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A project in partnership with:
Sykehjemsetaten
Oslo Kommune
Line T. Bogen, Rickard Jensen, Liz LeBlanc, Simon Søgnen Tveit...
PROCESS BOOK //08.12.14
PROTOTYPING		 29
THE TURN		 19
WORKSHOPS		 39
DELIVERABLES	51
RICH DESIGN SPACE	 47
REFLECTIONS	55...
3
PROJECT GROUP
Employee representative:
Elisabeth Jørgensen
Special Employee consultant:
Janke Damslova
Quality control:
...
4PROCESS BOOK //08.12.14
BACKGROUND
SAMHANDLINGS REFORM
SYE is in for a long period of change. As a
part of the strategy t...
PROCESS BOOK //08.12.14
INITIAL
RESEARCH
7PROCESS BOOK //08.12.14
THE START
On the following pages we will take you through
our journy of doing research, developin...
BESTILLERKONTORET,
BYDEL ALNA
Today we had two hours to talk with Marit. After
our conversation last week with Bjørg and B...
HJEMMETJENESTEN,
BYDEL GRORUD
Yesterday we met with head of
hjemmehjelptjenesten in bydel (district) Grorud in
Oslo. She h...
PROCESS BOOK //08.12.14 10
11 SEPTEMBER BYDEL GRORUD
BENTE
1. Nothing is standard. Each bydel decides who
gets what care b...
AHUS
At Ahus we met with Bjørn, one of the advisors as
the dept. for samhandling.
Samhandling = cooperations. Here between...
12PROCESS BOOK //08.12.14
12 SEPTEMBER
BJØRN & BENTE
1. Patients get better care at home (even
research says so)
2. Still ...
PROCESS BOOK //08.12.14 13
23 SEPTEMBER
TERESA
1. There has been an increase in patients, a
bigger turnover and more work ...
14PROCESS BOOK //08.12.14
3 OCTOBER
KRYSTYNA
1. Bestillerkontoret visits and evaluates every 2
weeks
2. Normal stay at a s...
15PROCESS BOOK //08.12.14
RICH DESIGN SPACE
THE FIRST MAPS
16PROCESS BOOK //08.12.14
CONNECTING THE DOTS
After our tour around Oslo, doing interviews and
gaining general insights ab...
17PROCESS BOOK //08.12.14
4 INITIAL CONCEPTS
DESIGN DIRECTIONS
1 HELSEHUS DYNAMICS
Structure within the short term homes.
...
PROCESS BOOK //08.12.14
THE
TURN
PROCESS BOOK //08.12.14 21
OUR CALENDARA PLAN FOR THE SEMESTER
R
SATURDAY SUNDAY MONDAY TUESDAY FRIDAY SATURDAY SUNDAY MON...
PROCESS BOOK //08.12.14 22
THE EXCEL SHEETS
This is the columns and numbers that met us when
mapping at SYE. No wonder Ben...
PROCESS BOOK //08.12.14 23
VISUALIZING THE MOVES
September October November December January
2015 2016
February March Apri...
PROCESS BOOK //08.12.14 24
MAPPING AT SYEVISUALIZING THE MOVES
PROCESS BOOK //08.12.14
SHIFTING DIRECTIONS
After Rickard and Line had a tutoring session with
Ted and Kaja at school -
we...
PROCESS BOOK //08.12.14
SOD SYMPOSIUM
RSD3 took place last week and we took this
opportunity to put a pause in our work. W...
PROCESS BOOK //08.12.14 27
CLEANING UP AND CONNECTING MAPS
SOD SYMPOSIUM
PROCESS BOOK //08.12.14 28
THE TURN
AFTER MAPPING
We started this project with a classic designerly
approach. We did broad...
PROCESS BOOK //08.12.14
PROTOTYPING
PROCESS BOOK //08.12.14 31
HELPING
COMMUNICATION
We have been sitting in on many meetings at SYE.
In these meetings Bente ...
PROCESS BOOK //08.12.14 32
BLOG POST
PROTOTYPING
HELPING
COMMUNICATION
The Communication tool“version 1.0”:
In the brief f...
PROCESS BOOK //08.12.14 33
PRODUCT DEVELOPMENT
After reflecting on the SYE meetings where we
visualized their conversation...
PROCESS BOOK //08.12.14 34
4TH
VERSION
(picture below)
To up the game we brought an acrylic board to this
next iteration s...
PROCESS BOOK //08.12.14 35
5TH
VERSION
After the previous iterations we cleared up our
layout and presented this last vers...
PROCESS BOOK //08.12.14 36
LAST TOUCH
PROTOTYPING
Good thing is that it is not too much to tweak
in order too make this to...
37
CREATING OWNERSHIP
The tool has progressed a lot during this project
and more and more information goes directly into
t...
PROCESS BOOK //08.12.14
WORKSHOPS
PROCESS BOOK //08.12.14 41
WORKSHOP AT SOLVANG
They have a regular meeting with Helse Hus
employees. We were allowed to hi...
PROCESS BOOK //08.12.14 42
30 OCTOBER SOLVANG SYKEHJEM
WORKSHOP 1
PROCESS BOOK //08.12.14 43
WORKSHOP 25 NOVEMBER AHO
PROCESS BOOK //08.12.14 44
WORKSHOP AT AHO
In the beginning of the semester, we asked to have
a big workshop. We knew it w...
PROCESS BOOK //08.12.14 45
AHO WORKSHOP
RICH DESIGN
SPACE
PROCESS BOOK //08.12.14 50
INSIGHTS REINVENTING
THE RICH DESIGN SPACE
Here we are coming towards“the end”and we
rolled out...
DELIVERABLES
PROCESS BOOK //08.12.14 54
DELIVERABLES
INSIGHT BOOK
Contains all our gained insights.
It has a map attached to visualize ...
PROCESS BOOK //08.12.14
REFLECTIONS
PROCESS BOOK //08.12.14 58
THE PROCESS
The system oriented approach has led us on a
journey we haven´t experienced before....
