Systemic Innovation: a discussion series

Human-centred system innovation: transforming perceptions of what a ‘system’ can be

Jesper Christiansen, Mindlab - 25.03.2013

How do we help or support people that live in situations that do not fit into the system's categories? This question is constantly reoccurring in the development of our public service systems.

Rather paradoxically, it seems that we almost have to advertise it when we are in fact attempting to create human-centred service systems. Why else did we put them in place if not for serving human-centred purposes? Given that systems are put in place to authorize activities and procedures that create value for society, are they creating the outcomes that we want them to create? In this blog, I wish to emphasize the need for abandoning the assumption that systems are meant to 'systematize' authorization by specifying every activity in a direct causal relationship with certain stable outputs. Instead I wish to ask more openly: what is it exactly that we want systems to authorize and how does this influence our perceptions of what systems can or should consist of?   

A very obvious example where this matter is persistent is the area of social care for vulnerable families. This area is increasingly becoming a nightmare scenario for Western nation states across the world. These are often at-risk families, which access many different services and are involved in several case plans at the same time. The challenge is to coordinate and integrate services that are addressing such different issues like child behaviour and education, domestic violence, drug or alcohol abuse, unemployment or work injury, financial crisis, unstable housing, physical or mental illness or other more or less common hardships of everyday life.

Working with Australian design agency ThinkPlace, MindLab took part in a project that set out to address these issues and transform the service system dealing with vulnerable families in the ACT region of Australia. The purpose was to develop new capabilities and processes to co-design and co-produce services with current service users as part of introducing a new human-centred, systemic approach to improve outcomes for vulnerable families. In this project, new ideas and policy proposals for rethinking and reshaping the service system were developed in the continuous interaction between strategic decision makers, frontline staff and the families themselves. More importantly in relation to a broader systemic change, there was a profound recognition of the project as a first iteration in a larger cultural change in the ACT government. This not only meant that, in relation to every insight or idea, the question of its systemic implications was raised as an inherent part of the process. It also implicitly implied that the project productively questioned the current perceptions of what a 'system' was or could be. 

Currently, most interventions focus on one family member or address one aspect of the problem because public agencies are focusing on living up to the standards that is defined within their own formal area of responsibility. Families then have to adapt to the agenda of the system rather than the other way around. Being evaluated on individual criteria rather than focusing on the whole family situation has many negative consequences. These include leaving vulnerable families misunderstood by the system in a fragile state while frequently experiencing having their cases closed before they feel that their problems have been solved. This results not only in a lack of continuity in interaction with public services, but also means that much of the efforts of families are being directed at opening their case again rather than addressing the actual problems in a meaningful and productive way. 

Consequently, instead of being helped or supported in productive processes of change, the system becomes an additional risk factor for the families and a barrier to (rather than driver of) change. This is not only an inefficient and ineffective use of public resources, but also becomes a question of public legitimacy. Especially since prolonged involvement with services without achieving progress results in families' mistrust in the system's ability or even intention to help them. In the UK, people involved in the 'Life-project' have called this the 'gyroscope problem' (see figure). Outside of the family, a lot of agencies, organisations and institutions ensure a tremendous amount of system activity. Yet on the inside, for the family, nothing changes.

The Life Project

The outcomes in the life project, the co-design project in the ACT and similar approaches across the world are overwhelmingly positive. Among the families, there are significant improvements in health, education and well-being as well as lowering rates of crime and unemployment. For public agencies, this is also creates much needed space in budgets as well as creating a more meaningful work environment for the employees working with the families on an everyday basis. But some questions emerge here: on a case level, does becoming more 'human-centred' mean that you automatically become less 'systemic'? And on a systemic level, how do we move from extensive piloting of seemingly valuable human-centred ideas and make these rather isolated interventions more than the sum of their parts? 

These questions raise the additional question of whether we are somehow caught up in an unproductive understanding of a 'system'? The insights coming out of the project to a large extent coincide with some general points from our experience in MindLab. We continuously find that involving citizens and other users in innovating public service systems and taking the complexity and context of their situation seriously poses at least three important design challenges that all seem to challenge or expand existing perceptions of what a 'systemic' approach can consist of:

Unscripted deliveries: how do we become systematic in an 'unscripted' way? 

There is a need for becoming less scripted and work with citizens rather than deliver services to them and instead work unscripted with focus on outcomes. Are unspecified approaches necessarily 'un-systemic' or unsystematic? 

Relational approaches: How do we build relationships and alliances around the problem/situation?

There is a need for taking ownership of the whole problem by building and facilitating effective relationships and networks around citizens to ensure continuity, coordination and 'case-handovers'. Does sharing responsibility in a relational way counteract a consistent and systemic approach in dealing with citizens in complex situations?  

Providing context: how do we create a continuous and iterative connection to the specific context? 

There is a need for an approach that can ensure that the whole contextual complexity of the situation is taken into consideration when decisions are made and case plans are defined. Could service the system to a lesser degree be crisis-driven and more build on the ability to actively relate to the contexts and experiences of citizens? 

A fundamental challenge seems to be how to, on a systemic level, apply and scale services that are highly relational and inherently rely on significant levels of mutual empathy and trust. Again some questions emerge: what kind of policies and regulations do support these human-centred approaches? How do we create 'systematic relationality' that work with citizens in improving their situation? How do we scale services that in their very nature require to be understood in their unique social context? And what kind of accountability and authorization are human-centred innovations introducing? 

All of these questions are pointing to a broader issue recognized by Bruno Latour some years ago when he reminded us that "everything that we thought were modern is now a matter of uncertainty"[1]. One consequence of this is that the systems of organisation that we ourselves have put in place to create safety, assurance and accountability have themselves become sources of uncertainty. So when we explore whether our systems should be capable of being more human-centred, we might have to abandon the assumption that they are meant to 'systematize' authorization by specifying every activity in a direct causal relationship with certain stable outputs. Instead, we might adopt the notion that in order to be human-centred, we need to explore what the relationship between systems and new authorizing environments could look like. Environments that inherently changes not only how systems work, but also transforms (or should transform) perceptions of what systems can be.

About MindLab

MindLab is a cross-ministerial innovation unit which involves citizens and businesses in developing new solutions for the public sector. Further details can be found here.

[1] Bruno Latour (1993): 'We have never been modern'. Harvard University Press.

(The views in this blog are the author's own and not necessarily those of Nesta)