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Theories of change to guide future service innovations

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This talk explores how Unboxed is using “Theories of Change” to guide the design of future service innovations towards desired outcomes and how this helps us evaluate the impact of our design work. Theories of change have been used since the 1990s to evaluate development programmes in many different contexts, such as philanthropy and international development. They can be used to guide the design process as well as to evaluate existing services. One of the main benefits of this approach is that it compels the design team to explicitly articulate assumptions about how a proposed concept might achieve an intended outcome and how these outcomes might lead to long-term impact. These assumptions can then be validated through prototyping and research activities. The talk will cover recent examples of applying this approach in our work with Guy’s and St Thomas’ NHS trust and with the Hackney Council housing repairs services in London. In both cases, the evidence of impact provided by this approach helped us gain buy-in from senior stakeholders and secure funding for further development of the digital services we were working on.

http://unboxed.co/

http://prototypingforimpact.com/

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Theories of change to guide future service innovations

  1. 1. Innovating for Impact with Theories of Change Boris Divjak @borisdivjak unboxed.co 2019
  2. 2. @BorisDivjak U N B O X E D Unboxed is a … digital innovation consultancy. service design software development agile collaboration
  3. 3. @BorisDivjak U N B O X E D Our purpose is to ...
  4. 4. @BorisDivjak U N B O X E D Our purpose is to ...
  5. 5. @BorisDivjak U N B O X E D Our purpose is to ...
  6. 6. @BorisDivjak U N B O X E D Our purpose is to improve lives with digital technology
  7. 7. @BorisDivjak U N B O X E D H E A L T H C A R E projects H O U S I N G projects E N E R G Y projects “Improve lives?”
  8. 8. @BorisDivjak U N B O X E D Happier and healthier patients? Improved quality of available social housing? Reduced air pollution? “Improve lives?” H E A L T H C A R E projects H O U S I N G projects E N E R G Y projects
  9. 9. @BorisDivjak U N B O X E D
  10. 10. @BorisDivjak U N B O X E D Impact of innovation is difficult to demonstrate: There are long delays between cause and effect. There are many contributing factors. There are often unintended consequences.
  11. 11. @BorisDivjak U N B O X E D Zoom out with T H E O R Y   O F   C H A N G E to construct a big picture of impact @BorisDivjak U N B O X E D
  12. 12. @BorisDivjak U N B O X E D Desired impact (might be affected by other factors in addition to our own innovations) Long-term outcomes
  13. 13. @BorisDivjak U N B O X E D Service innovations that we are proposing to implement Desired impact (might be affected by other factors in addition to our own innovations) New service concepts Long-term outcomes
  14. 14. @BorisDivjak U N B O X E D Service innovations that we are proposing to implement Direct result of implementing new service concepts Desired impact (might be affected by other factors in addition to our own innovations) New service concepts Intermediate outcomes Long-term outcomes
  15. 15. @BorisDivjak U N B O X E D Service innovations that we are proposing to implement Direct result of implementing new service concepts Desired impact (might be affected by other factors in addition to our own innovations) New service concepts Intermediate outcomes Long-term outcomes OUTCOMES CHAIN
  16. 16. @BorisDivjak U N B O X E D Reduced plastic waste in environment 5p charge for plastic bags Reduced consumption of plastic bags New service concepts Intermediate outcomes Long-term outcomes
  17. 17. @BorisDivjak U N B O X E D Reduced plastic waste in environment 5p charge for plastic bags Reduced consumption of plastic bags DELA Y DELA Y Individual links are easier to measure than the end-to-end impact PROXY MEASURE
  18. 18. @BorisDivjak U N B O X E D Reduced plastic waste in environment 5p charge for plastic bags Reduced consumption of plastic bags Explore other ideas that might lead to the same impact New materials? Recycling?