4
ON THE
SAME PAGE
Process Book
Sykehjemsetaten
Oslo Kommune
ON THE SAME PAGE process book
ON THE SAME PAGE process book
ON THE SAME PAGE process book
ON THE SAME PAGE process book
ON THE SAME PAGE process book
ON THE SAME PAGE process book
ON THE SAME PAGE process book
ON THE SAME PAGE process book
ON THE SAME PAGE process book
ON THE SAME PAGE process book
ON THE SAME PAGE process book
ON THE SAME PAGE process book
ON THE SAME PAGE process book
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ON THE SAME PAGE process book

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ON THE SAME PAGE was a 2014 master studio project at the Oslo School of Architecture and Design in collaboration with and serving Sykehjemsetaten, the directorate for eldrely homes in Oslo.

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ON THE SAME PAGE process book

  1. 1. A project in partnership with: Sykehjemsetaten Oslo Kommune Line T. Bogen, Rickard Jensen, Liz LeBlanc, Simon Søgnen Tveit Systems Oriented Design Fall 2014 ON THE SAME PAGEProcess Book
  2. 2. PROCESS BOOK //08.12.14 PROTOTYPING 29 THE TURN 19 WORKSHOPS 39 DELIVERABLES 51 RICH DESIGN SPACE 47 REFLECTIONS 55 INITIAL RESEARCH 05 BACKGROUND 03 PROCESS BOOK TABLE OF CONTENTS
  3. 3. 3 PROJECT GROUP Employee representative: Elisabeth Jørgensen Special Employee consultant: Janke Damslova Quality control: Inger Governess Kind Representative for the Physic/Occupational therapy: Ine Cecilie Ulven Representative the Nurses: Birgit Jensen Nursing Assistant and representative for Union members: Kjartan Goksøyr Representative for area 2 (private healthcare): Mona Kjekshus Representative for area 1 (public healthcare): Inger-Lise Kjos Economy Dpt. SYE: Bitte Thon TOP MANAGEMENT GROUP The director at Sykehjemsetaten (SYE): Helge Jagmann 4 Directors from districts Tove Stien (østensjø) Tore Pran (Alna) Kari Andreasen (Ullern) Marius Trahne (sagene) Dpt. Manager SYE quality, expertise and development Heidi Englund Director area 2, Private healthcare Anne Berger Sjølie Bærum municipality Bente Nesset The Central Council for the Elderly in Oslo Wenche Hansgaard The Union, Representing employees at SYE Svein Matisen Project leaders Bjørg Torill Madsen & Bente Solvberg Sæve The Top Management group ensures that the development of the four “Health houses” are coming through. They are also responsible for the development of concepts for the new “Health house” service and the service that will be provided at the long term facilities, “My home”. They are also responsible for developing the right competences. City Council Lead by the Mayor; Fabian Stang (Conservative Party) The mayor is elected among the city council members and the council's legal representative. He signs on behalf of the municipality in all cases where the authority is not granted to other. THE HIERARCHY WITHIN SYE Director at SYE Directors of Area 1 & 2 Manager at Institution Head nurse at institution LOCAL MOVING GROUPS While the project group ensures that the restructuring is carried out properly - the actual moving process is lead by “local teams”. The project leaders at SYE have the master plan and schedule for the moves. Together with representatives from the institutions involved - and the districts - the detailed plan for moving patients and employees are developed and executed. For a working document detailing one of these moves, see map number 6. This move also involves moving different staff members. Gatekeepers: Govermental Structure Surrounding this project. Oslo City Government Lead by Stian Berger Røsland (Conservative Party) Among 8 committee leaders; Aud Kvalbein, (The Christian Democrats KrF) councilor Health and Social Affairs Prepare cases and make recommendations to the City Council. “Long term patients have to move between houses voluntarily.” The project group is multifaceted because of the huge change that follows this restructuring process. This statement came after a riot in the media, caused by next of kins. In Oslo, patients themselves can choose their longterm facility (`Fritt sykehjemsvalg´). Some are more popular than others. One of the most popular facilities are being restructured into a health house. When media wrote about this, Aud made her statement and this caused a huge delay in the restructuring process. Reports to City Gov 6 “Decentralize power, give the local authority more control. Reduce bureaucracy.” The City Council of Oslo: “By April 1st 2014 we should have created four ”health-houses” in Oslo. These should take care of all short term patients. By gathering all short term patients in these facilities we will improve the services - get better expertise on rehabilitation, decrease hospital admittance and provide for elderly to live in their own homes rather then being institutionalized in long term facilities.” THE MISSION PERSONNEL STRUCTURE PROJECT FOCUS & ‘ON THE GROUND’ Bjørg Torill Madsen & Bente Solberg Sæve Brought in by the Director of SYE Broke the mission into 4 projects Short term: Health-house Longterm: My home New Price Model The Move THE MISSION CITY COUNCIL AND GOVERNMENT
  4. 4. 4PROCESS BOOK //08.12.14 BACKGROUND SAMHANDLINGS REFORM SYE is in for a long period of change. As a part of the strategy to meet the needs of tomorrow, reforms from The Ministry of Health and care are already set in motion. Due to Samhandlingsreformen 2012, Stortingsmelding 25 (2005-06 - mestring, muligheter og mening. Fremtidas omsorgsutfordringer), Omsorgsplan 2015, Stortingsmelding 29 (2012-13 Morgendagens omsorg) and Omsorgsplan 2020 -SYE is now restructuring their system of services towards elderly care. DIVIDING THE PATIENTS Sykehjemsetaten in Oslo (SYE) is in a process of restructuring their services towards elderly. Today Oslo has about 50 mixed nursing homes. Mixed meaning they house both long term and short term patients. SYE has a plan to separate these two groups within the nursing home system. The goal being that all patients in need of services will be taken care of in the most efficient and effective way, according to the omsorg 2020 plan. SYE will reach this goal by dividing the nursing homes. From the spring of 2016 there will be four short term houses in Oslo. The short term houses will take care of all patients that needs rehab and support to continue living in their own homes. Oslo will also have approximately 50 long term homes to take care of patients that no longer manage to live in their own homes. THE PLANS FOR CARE Omsorgsplan 2020 and 2015 are strategies developed by Helsedirektoratet that follows the stortingsmelding 25 & 29, to meet the needs of today, and challenges of tomorrow. Short: Omsorg 2015 is about increasing the number of 24hr care places, numbers of FTE’s in the elderly care services, making a plan for Dementia issues, and building better competence. Omsorg 2020 is about tomorrow: new user groups, new caring communities and networks, a national volunteering strategy and policy for nonprofit, cooperative-based and private service providers. Omsorg 2020 is also addressing questions about the surroundings for care services. Development and implementation of welfare technologies and developing future nursing and residential homes. INTRODUCTION TO POLITICAL LANDCSAPE 4
