Monthly Archives: February 2013

Sticky: Healing Wicked Problems in Health

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Can rethinking challenges together break through our most compelling health design problems?

February’s DwD held an open session for health and design professionals from across sectors in the community. Paolo Korre, Design Consultant at Mount Sinai Hospital, and Peter Jones hosted about 30 people from a diverse range of roles and sectors attended (starting off with a visual mapping of name tags by place and health intention).  Most of us reported as being external to healthcare (bottom of the grid), but we were lucky enough to get 4 or so closer to the front lines of care and practice.


The engagement was typical DwD :

1) Open circle share and introduction
2) Nominal group technique: Generating one well-framed question (or wicked problem) in health of personal interest
3) Selection for first round Open Space (5 groups)
4) Further selection for larger Cafe sessions (4 groups)
5) Post and share Cafe sketches

+ Hanging around to talk with those who wanted to stay longer

What is the possibility for creating better practices and healthier communities through health and care design? What experience and wisdom might emerge if we had the time and place to share it with a community of committed listeners?

The  following three intentions (at least 1 and 2) were upheld by the end of the evening:

  1. Bringing local participants together with opportunities for connection / collaboration
  2. Presenting authentic issues of concern to our work and communities
  3. Inventing possible avenues for action or engagement to follow

Of 30 or so initial wicked problems (or questions), one each proposed by each person, a first set of 5 were selected and engaged for a round:













  1. How can healthcare tech innovation be reconciled with costs?
  2. Why is healthcare so full of “problems?”
  3. What is health and who cares?
  4. How can we take ownership of our own health records?

A second round of Cafe sessions selected the most compelling themes from the first round of ideas. The final set of problems were taken on by four groups, with these responses sketched, posted (see the picture), and discussed in plenary.

James Caldwell (shown here engaged in the “Participaction” group) reviewed the workshop and discovered deeper insights and connections than we had time to develop at the close to the evening.

“Ideally each group was trying to create better practices that improved communication which would allow for better health. We presented real issues that hamper individuals and communities and tried to devise credible actions for health care engagement.”

The three that I will focus on are:
1. How do we redefine how to be radically inclusive?
2. If physical inactivity is the root of all health evil, why not ban it?
3. How do we create and maintain and own our own comprehensive health records?

“The result of any of these would mean that individuals become the drivers or agents of their own health. Ironically, the impact to the government’s financial system would be positive.”




All three issues have a few things in common:
1. They empower the individual
2. They lesson costs for the government
3. They improve the future health of the individual
4. They make for a more engaged society

“Of course any sane person would be asking why are we undertaking these initiatives today? Common sense would dictate that we would all be happier, healthier and more informed if we did. But I guess that’s why we call them “wicked problems”. Unfortunately too many groups that make too much money from individuals with health problems would lose, and I don’t think they will give up their control anytime soon.”

“I guess this is where designers can speak up and more effectively communicate to everyone why initiatives such as the three mentioned could help better our society. Designers could simplify the problem, the parameters, the solution and the message to a wider audience than the health industry or government could which would be seen as self-serving anyway.”

I agree with James that the 3 (actually all four) final problem areas are interconnected in the solutions. James is considering the outcomes, which show a virtuous cycle of healthy behavior (active lifestyles), inclusive public communication, and monitoring through electronic media. The fourth problem-solution (bottom of the board) was “creating community healing spaces.” I”m not sure this one was as well understood by the other groups, but it seems to me that James’ individual solution space is complemented by a public (or co-citizen-led) system of:

  1. Reframing inclusive healthcare to focus on those that need it most (who are unlikely to take individual initiative)
  2. Creating community centres as temporary (but connected) healing spaces,
  3. Thereby providing many opportunities to get off one’s butt
  4. Supported by personal health tracking in ever-decreasing cost and management, providing incentives to maintain a common health record.




On Building Culture through Participatory Design

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Guest post by Leah Snyder of Mixed Bag Mag

When Gelareh Saadatpajouh, Programs Coordinator at Toronto Design Offsite set out to facilitate Design with Dialogue’s TO DO session she decided to have our group explore, as she puts it:

“Design processes, where plurality of indeterminate factors is approached together and in an ongoing manner, and where designers become adept in handling the growing complexity in both materials of their craft and their position in the world.”

Increasingly designers are being called upon to search their souls in order to create with meaning. In a world exhausted by consumer culture and in desperate need of cultural revision we as designers can play a key role. As Gelareh got us up and activated with an exercise where we mimed our way of working it was clear why design thinking is so adaptable across platforms, disciplines and cultures. For as many people as were in the room there was a different design process. As we later shared our revelations from watching each other I realized that my own design process is also adaptable to where I am in my life’s journey and can shift when I have a renewed way of interacting with my world.


For over a decade my creation happened in isolation. Working with clients to design promotional tools and branding strategy there would be a two-way dialogue with the client after which I would go inside to then create something that would ultimately reach out. After another exercise where we were directed to find a design process action then go out into the group with that action to mingle I realized that my process has radically shifted. Now my first step is to reach out. I start by engaging in multi-directional dialogue, sometimes with other designers, but more often than not those dialogues are with people from many different walks of life. Sometimes those dialogues occur at street corners, even with strangers. I design as I walk, I process as I talk.

More and more I see others who design programs or products, ad campaigns or architecture instinctively, like me, reach out first as the point from which to start. As Design Week in Toronto demonstrated there is a community expanding around the questions “What is design?” and “Can we as designers contribute to modeling a new type of world?”. The idea of the collective is now being understood as the base from which we need to grow ideas. At a time when we require it the most the spirit of collaboration has motivated designers into taking more radical positions. The result –  fertile ground in which we see new materials and new models rapidly sprout.

For the last part of the workshop Gelareh had us break out into small groups “guided by a designer who shared something of their design, resulting in new “artifacts” that were then constructed through brainstorming, creative discussions, and active participation throughout the design process.”













On the street, a few days later, I randomly bumped into someone whose group I was in. I was able to ask her if the exercise we did on her project was helpful to her. Did it result in a new “artifact” for her work? The answer –  an enthusiastic yes! And as we walked up to the street corner together, before going our separate ways, we continued to design as we walked and process as we talked.