So the question remains, based on the conclusions we arrived at in part 3 around the potential difficulties of designers within health care environments, what therefore is the role of a designer within this sphere?
The aims and varied methods of user-centred design have been established, centring on the core themes of human-centred research and acknowledging that although user-centred design appears the most suitable approach to product design in health care, there are problems with the acceptance of such a design process. This leads to the consideration of multidisciplinary design teams, within which the designer fulfils their role but would also have the benefit of experts in medical, sociological and research fields.
It is widely accepted that strong participation from varying disciplines within a design project from beginning to end is crucial to the success of a user-centred project, particularly in health care (West, 2012) (Myerson, 2011) (Anderson, Davey, & West, 2011) (Design Council, 2007). Myserson in his address to the Kings Fund annual conference speaks in detail about the need for collaboration throughout the design process, ensuring that designers are present at the initial stages of the project and maintaining the influence of clinical professionals once a project had reached product development stage. The images taken from Myerson’s presentation show simply how he sees the team functioning. In the initial Co-Research phase, the clinicians take the lead with their professional knowledge, whilst input is maintained with design professionals, business experts and psychologists. Once the project moves to a Co-design phase, the design professionals take the lead in the project, but crucially the other parties do not leave the metaphorical table, with all groups maintaining input throughout (See Fig. 3 and Fig. 4).
Figure 3: Myerson, 2011. Co-research Diagram[presentation slide]
Figure 4: Myerson, 2011. Co-design Diagram[presentation slide]
This is reinforced by other organisations practising user-centred design, Bath Institute of Medical Engineering (BIME) is pioneering user-centred design for those with Dementia – as part of a live webinar Martin Sotheran, their head of Electronics and Computing reinforced the benefits of the use of multidisciplinary teams;
“With such a wide range of expertise, we reach better conclusions quicker” (Sotheran, 2012).This debunks the often held view that involving multiple professions will confuse and dilute decisions, somewhat like the old maxim that ‘a camel is a horse designed by committee’ – suggesting that with a variety of opinions comes poor decisions. Experience from both BIME and The Helen Hamlyn Centre gives clear indication that when done correctly, it can lead to both better and quicker design solutions reached.
Speaking in regard of the role this gives a designer, it is a role that calls for creative ideation and that requires skill both at the sketchbook and at the computer as well as knowledge of material properties and manufacturing processes. A design process that includes other professions in the discussions, concept generation and development need not limit a designer in their creativity. Instead it allows them to demonstrate and practice creative skills such as ideation, hand rendering and innovative concepts within a public arena, educating and impressing the other professions with the strength of their design thinking. Lunenfeld reiterates the worth of a designer conducting ‘design research’:
“Design research can be a way out of the banality of making beautiful/making functional. Design research can save the newest members of the profession from the solipsism of youth – the never ending allure of exclusively designing for yourself and your friends. And design research can even – with an even greater serendipity than usual – convince clients to do something they wouldn’t have had the wit or courage to pay for otherwise.” (Lunenfeld, 2003 p13)Lunenfeld is establishing the idea that researching as a designer enhances the ‘traditional’ role of a designer, allowing for more creative and innovative outputs rather than less. His specific context here also relates strongly to a user-centred design approach within health care. It is very true that those designing products and innovating within health care are not experiencing the need for them first-hand. Only design research can provide the insights and develop the concepts for design projects outside of the designers own understanding of life. Health care is in an arena where there is the need for detailed expertise to be transferred during a design project, it is vital that designers take up the role of researchers, even when it is the clinical professionals who hold the knowledge. Whilst it is true that clinical professionals can validate and challenge concepts based on their knowledge it is not the case that user-centred design seeks for the clinical professionals to develop this concepts out of their knowledge, it appears this is the process by which existing health care products have been designed and as has been established, errors are still occurring and patient’s lives being impacted upon. Instead it is crucial that design professionals are able to conduct intelligent and insightful research that gives rise to concepts that can be validated by the clinical professionals. As Lunenfeld states, it is research such as this that will bring about solutions that the client would never have considered otherwise. It is also important to note that to be such a resource the research collected should in some way be quantifiable, although anecdotal evidence can be a powerful tool, in an arena such as health care, it is necessary for design concepts to be evidence based. Rosalyn Cama, an expert in interior design for health care explains the need for research that stands up to scrutiny as she explains what she terms ‘evidence-based design’;
“The process of basing decisions about the built environment on credible research to achieve the best possible outcomes. This process gathers intelligence from a variety of sources, maps a project’s vision, hypothesizes optimal outcomes, and measures results. It keeps the design team on track for the best solution derived from baseline data and easily opens possibilities for innovative next solutions.” (Cama, 2011)In this case we are concerned with products rather than the built environment; however the principle still applies, that for serious consideration in a high risk industry designs must be based on measured research and measurable outcomes. This is not to discount the power of qualitative evidence, Christopher Ireland lays out a detailed and extremely insightful guide to powerful uses of qualitative research, touching on Focus groups, ethnography and participatory methods, clearly showing the value of such research methods (Ireland, 2003). Although this is a valuable area of research it is not central to the discussion of the role of the designer.
It has been established that the role of the designer in user-centred projects will undoubtedly have research at its heart. The research methods and skills that are employed also require designing. This is especially true when undertaking ethnography. Ireland defines Ethnography as; “a research approach that produces a detailed, in-depth observation of people’s behaviour, beliefs and preferences by observing and interacting with them in a natural environment” (Ireland, 2003). In depth Ethnographic research goes further than simply asking people what they want. In a quote often attributed to Henry Ford we see that this in depth research is necessary; “If I’d asked people what they wanted, they’d have said faster horses.” (Design Council, 2007). Aside from the unreliable attribution, this quote has other risks. At first glance it appears to suggest that you shouldn’t involve ‘normal’ people, often referred to as users, in the design process as they would restrict the innovation, asking simply for a better version of what already exists. However this quote in fact speaks a lot deeper to the need to undertake in depth research that alone can draw out the latent needs to the users. Laurel gives another example and expands on the idea:
“Customers typically can’t tell you what they want, and they can’t design a product, service or experience for you to sell them. If you had asked any number of people in 1957 what they would like to play with, none would have suggested a plastic hoop they could rotate around their hips.” (Laurel, 2003 p8)