  5. 5. PROCESS BOOK //08.12.14 INITIAL RESEARCH
  6. 6. 7PROCESS BOOK //08.12.14 THE START On the following pages we will take you through our journy of doing research, developing the communication tool product and facilitating workshops . As we took on this project, we had very little to non experience with Sykehjemsetaten, SYE. We did what were good at - went in with ears and eyes wide open and dived into the organization. We are very grateful to Bjørg Torill Madsen and Bente Sæve who has been nothing short of stellar. They have been opening doors all the way, and made it possible for us to turn all stones we could find in the large organization of Sykehjemsetaten. SYKEHJEMSETATEN INITIAL RESEARCH
  7. 7. BESTILLERKONTORET, BYDEL ALNA Today we had two hours to talk with Marit. After our conversation last week with Bjørg and Bente at Sykehjemsetaten we wanted to get a closer look at what the work looks like from inside the bydel. There are fifteen bydeler (districts) within the Oslo kommune (municipality). The residents of these bydeler access many of the health services through the bestillerkontoret. A few of our key take aways are: 1. Employees of bestillerkontoret check on patients in person to assess what kind of care they need after a stay in the hospital, or when transitioning to home care or into a long term nursing facility. 2. These employees have high quality medical training and practical experience in nursing, occupational therapy, physical therapy, and other specialties. They visit the homes multiple times each week to check on patients. 3. Contrary to what we thought from our last meeting, the evaluations are more than once each week. The employees coming to check on patients are not concerned that their residents are living in the same area of the helse hus. They would rather they be placed according to their medical needs. 4. Helse hus should not run like a nice spa, a place to relax. Instead, it could be treated like an efficient extension of the hospital. Patients need a place to get back to normal and recuperate after a trip to the hospital. Last but not least, we asked Marit what her dream for the helse hus would be. If she could have her way, all she wanted was a home filled with“high qualified staff that sees the whole patient, who is a bit firm, but with a warm heart”. She wanted to have a short term house that focused on goals and getting healthy people back home. INTERVIEWS BLOG POST
  8. 8. HJEMMETJENESTEN, BYDEL GRORUD Yesterday we met with head of hjemmehjelptjenesten in bydel (district) Grorud in Oslo. She has worked in hjemmetjenesten since 2002 and knows the service in and out. From her practice when she did home nursing - through leading the cooperation processes when the samhandlingsreform was introduced - and now as the leader of the whole hjemmetjeneste in Grorud. We found that samhandlingsreformen resulted in a much higher need of hjemmehjelp, as patients are discharged from hospital much sooner than before. Sometimes they are not finished with their treatment, and are sent home with IVs that gives antibiotics etc. This has lead to new tasks for the home-nurses, and also increased the need of highly educated employees in the hjemmehjelpen. Over the last few years the number of nurses in hjemmehjelpen has nearly doubled. The different population in the districts of Oslo demands very different help. From some districts where the home nurses mostly care for elderly - to the districts where the patients are younger. Like kids with chronic diseases, drug abusers, people with disabilities and such.. The meeting with Hjemmetjenesten opened our minds to think about the whole spectrum of people that at one point - or more permanent - is in need of their services. It is interesting to gain insight into the complexities surrounding introduction of the Samhandlingsreform. “It is not“easy”to get admitted to a long-term care facility. We have so many different services that we can provide for the patient so that they can live a happy and healthy life at home - for as long as possible. Our experience is that living at home for as long as it is safe is a good solution.” INTERVIEWS BLOG POST
  9. 9. PROCESS BOOK //08.12.14 10 11 SEPTEMBER BYDEL GRORUD BENTE 1. Nothing is standard. Each bydel decides who gets what care by whom 2. Communication is stronger and more open here. 3. Evaluation meeting is not enough time to give accurate vedtak 4. Opinion of private/public varies by district and demographic 5. Amount of public housing has huge impact 6. Many have been working 20- 25 years 7. Different employees have different strengths. Holistic view, or get it done 8. Hospitals, family, and politicians want more room in the nursing home. Patients and districts want them to be cared for at home 9. If you haven’t worked in home care, impressions aren’t great. 10. Miscommunication is an epidemic 11. Want primary person for each patient. But sometimes that’s not what the patient wants, or it’s dangerous, or it’s impossible with 24hr care 12. It’s easy to think things are going well but they only see employees a few times per day 13. Technology is working, they work with device to control HJEMMETJENESTE
