Pre-fuzzy front end alignment of multiple stakeholders in healthcare service innovation – Unpacking complexity through service and systems oriented design in Strategy Sandboxes

Contemporary health systems are deeply complex, organisationally and temporally. Recently, focus has increasingly been given to patient experiences and needs (LaVela & Gallan, 2014) and to developing services that accommodate a diversity of needs within formal institutions and their extensions into society. With patient-centred recovery and well-being as a focus, the challenge arises as to how innovative and sustainable services can be developed in contexts of such systems. While Service Design (SD) has emerged as a domain of design-based inquiry and professional practice, early studies have often centred on commercial partners, service delivery, customer experience and satisfaction views. However, such approaches ought to be coupled with Systemic Design efforts, due to the socio-technological complexity and interlinked nature of healthcare service development and change management (Jones, 2013). This is crucial in the front-end of related design.

In the Nordic countries, the public healthcare sector is seeking to increase partnerships with private actors in order to reach policy goals and offer healthcare services to a wider demographic in a time of resource shortage. Ensuring a fruitful collaboration between public and private sectors becomes central as a matter of design and innovation. Such collaborations also amount to complex social systems, where actors need to understand patient journeys and medical procedures, co-create innovative solutions and distribute ownership, assignments and risks. Establishing collaborative partnerships between healthcare actors and private commercial actors can be challenging due to the deeply institutionalised ways of working and siloed expertise of the medical sector.

This calls for processes and tools that support communication and alignment of diverse actors’ views embedded in such complex social systems to be further developed and better understood systemically. This is especially crucial in the front end of related design, often referred to as the ‘fuzzy front end’. The authors have tackled these challenges facing innovative partnerships through the development and proposal of a Strategy Sandbox workshop pilot.