I rapporten presenteras resultaten från projektet Säker och användarcentrerad vård och omsorg i hemmiljö med deltagare från KTH, Region Stockholm, Stockholms stad, Capio Primärvård AB och Cuviva AB. Syftet med projektet har varit att bidra till ökad samordning i vård- och omsorgssystemet kring sköra äldre som erhåller vård och omsorg i sin hemmiljö. Studien visar på ett antal hinder som gör det utmanande att implementera nya arbetsmetoder och lösningar. Bland annat identifierades målkonflikter mellan såväl organisationer som mellan professioner och deras respektive drivkrafter, ansvar och befogenhet. Studien visar även på ett behov av översyn kring styrmetoder såsom ersättningsmodeller, uppföljning, granskning och hur lagar tolkas. Baserat på insikterna från projektet identifierades ett antal områden för utveckling som är tänkta att ske i framtida samverkan mellan de olika deltagande organisationerna. 

Purpose: The increasing size of the elderly population is emerging as a primary catalyst for the escalation of healthcare expenditure, and a sense of urgency is manifest. However, the complexity of the health- and elderly care systems provides challenges in improving system efficiency. Hence, the system-level understanding of the main obstacles to integration care needs further exploration. In order to better integrate health- and elderly care, the study needs to identify the actual misalignments underpinning the issue. This study provides the theoretical foundations for resource misalignments and provides empirical examples of these. Design/methodology/approach: Semi-structured interviews with multiple stakeholders on various hierarchical levels were carried out to create a more complete view of the system and resources deployed in health- and elderly care. The application of user-centered design methods and co-creation with employees have also been crucial to the outcomes of the study. Findings: Results show that health- and elderly care is a large-scale complex system. The overlapping and mutually reinforcing misalignments are: (1) regulation and policy differences, (2) stakeholder quantity and variation, (3) external control of health- and elderly care, (3) decreasing collaboration and (4) communication channels and IT development. Originality/value: This qualitative study builds on institutional theory and resource integration theory and contributes with empirical descriptions of misalignments in the health- and elderly care system. These descriptions will serve as points of departure for systems design to improve the efficiency and effectiveness of health- and elderly care.

The purpose of this paper is to increase our understanding of how designers perceive the past and future development in the discipline. Moreover, the paper explores the designer's role in working with system transformation and transition. The research study builds on interviews among designers working both as consultants and in-house designers and on observations in a research project at the truck manufacturer Scania. Not many years ago, designers strived to have a strategic impact in client organizations, which demanded an increased understanding among other disciplines about how the design process can contribute beyond the aesthetically appealing product. Thus, to contribute on a strategic level, designers needed to work in a multidisciplinary manner, involving other disciplines in the client firm. Moreover, as design thinking received increased attention among clients, it added to the understanding of design processes and methods, enabling clients to understand and integrate different perspectives, the end-user among others, in their work. As client firms began to adopt design thinking, designers were not only asked to facilitate interdisciplinary workshops but also coach and teach the design process and methods to employees at the client firm. Businesses, as well as public organizations, face new challenges, and the offerings have become more complex. Designers are involved in activities aiming for change in complex socio-technical systems as organizations are undergoing a servitization with changes in business models and involving more actors in the value-creating network. In the paper, we exemplify how design methods and processes may contribute to system transformation and transition. However, we also describe a shift in the designer’s role from working in an interdisciplinary manner with the aim to understand other stakeholders to become a stakeholder in transdisciplinary work applying methods from the system thinking field.

The driver plays an essential role in detecting and handling vehicle faults, and he/she is an important actor in the diagnosis service system. When developing self-driving vehicles, exploring the driver’s role could create knowledge regarding which reconsiderations are needed when designing a driverless diagnosis service system. A service design research study has been performed regarding the driver’s role in fault detection and troubleshooting. Based on semi-structured interviews and a workshop, a system map, information flowchart, and decision-making process have been developed. Furthermore, a scenario is used to exemplify how a control tower can support a diagnosis service system for self-driving vehicles. Examples are given of how a control tower operator can replace actions and decisions that today are handled onboard by the driver. 