  10. 10. AHUS At Ahus we met with Bjørn, one of the advisors as the dept. for samhandling. Samhandling = cooperations. Here between hospital and municipality, but also between hospital and many other connected actors... We’ll concentrate on the connection to bestillerkontoret. We have now learned that the Bestillerkontor is sort of the glue between different care-facilities and the patient. Either the hospital, your GP or you yourself reach out to the bestillerkontor - so that they can evaluate your need for help/care. If the hospital is the one noticing the bestillerkontor about a patient that needs help - this can happen in two ways. Common for these two approaches is that they have to make contact with the bestillerkontor within the first 24 hours after patient is admitted to hospital. If patient is known in the health care system - there is already a journal and a file following the patient. If not - Ahus makes a new case - and via GERICA this is sent to the bestillerkontor. Samhandlingsreformen had a huge impact on the flow in the hospital. Now patients are sent home much sooner than before. The responsibility of rehabilitating patients are moved to the municipalities. When the reform was set in action - departments at the hospital was emptied over night - as the care facilities in the municipalities and districts had to take over the responsibility. With this reform the weight shifted in the system. I think we will have to dig deeper into what impacts that has on the health&care systems in the districts... Bjørn also had a suspicion that the GPs are gatekeepers, that they don’t know enough about the system. Due to hospital diseases and risk of “getting more dependent on nursing”the advisors at the hospital also think that home care is the better solution. INTERVIEWS BLOG POST
  11. 11. 12PROCESS BOOK //08.12.14 12 SEPTEMBER BJØRN & BENTE 1. Patients get better care at home (even research says so) 2. Still not ideal communication between Ahus and bestillerkontoret 3. Positive reaction to changes. It gives common communication. 4. Reform about increasing collaboration so patients get the best care 5. GP’s are gatekeepers who don’t see the whole picture 6. 2012 effect- hospital is empty AHUS SYKEHUS
  12. 12. PROCESS BOOK //08.12.14 13 23 SEPTEMBER TERESA 1. There has been an increase in patients, a bigger turnover and more work in general for nursing homes after samhandlingsreformen. 2. Becoming a health house requires a higher number of full time employees, yet the number of beds remains the same. 3. About 90 % of the current employees at Solvang will be moved to other nursing homes as a direct consequence of competence following the patients. 4. There will be no unskilled nurses at health houses. 5. Personal information concerning the patient, such as eating and sleeping habits are included in the reports in the Gerica journal. 6. Restructuring Solvang, all long term patients are given the choice of either moving internally to a different ward, or to another nursing home. The majority chooses to stay at Solvang. SOLVANG SYKEHJEM
  13. 13. 14PROCESS BOOK //08.12.14 3 OCTOBER KRYSTYNA 1. Bestillerkontoret visits and evaluates every 2 weeks 2. Normal stay at a short term facility is 2-3 weeks 3. Patients with dementia can seem calm and balanced in hospital, but act out in nursing home. 4. First evaluation of patient consists of a cross disciplinary team. 5. Regular meetings for special case patients include Bestillerkontor, patient, next of kin and a representative from the nursing home 6. Some patients have scheduled visits allowing them stay for instance two weeks in a nursing home followed by four weeks at home. HONEY 1. A long term nurse can stay at a health house if that nurse acquires the necessary competence 2. There is unclarity as to what competence is needed for short term vs long term patients. 3. The potential possibility of staying at your facility renders the nurse passive as to whether or not to apply other places. 4. Practical elements that change when switching workplace, such as proximity to home or kindergarten, play a smaller role than losing colleagues and patient relations. LILLEBORG SYKEHJEM
  14. 14. 15PROCESS BOOK //08.12.14 RICH DESIGN SPACE THE FIRST MAPS
  15. 15. 16PROCESS BOOK //08.12.14 CONNECTING THE DOTS After our tour around Oslo, doing interviews and gaining general insights about SYE, we got ready for our first milestone meeting at school. We reorganized our rich designs pace. Pulled out all our larger and not so large maps - and started connecting the bits and pieces so that we could get the overview to connect the dots. In the mess of connections we found some interesting areas for design directions. For example we discovered that the Bestillerkontoret is actually the hing between many of the actors providing health care services. We had also been playing with the thought of developing systems for the dynamics in the coming helsehus. And we were looking into the SYE structure. At the milestone meeting at 15th of September we presented four design directions that we wanted to pursue.
  16. 16. 17PROCESS BOOK //08.12.14 4 INITIAL CONCEPTS DESIGN DIRECTIONS 1 HELSEHUS DYNAMICS Structure within the short term homes. 2 BK EVALUATION PROCESS Getting the decition for level of care right, on the first try. 3 KEEP PATIENTS AT HOME Combining comforts of home with medical care. 4 THE SYE STRUCTURE Hierarchy & logistics in the municipality. Impact Radius Ripple Effect Horizontal Effect Vertical Effect Implementation Barriers Evaluation Process HIGH HIGH HIGH HIGH TECHNICAL ORGANIZATIONAL Keep Patients at Home TECHNICAL CULTURAL MEDIUM MEDIUM HIGH MEDIUM Helse Hus Dynamics ECONOMIC TECHNICAL SMALL HIGH HIGH MEDIUM Organizational Structure ORGANIZATIONAL CULTURAL HIGH HIGH MEDIUM HIGH
  17. 17. PROCESS BOOK //08.12.14 THE TURN
  18. 18. PROCESS BOOK //08.12.14 21 OUR CALENDARA PLAN FOR THE SEMESTER R SATURDAY SUNDAY MONDAY TUESDAY FRIDAY SATURDAY SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY | |Systems Oriented Design (SOD) |Autumn 2014 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Milestone presentations AHO WORKS EXHIBITION 09:00 - 16:00 Big & Small Auditorium Final Presentations. Invite your project partners. Exhibition is part of the evaluation. (price for best exhibition) 09:00 - 16:00 Big & Small Auditorium Exhibition space presentation. Exhibition is part of the evaluation. (price for best exhibition) Exhibition Setup Exhibition Setup WEDNESDAY THURSDAY FRIDAY MONDAMONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY SUNDAYMONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SATURDAY SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY MONDAY TUESDAY WEDNESD MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 09:00 - 16:00 Group Room 4&5 Elevator Pitch. Implementation. 3 posters. (Pecha Kucha Format - 20 slides and 20 seconds each slide) 09:00 - 16:00 Tegnesal 9 Rich Design Space and 3 elevator pitch posters. 09:00 - 16:00 Reverse Archaeology Presentation. The future systems landscape. 