development. This Winston Churchill Memorial Trust Fellowship looked at how design is being used in two different international contexts to tackle complex, systemic problems in government and society. The objective was to improve understanding of how design is providing new approaches in government. Examples from the research showed the potential of design to bring insights from real people into the development of the services and systems and how visual techniques can be used to encourage engagement in government processes and make them more legible. It also demonstrated the potential of design to break down disciplinary silos and conceptualise entire systems whilst retaining a detailed view of specific interactions or ‘touch points’. The examples also showed the potential for design approaches to reduce risk through frequent early testing and prototyping. For design work in government to take hold, more evidence of impact is needed, along with the right kinds of spaces, plans for on-going support and clear articulation of how and where design adds value to different types of projects in government. To conclude, in the Museum of Modern Art’s, Architecture and Design Department in New York, there is an excellent description by Paola Antonelli of how the discipline of design is evolving and being deployed in wider contexts, including government policy:

“One of design’s fundamental tasks is to help people cope with change – and to create change. Designers stand between revolutions and everyday life, they make innovations manageable so they can be embraced and assimilated. For this reason designers will increasingly be at the nexus of culture, politics and society. Like physicists designers will be theoretical and applied. Theoretical designers will be exquisite generalists ready to roll their sleeves up. Applied designers will continue to make objects never forgetting functionality and elegance. Objects however, will not always be physical; they will often be shared, not owned; they might be starters that people will complete and customise at home using 3D printers and other on-demand services; or they will be tools that allow scientists, policy makers and citizens to visualise and manage complex systems.”

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http://www.moma.org/explore/collection/architecture_design

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Questions for further research:

1. Are there common design principles and methods in frontline projects (on the service implementation level) and in strategic projects (on the policy-level)?

2. How do design methods sit alongside factors that influence and inform policy making such as public opinion, political decision making and statistical evidence?

3. How do design methods work in conjunction with other approaches being introduced into policy development such as well-being analysis and behavioural insights?

4. Should civil servants be educated in design and how should this education happen, for example in public policy degrees or in house training?

5. What training is needed for designers, who are accustomed to frontline projects, to work at more structural levels in government, for example familiarity with policy development and language used?

6. How do design principles such as failing quick and early work in cultures where failure cannot be tolerated? Can they be used to reduce risk upstream through ‘safe testing’ before ideas are widely implemented?

Martin, Ruiz de Azua, Basic House Museum of Modern Art, New York

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Appendix 1, Outline of Itinerary Itinerary Japan, August 2013

Name Title Description

Beth Hogben Head of Science and Innovation Network, British Embassy, Tokyo

International network on science and innovation run by the Department for Business, Innovation and Skills and the Foreign Office.

Akiko Yanagisawa Senior Trade Advisor, UK Trade and Investment

Responsible for trade relations including the promotion of UK design in Japan.

Dr Hideki Ito, Director, Institute of Gerontology, Tokyo

Practicing gerontology hospital with medical and social science research facilities.

Dr Ryutaro Takahashi, M.D., Ph.D.

Vice Director of the institute and head of Social and Human Sciences, Institute of Gerontology, Tokyo

Dr Yoshinori Fujiwara, M.D., Ph.D.

Team leader for Promoting Participation and Contribution to Society, Institute of Gerontology, Tokyo

Mr Okada

Fujitsu Laboratories

Multi-disciplinary research centre, part of Fujitsu’s R&D capacity.

Mr Shoji

International University of Japan GLOCOM

Research unit at one of Tokyo’s leading universities.

Mr Tokuda Smart Ageing and Dementia Friendship Club

Social enterprise working on community support for dementia.

Professor Satoshi Kose Shizuoka University Well-known university in the fields of engineering, in creative innovation, and in the invention of next generation technology

Manami Yausa Head of Arts, British Council Tokyo

Nanami Akimoto British Council Tokyo

Hozumi Takeo, TOTO LTD, Universal Design Research Center

Japan’s leading domestic bathroom manufacturer

Dr. Barbara Rhode Head of the Science and Technology Section Delegation of the European Union to Japan

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Yoshiko Hayashi Planning Division, Housing and Architecture Bureau, City of Yokohama

Running Yokohama ‘wise city’ project.

Kouhei Oono, Planning Division, Housing and Architecture Bureau, City of Yokohama

Yasuyuki Akimoto, Director of Planning Department, Housing and Architecture Bureau City of Yokohama

Itinerary USA, November 2013 Boston. Massachusetts

Name Title Description

Valerie Fletcher Executive Director, Institute of Human Centred Design

Longstanding organisation based working on inclusive design. (Boston)

Harry West Principal, Profit Design Commercial agency (NYC)

Tracy Swyst Coordinator, Design Industry Group of Massachusetts

Local design network

Michael Westcott Director, Design Management Institute

International membership body of design businesses.