While the design industry is moving into new domains, it seems that potential customers do not always understand how the designer can contribute beyond the aesthetically appealing product. The overall purpose of this thesis is to expand our understanding of design as an enabling service in the context of small and medium sized enterprises. An enabling design service has the potential to result in organizational learning and change. The co-creation of new knowledge and competencies can in turn enable the customer organization to become more innovative and able to deal with an ambiguous environment. The first part of the research consisted of interviews and workshops with the major industrial design consultancies in Sweden and Finland and some smaller American consultancies. A conceptual business model canvas based on service dominant logic is presented in the thesis to increase our understanding of the business of the industrial design consultancy. During the study, we observed several changes in the organization of the industrial design consultancy. We also noticed self-confidence among the industrial design consultancies in respect to their skills in methods to orchestrate collaboration and contribute to strategic development in customer organizations. An analysis of the initial interviews and workshops together with a literature study helped me to summarize the characteristics of the methods and processes designers are educated in as being integrative, collaborative and explorative. They are integrative in that they incorporate hands with thought, and theory with practice. They are collaborative in that interaction between individuals is a necessity to solve the wicked, ambiguous and open-ended problems the designer usually faces. This has resulted in designers being educated in methods involving a broad range of stakeholders such as users in development processes. Finally, the methods and processes are explorative in that they aim at ingenuity and focus on how things ought to be rather than on the present state. The second part of the research consisted of interviews and observations and had a focus on shared activities between design students and participants from small and medium sized companies. Design methods and processes were put into the context of organizational learning and change theories that centered on knowing as embodied and encultured. An activity theoretical model was applied to enrich the analysis of the diversity of perspectives that may lead to conflicting interpretation and negotiation in shared activities. The concepts of place and space were used to highlight the dynamics between how structures and human desires and needs motivated participants in the shared activities. Place is characterized by stability and is the strategy of the prevailing and often connected to identity. Space is practiced place and connected to change and human agency. The thesis presents how design services enabled individuals and organizations to be introduced to and to strengthen a given place, such as a discipline or organization. It also provides examples of the opposite, with individuals distancing themselves from a place, such as a discipline. Mediating artifacts and the integration of doing and reflection created experiences that evoked emotional involvement and enactment among the participants. Most activities resulted in creating space for change and learning and the outcome can be characterized as business and organiza­tional development.

Många industridesignkonsultföretag har som ambition att anta en strategisk roll i sina kundföretag. Design ses i detta sammanhang som ett viktigt konkurrensmedel med en kreativ process som stödjer en innovationsdriven verksamhet. Samtidigt saknas ofta kunskap, framförallt i små och medelstora företag - SMF, om hur designmetoder och processer kan bidra utöver skapandet av estetiskt tilltalande produkter. Denna avhandling inriktar sig på en förståelse av design som en social aktivitet och ett specifikt sätt att skapa kunskap.

Det övergripande syftet med avhandlingen är att öka förståelsen för hur designtjänster kan bidra till att möjliggöra och underlätta organisatoriskt lärande och förändringsprocesser för att på så sätt stärka innovationsförmågan i SMF. Studier visar att de företag som har en historia av att arbeta strategiskt med design är mer innovativa, exporterar mer och tvingas inte konkurrera lika mycket med pris. Baserat på detta bör SMF kunna dra fördel av att samarbeta med designers vilket även gagnar samhället i stort då företagandet inom Europeiska Unionen idag till 99 procent består av SMF.

Forskningsprocessen har bestått av litteraturstudier inom design, organisatoriskt lärande och förändringsarbete och empiriska undersökningar i form av observationer, intervjuer och deltagande i workshops. Initialt låg fokus på designkonsulten, dess förståelse för den egna affärssituationen och bidrag i kundföretagen. Studien visade att industridesignkonsultföretag genomgår en förändring vad gäller organisation, ledning och de kompetenser de anställer. Detta är bland annat en konsekvens av ett breddat designerbjudande. Vi observerade en självtillit bland designer avseende deras förmåga att genom sitt explorativa förhållningssätt bidra till strategiskt utveckling, innovation och annat förändringsarbete i kundorganisationen

Genom att studera konkreta aktiviteter mellan SMF och designers flyttades fokus till relationsskapande och dynamiken i samarbetet mellan de båda parterna. Bland annat visade studierna på behovet av att introducera designmetoder och processer tidigt i den gemensamma processen. Detta skapar en förståelse för designprocessen och dess metoder och hur dessa skiljer sig från hur kundorganisationen vanligtvis arbetar med förändringsprocesser. En tidig samverkan var även viktig för att designer skulle kunna förhandla till sig mer utrymme för kreativt utforskande. I de fall beslutsfattare var aktivt involverade i designprocessen upplevdes slutresultatet i ökad utsträckning som positivt. Genom att involvera beslutsfattare kunde uppdragsbeskrivningen bli ett levande dokument och målsättningen förändras under aktivitetens gång allteftersom nya problem och möjligheter dök upp.