09:00 - 16:00 Tegnesal 9 giga map presentations of future systems. Proposed Day Stakeholder Workshop Making DeliverablesConcept DevelopmentInsight Work Testing & Iterations WEDNESDAY THURSDAY Decision Day: Narrow Down Scope Decision Day: Individual Problems Defined Decision Day: Final Deliverables Determined 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 2 IMMEDIATE NEEDS After an intense period of doing interviews with bestillerkontor, home help, leaders at different nursing homes, avdeling for samhandling at Ahus and nurses in nursing homes, we presented four design directions at the first milestone meeting. These directions was a result of our research, mapping and analyzing potential areas where we saw a need for change and innovation. When presenting these for the project leaders at SYE, two things became clear. They were not custom to the designerly approach and our methods for identifying an intervention point. And as Bjørg Torill Madsen said; We went to a second meeting with Bjørg and Bente at SYE where we presented our design directions again. We had a discussion about these - we agreed on that, in addition to our intent on pursuing the ideas we had, we would do a session at SYE where we visualized their Excel Sheets with all the numbers for the move. Starting this work we thought this was going to be a straight forward job. However - this is when we really understood the complexity of the restructuring process. While we were working in the SYE office we started sitting in on the meetings where Bente Sæve and leaders of the coming Helsehus were planning moves. We started illustrating their conversations. Made time lines and floor plan-structures on big sheets. And as soon as the participants in the meeting could relate to the drawings we made, they instantly started using them to point to - and the illustrations became a way for them to very visually construct their communications, which led to a consensus regarding what they were talking about. They could all of a sudden follow each others chains of thoughts in the discussions. “But what about right now?”- Bjørg Torill Madsen
  19. 19. PROCESS BOOK //08.12.14 22 THE EXCEL SHEETS This is the columns and numbers that met us when mapping at SYE. No wonder Bente and Bjørg Torill are struggling explaining the project to other stakeholders. VISUALIZING THE MOVES
  20. 20. PROCESS BOOK //08.12.14 23 VISUALIZING THE MOVES September October November December January 2015 2016 February March April May June July August September October November December January October 2015 27 1714 9 22 Hoveseter Smestad Sofienberg 7 5 Romsås Grunerløkka 3221 6 917 17 5 16 17 Majorstua Kingosgate 28 Rødtvet Ammerud 2023 FurusetMadserudLambertseter Lillohjemmet Akerselva 17 Akerselva Vålerenga 29 927 26 10 19 20178 8 13961513 Moving Patients & Staff Between Nursing Homes HOW TO READ THIS MAP The top portion also shows staff that will need to move in order to fill the needs of the new patient population. The bottom portion shows the different type of patients that will be relocated. This lower portion is based on a time line over the next 14 months. For example: Akerselva, a newly long term facility is moving 17 regular short term patients spaces to Lilleborg, a new short term home, or Helse Hus. They are also receiving 8, regular long term places in return. Akerselva will send 14.26 FTEs to Lilleborg to assist with this new patient population. Akerselva will receive 8 FTEs from Lillohjemmet because they cannot send patients to Tåsen, because it is privately held. MAP LEGEND POINTS OF INTEREST Lambertseter MovingStaffMovingPatients Langerud Abildsø Furuset Ammerud Rødtvet Romsås Madserud Smestad Majorstua Lillohjemmet Vålerenga Sofienberg Kingosgate Grunerløkka Akerselva 41 28 33 51.6 1.75 13 14 3.9 14.26 7 24.26 7 44.66 24 6.4 9 8 Lillohjemmet 8 RYEN SOLVANG TÅSEN LILLEBORG LILLEBORG Akerselva 14.26 Short Term Patients Long Term Patients Facilities Staff Ordinary RehabRus Ordinary Intensive Care Unspecified Specialty UDI Direction of the move: Origin Destination Number of Patients or FTEs 17 Public Long Term Home Private Long Term Home PRIVATE SHORT TERM PUBLIC SHORT TERM A A B BB A Romsås is becoming private and the Oslo Kommune wants to keep substance abuse treatment competences within the public sector. This means that the employees with this special training must also move into Ryen before the privatization is finalized. B Tåsen is private so employees will have to find a new place to work after the short term patients leave. They will have to move into a different quadrant of the city to find work at a short term facility, as there is only one health house for each. D C C C C C C These matches may seem equal, but remember that short term and long term patients require very different needs. Between Grunerløkka and Lilleborg they switch the correct amount of FTEs to match the patient move. The other four are between public and private homes, which makes it difficult to move staff. D While the moves have individual deadlines over the next 14 months, the patients and employees could be moved at any time before their date. The markers here are spread out in the month prior to their deadline. For instance, a move that should happen before June 1 2015 looks like it will take place in May 2015. E E FTEs may look easy to trade back and forth, but this does not yet take into account the different competence such as rehabilitation, physical or ergo therapies, nurses, or non-medical staff. Note: There are some exceptions to this moving system. Some patients are moving between long term facilities due to special medical needs. These are not listed on this version but will be added later on in the project. This map reflects the knowledge we have as of October 14, 2014 and is subject to change. THE CITY OVERVIEW This is the excel sheet from the picture on the previous page. We also added the move of employees. The map created great enthusiasm. The city overview map answered to the original brief Sye came with to AHO. They wanted us to help them communicate their moving plans. When presenting this map for the whole projectgroup we threw out a couple of ideas building on this map. For example we suggested that this could be an online informationservica accessable for all employees in SYE. Or it could be a part of a newsfeed, like a blog, where everything about the move could be presented to employees. Our research had shown that information is an issue. Employees were caught between either getting no information - leaving them confused and worried, or too musch information - leaving them uncertain about what is the right info, and who to trust? We had some ideas on how to execute these ideas. However, during the following week we came to the realization previously mentioned; One thing was the issue regarding information to employees. An other pressing issue was that we understod that the level of confusion during the plannig meetings led to confusion about what was actually appropriate information to give to the employees back at the nursinghomes. As we developed the communicationtool we left the ideas on making a“newsfeed”.
