1) Danish welfare design goes beyond products like prosthetics and catheters to also include important service design that addresses challenges facing the Scandinavian welfare model. 2) Design School Kolding has conducted projects to find new ways to involve civil society in welfare, such as allowing mentally disabled people greater freedom and better care for the physically handicapped. 3) One project involved designing social relationships at an institution for individuals with severe impairments by creating a better way for residents to "have guests" and increasing their quality of life through more relationships.

1. CONNECTING PEOPLE THROUGH DESIGN
By Elsebeth Gerner Nielsen
Rector, Design School Kolding

2. 2
DEMOCRATIC
DESIGN
Over the past century, all Scandinavians earned the right to a
hospital bed when they fell ill and seats for their children in free
public schools. However, that is not the whole story. Scandina-vian
designers and architects have also contributed to ensure
that the welfare state’s material dimensions were of a high aes-thetic
and functional quality – to the benefit of everyone.
Scandinavian design has always been dem-ocratic,
and it remains so if you examine the
development of welfare technology. In Den-mark,
companies such as Novo Nordisk, No-vozymes
and Coloplast have made it possible
to live with a number of common diseases – in-cluding
diabetes – thanks to good design solu-tions.
Coloplast recently won a Red Dot Award for
their SpeediCath Compact Set, a range of cathe-ters
for people suffering from incontinence. They
won because of their stylish, iconic and non-stig-matising
design. At Design School Kolding, In-dustrial
Designer Patrick Bennekov Bomholt Jo-hansen
has created a prosthesis for veterans of
war who return from combat without limbs. Jo-hansen
says his personalised prostheses “are de-veloped
around the interests, dreams, fantasies
and activities of each individual. Instead of having
to use the same silicone-covered leg every day,
they should be able to select their favourite leg, in
the same way we select shoes”.
Thanks to these sorts of welfare solutions, the
Danish health and welfare sector is worth 3.6
percent of the Danish economy and is responsi-ble
for 12 percent of its exports. These numbers
alone justify why Design School Kolding should
focus on welfare design and well-being as an
area of specialisation for all students, regardless
of whether they are fashion designers, industri-al
designers or communication designers. We
recently strengthened our investment through
a partnership agreement with Hospital Lillebælt
and the appointment of Denmark’s first professor
of welfare design, Andrea Corradini from Italy.

3. CASE
While the established system only offers a regular prosthesis,
Patrick Bennekov Bomholt Johansen has considered the over-all
life situation of the amputee: How can the missing limb be-come
an asset for creating and expressing a new identity and a
different life?
Limb was completed as an MA project in collaboration with Aktive Unge Amputerede,
Bandagist Centeret, Ecco, Meatshop Tattoo, 2014
LIMB
EMOTIONAL DESIGN
is welfare design

4. 4
GREY ZONE SOLUTIONS
Our focus is on the hospital’s so-called grey
zones – areas where problems arise but there is
no dedicated professional industry or business
to call upon for solutions. Patient security is one
of these areas. Improper medication costs the
Danish society between four and six billion kro-ner
every year. How do we solve this problem? In-dustrial
Designer Hân Pham has proposed a new
medicine handling system, which requires nurses
who distribute medication in paediatric wards to
wear a small diadem, which indicates that they
are not to be disturbed. Assistant Professor Eva
Knutz is working on another project called Shared
Decision Making to improve communication with
patients – regardless of their social background
– so that they get involved in making properly in-formed
decisions about the best course of treat-ment.
In this field, design is about empowerment
and resilience.