Deltagare i en aktivitet bär med sig en unik historia, kultur och identitet som bland annat utgår från den disciplin eller organisationer de tillhör. Detta leder till att olika perspektiv och kommunikationsredskap, som exempelvis begrepp och prototyper, introduceras i den gemensamma aktiviteten. Att synliggöra dessa men även vilka önskningar och behov som motiverar aktiveten, hur man tolkar regler och fördelar arbete och ansvar, är av vikt för hur samarbetet i aktiviteten fortlöper. I avhandlingen beskrivs och rekommenderas såväl forskare som designpraktiker att använda en aktivitetsteoretisk modell för att öka förståelse för och understödja samarbetet mellan designers och deltagare från SMF.

Visualiseringsmetoder underlättade integrationen av handlande och reflektion, samarbete och ett utforskande förhållningssätt. I flera fall ledde designaktiviteten till ett känslomässigt engagemang vilket i sin tur ledde till nya erfarenheter och lärande. Resultaten kan karakteriseras som affärsutveckling och organisatorisk utveckling. Avhandlingen lyfter fram behovet av långsiktiga relationer och att designern deltar i implementering av resultat för att den nya kunskapen skall få fäste i kundorganisationen.

Avsikten med denna avhandling är att den skall bidra till en pågående diskussion inom designforskningen kring hur designaktiviteter kan bidra till att utveckla organisatoriskt lärande och förändringsprocesser. Min förhoppning är även att den skall bidra till designerns praktiska arbete.

Both academic journals and business magazines show an increased interest in the concept of

design thinking (e.g. Boland et al, 2008; Brown, 2008; Leavy, 2010; Martin 2010). The

design thinking concept emphasises the actual activity of solving problems with a design

approach, associating it to the designer’s knowledge and competence instead of the intimate

link between design and the physical objects (Eneberg, 2011). Yet design consultancies still

have problems charging for intangible components in their offerings and for the role of

strategic consultants. We argue that the design thinking concept is in line with a service

dominant logic rather than a goods dominant logic, and that this approach can be the basis for

communicating the value of design to clients. The problem faced by industrial design

consultancies is not unique and hence the findings can contribute.

Design Thinking is a rather new concept for increasing innovation capabilities in organizations. Organizational Development is a concept from the 1950s aiming at modernizing organizations through participatory methods. As organizations struggle with constant change and to become more innovative we will compare and discuss design thinking and organizational development and explore what we can learn from these concepts that have many similar aspects. Design is argued to be moving into new territories, changing its focus towards the ideas that organizes a system or environment (Buchanan, 2001). At the same time there are clear resemblances to new organizational development not the least regarding participatory methods (Eneberg, 2012). In this paper we describe the ontological and epistemological development of organizational theory, change, and development with the aim to discuss the role of design thinking as an enabling concept in the revitalization of organizational development that includes a reintroduction of democratic values in organizational change.

The contribution of design is often regarded as providing a relieving service that delivers aesthetic competence at the end of a product development process. Previous studies have shown that industrial design consultancies aspire to be a strategic resource in their client firms, and that the focus of design is becoming increasingly intangible. The claim is that the competencies of the designer can be used to enhance innovation and the strategic process in client firms. At the same time, studies indicate that industrial design consultancies have a problem getting commissioned and paid for the intangible parts of their service. This indicates a problem in communicating the contribution of enabling design services to client firms. A literature study was conducted regarding the characteristics of design (thinking), its methods and processes. The purpose was to put these characteristics into the context of symbolic-interpretive influenced organizational development by comparing them with the properties that is argued to form the basis for sensemaking theory as described by Weick in 1995. The aim of the paper is to contribute to the understanding of enabling design service.

It is argued that the focus of design is becoming increasingly intangible. At the same time as design consultants are expanding their offerings with new services aimed at enhancing innovation and the strategic process in client firms, studies indicate that industrial design consultancies have a problem getting commissioned and paid for the intangible parts of their service. One possible explanation is that design is regarded as providing a relieving service that delivers aesthetic competence at the end of a product development process. This indicates a problem in communicating the contribution of enabling design services to client firms.

The aim of this paper is to increase the understanding of enabling design services. This is done by comparing the characteristics of design thinking, its methods and processes with sensemaking theory as described by Weick (1995).