  21. 21. PROCESS BOOK //08.12.14 24 MAPPING AT SYEVISUALIZING THE MOVES
  22. 22. PROCESS BOOK //08.12.14 SHIFTING DIRECTIONS After Rickard and Line had a tutoring session with Ted and Kaja at school - we got some guidance to how we could form this project. We have done interviews with many different actors and stakeholders - they all have different agendas, wishes for the outcome of our work and opinions on what is important in the restructuring process. So - as the restructuring process is already started - we have decided that our project and deliverers for this SOD course will consist of several part-deliveries that we make through out this semester. Instead of focusing on making a service or product we will see the“process as the result”. Through our systemic approach we will facilitate workshops, visualize SYEs wicked problems, enable moves to go smooth- and so on. Methods and“results”of these interventions will be our delivery. Our result after this course. Oh. and in the beginning of this month LiveWork was announced the winner of the SYE preDIP.. During the last months we have gained LOADS of insights. We decided to try and sum up the research and present it at the RSD3 symposium. We spent two days on the 9th and 10th of October to go to SYE. There we mapped the moving between nursing homes - on the way to establish the four health houses. Bente Sæve answered a lot of questions. We got an even better overview. The maps were presented at the RSD3. Next up is creating a communication-tool. While mapping at SYE, we sat in on some of their strategy meetings regarding moving beds and patients. As we were illustrating their conversation, the participants in the meetings started to point to our drawings/maps as they were discussing. It became very clear that by pointing to illustrations they were able to be more clear - and on the same page - in their discussions. Less confusion - more consensus. THE TURN BLOG POST
  23. 23. PROCESS BOOK //08.12.14 SOD SYMPOSIUM RSD3 took place last week and we took this opportunity to put a pause in our work. We had gathered so much new information from the mapping sessions and needed to take some time and gather what we knew. We also decided to show our work in a slightly different way than has been done in the past. It is typical for SOD students to put up their maps as they have been working on them. While this certainly shows the richness of their process, it makes it difficult for anyone who is not familiar with the project to understand. We wanted to create one display that showed the complexity of our project in a way that was accessible and approachable. We also wanted to get into digital space to make everything as clear as possible. Almost all of the information we showed was new to us (within the last week) so it was also helpful for us to see how it connected together. Each project from the SOD class had the same introduction poster. We placed a small key below ours to explain all the other elements in our exhibition. The main map in the center shows the moves of patients and staff over the next fourteen months. To the right is the governmental hierarchy and structure around this whole initiative. On the table, from left to right, is a model of Oslo and the actors, an animation showing the moves in a geographic setting, and a zoom in to just one of the moves. Showing how all these pieces fit together helped us clarify where we are in the project. We are not sure if the guests of RSD3 understood it without us, but it certainly helped us put a flag down in our process. THE TURN BLOG POST
  24. 24. PROCESS BOOK //08.12.14 27 CLEANING UP AND CONNECTING MAPS SOD SYMPOSIUM
  25. 25. PROCESS BOOK //08.12.14 28 THE TURN AFTER MAPPING We started this project with a classic designerly approach. We did broad research in order to get to know the landscape we were going to work within. Our mission was to find possible intervention points where we could use design processes to develop a concept that we would present at the end of the project. But as we have mentioned, after first milestone meeting we took a pause from that, to focus on what Bente and Bjørg were requesting. After the intense mapping days at SYE we took a moment to reflect on where this work had taken us - and realized that we wanted to pursue the track we were on. On the right hand side we have listed the 4 most important reasons why we left the first four design directions behind. CHANGING THE DIRECTION 1. 2. 3. 4. One of our directions was about the dynamicsin the new helsehus. We actually knew that a designfirm in Oslo, Live|work, was going to make the concept for this service as SYE had set out a competition for this. We obviously did not want to do a project that would be done by professionals after all. so with this in mind we left that direction. We wanted to take care of the employees. The big picture was that they were excited to be a part of making a better future for elderly care in Oslo. They were just confused due to the malbalance of information. The projectgroup at SYE had immediate need for organizational help in their meetings. We saw the opportunity to create something that would mutual benneficial. We could use our skills as designers to develop a useful product for SYE. We saw that vi could make an impact.
  26. 26. PROCESS BOOK //08.12.14 PROTOTYPING
  27. 27. PROCESS BOOK //08.12.14 31 HELPING COMMUNICATION We have been sitting in on many meetings at SYE. In these meetings Bente Sæve, and the respective leaders of the nursing homes involved, are planning the move of beds, patients and employees. We have been following the move between Abildsø and Ryen, and Kingosgate and Lilleborg especially close. We have also been shadowing other move-meetings, regarding other nursing homes, and we have discovered sort of a reoccurring pattern. First a rough sketch on how the meetings are organized; 1“The prep” For each move there are a series of meetings starting on a high level in the hierarchy. The project group at Sye, with union-people, formidlingen and representatives for different groups of employees, are initiating a first meeting for to start planning move and establishing of “helsehus”. In this first meeting the leader of the nursing home that is becoming a helsehus is invited. Union-people and representatives for employees are continuously following meetings where employee related issues are addressed. 2“The coupling up” After“prepping”, the institute leader for the exchanging nursing home is invited to the meeting no. 2. Here the two leaders have their first sit-down to talk about the move, and exchange of patients and employees. In this meeting Bente Sæve is giving a brief on the status of the project. Tentative dates for move are discussed. No. of patients and beds are updated and placed in right dpt. at new destination. 3“The protocol” Then comes a meeting where the parties sign a protocol where they agree on terms reg. the move of staff. During these meetings there are constant discussions on MANY other issues; - furniture - improving buildings - employee needs - frustrations towards the change and so on. 3.1 3.2 3.3 ... More meetings to prepare for an easy transition. The meeting no 3s, we call them. When it’s time to discuss employees and FTE’s were touching on the real complexity in this project of restructurig. The move should follow certain principals. When opsticles occur it may require new meetings and planning“back at home”- in the respective nursing homes. Which means delays and more meetings. OUR OBSERVATIONS - there are a lot of numbers to be straight about. - there are a lot of building related stuff to remember. names of departments/floors/rooms. - all the participants in the meetings have their own notes. - some make small sketches in own book while discussing/explaining. - some gesticulate in the air... - everybody forgets, from time to time, exact numbers and so on. - often confusion about what is actually being discussed at the time. - misunderstandings. - repetition due to confusion PROTOTYPING BLOG POST
  28. 28. PROCESS BOOK //08.12.14 32 BLOG POST PROTOTYPING HELPING COMMUNICATION The Communication tool“version 1.0”: In the brief from SYE they expressed a need for making their project more visual, in a way so that they could easier explain it to others, such as politicians. While sitting in on a meeting, we started visualizing their conversation. And started understanding what caused the most of the confusion and time-consuming discussions. As everybody in the meetings are following their own notes in their own books they tend to misunderstand and talk passed each others when discussing number of patients, employees, fte’s. We came to realize that if we could facilitate their discussion by illustrating it - we could save time, confusion and frustration. Not only did the projectleaders at SYE have problems communicating and explaning the project “outside”of the projectgroup. They even had some problems communicationg between themselves in their own meetings. So we thought we coud test som mappingmethods that we learnd in one of our SOD lectures. We tried to draw up a timeline for moves. And structuring floors and dpts. in the nursinghomes. First step was a super easy visualization - floors and dpts drawn on paper during a meeting at SYE. Instantly all the people around the table lifted their eyes from their notes and started pointing to the “common”sheet - where everybody could follow what was being discussed. This has come to be one of our most important maps, as this was the beginning of the communication tool prototyping.