  19. 19. @BorisDivjak U N B O X E D Reduced plastic waste in environment 5p charge for plastic bags Reduced consumption of plastic bags Explore potential unintended consequences of proposed service concepts Plastic industry loss? Reusable bags even worse?
  20. 20. @BorisDivjak U N B O X E D In practice, this is can be a messy process
  21. 21. @BorisDivjak U N B O X E D ASSUMPTIONS THAT REQUIRE EVIDENCE
  22. 22. @BorisDivjak U N B O X E D ‘Theory of change is an   O N G O I N G   P R O C E S S   O F   R E F L E C T I O N  to explore change and how it happens, and what that means for the part we play in a particular context.’ ––– James, C. (2011) “Theory of Change Review. A report commissioned by Comic Relief”
  23. 23. @BorisDivjak U N B O X E D ( R E ) D E F I N E your Theory of Change E V A L U A T E outcomes and assumptions P R O T O T Y P E new service concepts Zooming out Zooming in Innovation for Impact learning cycle
  24. 24. @BorisDivjak U N B O X E D Zoom in with R A P I D   E X P E R I M E N T S to evaluate impact of new concepts @BorisDivjak U N B O X E D
  25. 25. @BorisDivjak U N B O X E D Rapid experiments: Design and test small interventions in short iterations; Aim to learn, not to measure; Collect just enough data to make informed decisions.
  26. 26. @BorisDivjak U N B O X E D Example project: GP referrals (to hospitals) are often missing key information or test results, the absence of which causes delays to patients receiving a diagnosis and treatment and significant disruption to clinic schedules.
  27. 27. @BorisDivjak U N B O X E D Better patient information Allocated to correct clinic Tests before appointment Increased capacity within existing services Reduced cost per patient New service concepts Faster confirmed diagnosis & treatment Fewer unnecessary follow-up appointments Happier, healthier patients Intermediate outcomes Long-term outcomes
  28. 28. @BorisDivjak U N B O X E D Better patient information Allocated to correct clinic Tests before appointment Increased capacity within existing services Reduced cost per patient New service concepts Faster confirmed diagnosis & treatment Fewer unnecessary follow-up appointments Happier, healthier patients Intermediate outcomes Long-term outcomes
  29. 29. @BorisDivjak U N B O X E D If we provide ... online questionnaire for patients before their first appointment … then ... patients will be allocated to the correct clinic New service concept Intermediate outcome
  30. 30. @BorisDivjak U N B O X E D If we provide ... online questionnaire for patients before their first appointment … then ... patients will be allocated to the correct clinic New service concept Intermediate outcome P R O T O T Y P E E V A L U  A T E
  31. 31. @BorisDivjak U N B O X E D P R O T O T Y P E E V A L U  A T E We started with a simple paper questionnaire … … and evaluated the experiment by manually assessing each response.
  32. 32. @BorisDivjak U N B O X E D P R O T O T Y P E E V A L U  A T E We gradually built more refined prototypes ... … and conducted experiments with a variety of methods, but always with the aim of validating our ToC. I liked it. It made me feel prepared.
  33. 33. @BorisDivjak U N B O X E D Online questionnaire (For patients) Allocated to correct clinic Tests before appointment Increased capacity within existing services Reduced cost per patient Faster confirmed diagnosis & treatment Fewer unnecessary follow-up appointments Happier, healthier patients ? ? Refine the Theory of Change based on new learning EXP 1 EXP 2 EXP 3 EXP 4, 5
  34. 34. @BorisDivjak U N B O X E D Learn with the P R O T O T Y P I N G   F O R   I M P A C T toolkit for rapid experiments with theories of change @BorisDivjak U N B O X E D
  35. 35. @BorisDivjak U N B O X E D
  36. 36. @BorisDivjak U N B O X E D
  37. 37. @BorisDivjak U N B O X E D P R O T O T Y P I N G    M E T H O D S V A L I D A T I O N M E T H O D S
  38. 38. @BorisDivjak U N B O X E D Try it out and talk to me about it: www.prototypingforimpact.com Change it and make it your own under Creative Commons.
  39. 39. Thank You Boris Divjak boris.divjak@unboxed.co

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