Anne Marie Stein Dean, Professional and Continuing Education, Massachusetts College of Art and Design

Arts university

Stephan J. Clambaneva VP North East District, Industrial Designers Society of America

USA membership body for industrial designers.

Kerry Bodine Vice President and Principal Analyst, Forrester Research

Author of Outside In, knows our work well. (San Francisco)

Darragh Murphy Partner, Driving Design Strategies

Formerly at Design for Wales, now running a design consultancy in Brazil.

Paul Sternberg Ravensbourne College Leads the MDes in Design Management and Innovation

Pittsburgh (Skype call)

Name Title Description

Justin Knecht Senior Program Director, LUMA Institute

Teaches Human Centred Design toolkit, primarily to businesses - some work in the public sector.

Providence, Rhode Island

Name Title Description

Saul Kaplan Founder, Business Innovation Factory

Tests and designs new systems – particularly in

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healthcare.

Mickey Ackerman Chief Design Strategist, Business Innovation Factory

Former director of Industrial Design programme at RISD.

Charlie Cannon Professor, Industrial Design Department, Rhode Island School of Design

Currently working on a large-scale community development programme in Canada

Hannah Chung Co-Founder, Sproutel Founded company that makes teddy bears to help children cope with diabetes.

Allan Tear Co-Founder, Betaspring Tech start up incubator, hosted event for us.

New York

Name Title Description

Chelsea Mauldin Executive Director, Public Policy Lab

Not-for-profit delivering service design work in government.

Bryan Boyer Formerly Helsinki Design Lab, currently setting up a co-working space.

Richard Whitehall Partner, Smart Design Commercial Agency.

Ric Grefe Executive Director, AIGA Has worked on communications design in US government.

Lara Penin Assistant Professor, Transdisciplinary Design, Parsons The New School

Part of DESIS and researching design for government.

Jamer Hunt Associate Professor of Transdisciplinary Design, School of Design Strategies, Parsons The New School

Established the MFA in Transdiciplinary Design at Parsons The New School,

Washington DC

Abby Wilson (and 20 cross-government civil servants)

Director, The Lab @OPM (Office of Personnel Management)

Design-led innovation unit in federal government.

Paolo Alto, California

Name Title Description

Banny Banerjee Director, ChangeLabs, d.School, Stanford University

Working on large-scale complex problems using design as a means for transdisciplinary collaboration.

Pasadena, Los Angeles

Name Title Description

Mariana Amatullo Vice President, Design Matters Department, Arts Centre Pasadena

Part of DESIS and well connected to EU public sector design community.

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Appendix 2, Outcomes of the Fellowship Key Impacts The Fellowship enabled me to meet well over 100 people, attend an international conference and present at three specially organised events. The insights have already begun to inform my work in the UK significantly, and have resulted in many lasting contacts. Key impacts include: Events during the Fellowship:

- British Council, Tokyo: gave a keynote presentation at a specially organised workshop event on design-led innovation in ageing, with 60 participants including staff from Fujitsu, TOTO, Honda. See the event write-up: http://www.britishcouncil.jp/en/events/ageing-better-by-design

- Design Management Institute, Experience Innovation Conference: attending an international conference on the user experience in business.

- DesignxRI, Providence Rhode Island: gave a keynote presentation at the BetaSpring Incubator at a specially organised event and panel discussion on the use of design methodologies in business and the public sector with an audience of designers, local government, local design businesses and start-ups. See the event slides: http://www.slideshare.net/DESIGNxRI/camilla-buchanan-uk-design-council-dxri-providence

- The Lab @ the Office of Personnel Management, Washington DC: presented at a specially organised roundtable discussion to present insights on use of design in the UK government with 20 civil servants across US government.

Events after the Fellowship:

- Presentation to new intake of Fellows (March 2014) - Presentation to Design Council staff (March 2014)

Wider impacts:

- The fellowship has significantly improved my understanding of the potential for design approaches to tackle complex problems, particularly in the public sector. Insights have already informed opinion pieces, consultation responses and blogs, for example: http://www.designcouncil.org.uk/news-opinion/cabinet-s-new-policy-lab-should-boost-design-policy-making

- Findings have been circulated widely to contacts in local government, universities, (University of the Arts London, Lancaster, and Royal College of Art) central government (Cabinet Office, Department for Business Innovation and Skills).

- The Fellowship also created lasting contacts and there are early conversations in both the USA and Japan about future opportunities.

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Creative Confidence workshop, IDEO at the ‘Experience Innovation’ conference, Design Management Institute Boston http://www.dmi.org/dmi/html/conference/annual13/conference.htm