3. A narrow focus on the design of services
does not account for the invisible systemic
relationships and interdependencies that need
to be transformed to realize long-term change.
Problem
4. Three Horizons of Service Design
Three Horizons Framework adapted from Hodgson & Curry (2008)
43. Richard’s Diagnosis Story
The room was silent, except for the tick, tick, tick of clock. Despite the
snowstorm outside, the office was overheated and stuffy. The neurologist removed
her jacket and placed it slowly on the desk in front of her, as if she was
stalling. She gave Richard what seemed like a half-hearted smile before for she
began. Richard looked pale and was stairing blankly at the doctor’s files, when
she finally spoke.
“Richard, I am afraid I have some bad news.” Richard didn’t look up. Julie
screeched her chair as she moved closer to Richard and took his sweaty, but cold
hand in an attempt to reassure him.
“After all the assessments, we have a diagnosis”. Julie squeezed Richard’s hand
a bit tighter. “From the blood tests and imaging we did, we can rule out other
causes for your memory loss. We think you have Early Onset Alzheimers.” Richard
continued staring, but with each word, Julie seemed to sit straighter and
straighter in her chair.
“Do you know what this means, Richard?” He didn’t blink. “ I am sure you know
what Alzheimers is. Early Onset Alzheimers is when people get Alzheimers before
the age of 65, or in your case 53.” Julie squirmed in her seat, knowing this
would mean more hard times to come.
“I have a few pamphlets here that explain more about the symptoms and possible
coping strategies.” She said shifting their position on the desk toward Richard.
“I will give you a perscription for the sleeping pills. Hopefully that will help
with your insomnia. We will start with that and then we can meet again in a
month.” The neurologist spoke in a reassuring manner, but was already typing into
the keyboard while she spoke.
ignored
caregiving
role?
passive patient
sterile, clinical
setting
busy
workload?
50. professional status
Dr. Andresson
1. wear regular clothes into work
2. don’t get changed as normal
3. note people’s reactions and any
differences in interactions
plain jane
- I felt less noticed and
respected in some situations
- Discharge nurse looked passed
me and asked colleague for advice
- Felt that I could connect with
some difficult to reach patients
- Scrubs and badge are key ways
we uphold our professional roles
60. “If a factory is torn down but the rationality which
produced it is left standing, then that rationality will
simply produce another factory. If a revolution destroys
a systematic government, but the systematic patterns
of thought that produced that government are left
intact, then those patterns will repeat themselves in the
succeeding government. There’s so much talk about the
system. And so little understanding.”
- Robert M. Pirsig, Zen and the Art of Motercycle
Maintenance, 1974
61. Contact:
Josina Vink
Associate Professor of Service Design
Oslo School of Architecture & Design (AHO)
josina.vink@aho.no
@josinavink
Illustrations:
Erin McPhee
Special thanks to:
Experio Lab Sweden
Tomas Edman
Felicia Nilsson
Birgit Mager
My research collaborators:
Katarina Wetter-Edman
Kaisa Koskela-Huotari
Bård Tronvoll
Bo Edvardsson
Thank you!