  29. 29. PROCESS BOOK //08.12.14 33 PRODUCT DEVELOPMENT After reflecting on the SYE meetings where we visualized their conversation, we went back to school and tried to develop what we have called “the communication-tool”. Here’s a 5 step sum up on the iteration. 1ST VERSION (Top left picture) As we had the idea of having placeholders for beds, employees and patients - we made some hundred pieces... We really wanted to show the complexity in the large number of people involved. We wanted it to look“huge”. The picture is from first iteration at school. We tried to use the tool ourselves and realized it was too many bits and pieces. So we cut down on number of pieces and made them from acrylic plates. These chips we brought to SYE to use them in the meeting between Abisdsø and Ryen. It could have gone better: -Wrong level on meeting, this was the first meeting where they had an overall discussion about the move. The tempo was to high for our tool, which was too detailed. -The tool had to many components - hard to use. -The discussion was about human relations and rough numbers of how many patients were moving from Abildsø to Ryen. So we narrowed down number of pieces. Made the tool look nicer - and tried again. 2ND VERSION (Bottom left picture) We decided to skip most of the chips. Didn’t work last time. Here we tried a super simple version with just the two nursing homes in question, which was Abildsø and Ryen. -Right level and right discussion in meeting. -Less parts made it easier to use. -More visual and less physical pieces this time. -It became too messy though, because it had to little structure and inconsistent coloring. -High level of us facilitating the use of the tool. PROTOTYPING BLOG POST
  30. 30. PROCESS BOOK //08.12.14 34 4TH VERSION (picture below) To up the game we brought an acrylic board to this next iteration so that we could draw - and erase fast. It looked kind of cool. And it was fun to use - but documenting and updating the map after the meeting was not that easy. And since you need a whiteboard marker to write on it we unintentionally excluded participants to contribute to the common worksheet. But - as we started thinking about how this tool should be used in the future - we thought that adding a big board to the package was’nt necessarily such a good idea. So we left the board. 3RD VERSION (picture above) Better setup, sketch of floor-plans made the tool easy to use fast. Reintroduced some “subject”pieces in an atempt to guide the conversations towards ether patients, employees, supportfunctions etc. Clear & straight lines symbolizing patients moving. Easy to add details, though on postits Very visual! Tool made it easy for those who came in late to catch up. Over all pretty happy about this iteration. Could wish for a little bit more structure though. BLOG POST PROTOTYPING
  31. 31. PROCESS BOOK //08.12.14 35 5TH VERSION After the previous iterations we cleared up our layout and presented this last version of the tool. Now being a plotted sheet with pre made structures and room for the participants to fill in new notes and numbers. This was a“no2”meeting. First meeting with both institutional leaders. Hilde from Kingosgate and Gerd from Ryen. The meaning is to create a feeling of ownership to the project from both inst.leaders - and for them to get of on the right foot in planning the move of their patients. We took a few minutes in the beginning of the meeting and told them that during the past few months of sitting in on their meetings - one of our key findings is that visualization is golden! If the participants in the meetings can see what they discuss - the communication runs so much smoother. No need to repeat as much - and high level of consensus all the way. This time we had decided to skip the acrylic plate. It is not as useful as it is a “cool feature”. And the“users”seems more comfortable drawing straight on paper. Gerd really took charge and used the tool for what its worth. I think we can say that the idea is good. Now it’s a matter of how we actually present this tool to the end user. PROTOTYPING BLOG POST
  32. 32. PROCESS BOOK //08.12.14 36 LAST TOUCH PROTOTYPING Good thing is that it is not too much to tweak in order too make this tool usable without us facilitating. The two most important notes, given our time scope, from last iteration on the tool: It needs an illustration on the connected LT home on same sheet. So that patients going from ST to LT is also in the map. And. The no 3 meetings may need more rounds. It is obvious that the matching patient+competence move is very complicated. PROTOTYPING BLOG POST
  33. 33. 37 CREATING OWNERSHIP The tool has progressed a lot during this project and more and more information goes directly into this common worksheet. This version of the communication tool enables the participants to get an overview of where all patients and employees that are moving into the Helsehus are coming from and what floor they are moving into. There is also floors of the long term facility that the Helsehus people are moving into. On top of this they have one area on the sheet available for adding general notes and one for things that needs to be followed through. Our plans of getting the project group to adopt this way of working is almost complete. From the first time we used the worksheet up until now, the level of facilitation from us has continuously decreased. Now they are using it even without us there. The picture above is actually taken when Line stopped by at the end of a meeting. Bente has been facilitating the use of the tool all by herself. That was a great testimoni to get as we were entering final production mode back at school. PROCESS BOOK //08.12.14 FINAL VERSION PROTOTYPING
  34. 34. PROCESS BOOK //08.12.14 WORKSHOPS
  35. 35. PROCESS BOOK //08.12.14 41 WORKSHOP AT SOLVANG They have a regular meeting with Helse Hus employees. We were allowed to hijack this meeting and use part of it for our workshop. We wanted to use this time to get the employees to start thinking about the future. They have been so focused on the move and all the work that will take. So we decided to get them to envision all the benefits for the employees, patients, family members, and for the system as a whole. We asked each group to think of ways this new system could benefit their target. If it would greatly affect this user group, the post-it went in the middle of the circle (see next page,top left picture, on the wall). If it was more of a secondary or minor effect, the post-it was placed on the outside of the circle. This was a bit of a challenge for our participants, as they were not used to thinking about the Helsehus in this way. We provided some prompt cards with questions to get them to think about specifics. After they presented their tasks we asked them each to choose one. We then asked them to get in groups of three and discuss why they had chosen this particular benefit or change. We made a template to fill out. This template asked them to imagine that this benefit already exists, and then “look back”and imagine how it came to be. This helped them talk about specifics like barriers and team members who would need to be on the project. We wanted them to discuss this with each other, but it was difficult to encourage that. Mostly, they wanted to think it through themselves, then chat afterwards. Our last task was just to place their new project pages on a time line. On one end is 2015 and the other is 2020. We wanted to know when these projects would likely be complete. We also asked them if the projects would be“nice to have”or “need to have”to try and see how they viewed changes. In reality, only one was“nice to have”. This group really does want to make a lot of necessary and impactful changes. At the end of the workshop, the whole group broke into a discussion. It was clear from this last section that they wanted to discuss with each other. Before the workshop started they had their update on numbers of patients that had been moved, and more on the logistics side. We brought this with us into the planning for the next workshop, we decided that we should leave time for ventilation about the changes that are under way. WORKSHOPS BLOG POST
  36. 36. PROCESS BOOK //08.12.14 42 30 OCTOBER SOLVANG SYKEHJEM WORKSHOP 1
  37. 37. PROCESS BOOK //08.12.14 43 WORKSHOP 25 NOVEMBER AHO
  38. 38. PROCESS BOOK //08.12.14 44 WORKSHOP AT AHO In the beginning of the semester, we asked to have a big workshop. We knew it would take some time to organize and schedule but had no immediate plans for what we wanted to get out of it. We also figured we’d get about 20 participants, maybe 30 tops. A few months later we had our workshop. It was drastically different than we anticipated. For starters, we had about 50 people instead of the 20 we’d assumed. the task we had them perform was quite standard, but the workshop itself took a fair amount of planning and coordination. The task was as follows: 1. Participants were divided into ten groups before they arrived. They each sat at their tables and we given a blank journey for a patient. 2. Each group was assigned a patient, some groups had the same patient. In an envelop was a description of a patient, as well as their immediate medical needs. 3. We asked each group to map out the patient’s journey: Where would they go? Who would the see? who was present when a decision was made? 4. Once they had completed their journeys, we asked them to open another envelope. This contained a twist to the story: What if the patient’s wound does not heal? What if they suddenly lose a lot of weight? We wanted to see how they would rearrange a journey when something goes wrong, something that may not be anyone’s fault. Groups with the same patient had different twists, to see how one journey could start the same, but end up in very different places. 5. Now that they had a journey (nearly two journeys in some cases), we asked them to label some highlights. These included“When did the patient feel most supported? Least supported?”,“When did the employee feel like they were in control? Out of control?”, etc. 6. The last task was to write on an anonymous card what they thought was the biggest challenge. We also had them note their one wish for this systems/ journey. We wanted to keep this anonymous so people would be more free to criticize the system. 7. Each group presented their journey to the whole workshop. All in all, we felt this workshop went very smoothly. We kept ourselves to a strict clock and managed to get everything done that we needed to. Although this particular workshop was about patient journeys, our main goal was communication. We are happy to collect the journeys are read about the challenges that exist. This is more than relevant for our work. But we also wanted to do something else. We wanted to encourage open discussion and dialogue between nursing care workers who do not work side by side. There are changes coming for all of them. This is a time where they need to feel supported and encouraged. We wanted to show that they are all in this together. WORKSHOPS BLOG POST
  39. 39. PROCESS BOOK //08.12.14 45 AHO WORKSHOP
  40. 40. RICH DESIGN SPACE
  41. 41. PROCESS BOOK //08.12.14 50 INSIGHTS REINVENTING THE RICH DESIGN SPACE Here we are coming towards“the end”and we rolled out all our maps and reinvented our rich design space. Through this project we have surrounded us with the maps we have been working on, and actively used them as source of information. As we are in this systemic approach - we are reviewing our own system of notes and knowledge - to make an insights book of it! RICH DESIGN SPACE BLOG POST
  42. 42. DELIVERABLES
  43. 43. PROCESS BOOK //08.12.14 54 DELIVERABLES INSIGHT BOOK Contains all our gained insights. It has a map attached to visualize all this. We made this book because we did not want all tis valuable insights to get lost and disapear, as this can be useful for the project Live|Work PROCESS BOOK Contains the story of our project, told in puctures, small articles and through our blog. MAPS City owerview map Hierarchy map Insightsbook map All the maps that are templates used in the communication tool THE COMMUNICATION TOOL A digital package of all templates A user manual for whom leading the meeting An introduction folder for the institutional leaders involved in meetings 54PROCESS BOOK //08.12.14
  44. 44. PROCESS BOOK //08.12.14 REFLECTIONS
  45. 45. PROCESS BOOK //08.12.14 58 THE PROCESS The system oriented approach has led us on a journey we haven´t experienced before. We have had an interesting course of this project, with the main focus shifting two times due to our search for interventions points with big impacts. The initial brief was to help the project group at Sykehjemsetaten communicate their moving plans to stakeholders affected by the restructuring process taking place in Oslo. However our focus for the first month was on delivering a“shiny”concept at the end of the process, basically neglecting the brief. When presenting the four directions we thought this project could take, our partners were mildly interested, because as we soon would understand, they had pressing needs related to the moving process. We turned our focus towards the communication issues Sykehjemsetaten had, which was what the original brief was all about. We thought that helping them with this would lead to them let us go back to working on the“shiny”concepts. That never happened, because we found something that we could do right now that would have an immediate impact on both the moving process and most likely on the coming work that Livework would do. It would have that effect because it is the people being affected by the moving process that are going to adopt or reject the new concepts Livework will deliver. Making the current process go as smooth as possible is therefor essential. THE PARTNERS Our partners this semester, Bjørg Torill and Bente Sæve from Sykehjemsetaten, have been absolutely fantastic. They have opened every door we wanted to look behind, giving us access to people all over Oslo. They are very opened minded though precise about their opinions, which is exactly what a designer wishes for. It´s also very inspiring to work along side them because they have big plans for Sykehjemsetaten. They want to change from being a traditional hierarchical organization to a more dynamic one, with empowered leaders throughout the organization. THE OUTCOME We have two main contributions from this project, which are the insight documents and the communication tool. The insight document is a delivery that we hand over to the service design consultancy Livework, who are now developing the concepts for the services that will be offered in the Helsehus and “Mitt hjem”. In these documents we have gathered various insights from across the landscape we were in the first month and a half. Some of these will be highly relevant to Livework´s project, while others might just be curiosities. The communication tool is the innovation we have done in this project and it is a very specialized tool, to be used when planning moves of patients and employees in order to become Helsehus respectively long term facility (“Mitt hjem”). We mean that the impact of this“small”intervention will have a mayor impact, both on making the moving process run smoothly but also for the changes that will continue after the separation of patients. The restructuring which is going on in Oslo right now will take around 2 years in total, with around 20-25 separate moves, and every thing that helps the progression of the planning for these moves are crucial. Also, this restructuring process is something that is most likely going to take place in other cities in Norway soon (they´re are looking to Oslo to see how it goes first), so the communication tool can play a small but important role in if this strategy becomes national or not. CREATING VALUEREFLECTIONS
  46. 46. 4 ON THE SAME PAGE Process Book Sykehjemsetaten Oslo Kommune

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