5. 5
CASE
Industrial Designer Hân Pham has created a set of design solu-tions
to minimise the number of medication errors generated
by disturbances and interruptions. Studies show that it takes 25
minutes to get back on track and to focus, once you have been
interrupted and in this window, fatal errors can occur. The design
solutions include safe medication checklists for doctors and nurs-es,
an iPad stand with video instructions, an awareness campaign
about disturbances and interruptions, and a patient book for chil-dren
aged 3-9.
Medicine Handling – Barriers Against Errors was completed in collaboration with
Kolding Hospital, 2011-2012.
INDUSTRIAL DESIGN
is welfare design
MEDICINE
HANDLING

6. 6
CASE
Assistant Professor Eva Knutz has participated in a number of
consultations about cancer diagnosis and examined how shared
decision making is practiced in hospitals. Through a number of
design experiments Eva Knutz investigates the power structures
of the consultations. The aim of these experiments is to make
inquiries into the hospital’s own conception of democracy and to
use design activism to re-negotiate the roles and rights for pa-tients
thereby exploring various disruptive realities wherein the pa-tient
becomes a citizen with democratic rights. The research results
could potentially enhance democratic practices in patient-doctor
consultations.
Patient Democracy is integrated into the partnership agreement between Design School
Kolding and Hospital Lillebælt: Eva worked closely together with the Health Service Re-search
Unit and the Oncological Department at Vejle Hospital. 2013-2014
SERVICE DESIGN
is welfare design
PATIENT
DEMOCRACY

7. 7
CASE
SERVICE DESIGN
is welfare design
Architect Anne Corlin and a team of designers have come up
with a number of recommendations for how to improve hos-pital
wayfinding in order to minimise patient anxiety and avoid
interruptions of staff, which may lead to errors. Their approach
redefines the classic definition of wayfinding because it suggests
that wayfinding begins even with the notice letter that the patient
receives, and which represents his or her first encounter with the
system. Also, the Wayfinding project considers the fact that treat-ments
are changed regularly, which means that the buildings and
the design of the buildings must be flexible in order to meet shifting
requirements. To solve this, the design team uses lights, colours and
pictograms because they are cheap, effective and flexible.
Wayfinding, Middelfart Hospital was completed in collaboration with Middelfart Hos-pital,
2013-2014
WAYFINDING

8. 8
DESIGNING RELATIONSHIPS
Vejle Municipality asked Design School Kolding
to help design social relationships. The concrete
case was Skansebakken, a large institution that
cares for individuals with severe physical and
mental impairment. The designers went about
the challenge employing a series of design meth-ods
in order to create an understanding of the
residents and staff; define and formulate recog-nised
and unrecognised needs and desires; come
up with ideas; prototype a model, and finally test
it. Together with Skansebakken’s staff, they de-cided
to design a better way of ‘having guests’.
It is not easy to greet guests, or even be one,
but thankfully a number of people have taken up
Skansebakken’s invitation to visit. The staff has
already realised that there are benefits to increas-ing
the volume of visitors and that hospitality pays
off. Furthermore, evaluations show that here the
residents’ quality of life has improved; they now
have more relationships with friends, acquaint-ances,
and civil society.
GETTING
CIVIL
SOCIETY
INVOLVED
In other words, Danish welfare design is far
more than prostheses, catheters, insulin in-jections
and other product design. Service
design is at least as important, given the chal-lenges
that the Scandinavian welfare model
faces. In recent years, many of Design School
Kolding’s projects for the public sector have fo-cused
on finding new ways to involve civil soci-ety
by, for example, helping children learn more,
allowing mentally disabled people greater free-dom
in their own home, or providing better care
for the physically handicapped. The projects arise
because of the realisation that we can no longer
afford to let the state bear all the responsibility
for resolving social issues, and that there are also
humanistic and existential problems associated
with the Scandinavian welfare model. Loneliness
is one of our greatest health issues. We seem to
focus more and more on individualism and state
dependence that turns citizens and humans into
clients and patients whose needs are considered
in terms of their economic and human costs. In
Denmark, at least there is an enormous demand
for solutions that hand back some of the respon-sibility
of care to civil society, supporting a move-ment
from welfare state to welfare society. Let
me give you a specific example.

9. 9
ACCESSIBILITY
RATHER THAN CONTROL
But what is the point of getting more guests to
visit Skansebakken? Because all human life is
created through our relationships with others.
Developmentally challenged people have the
same needs as others, but the modern welfare
state has not realised this. On the contrary, peo-ple
are treated as individuals instead of people-with-
a-relationship-to-the-world. As a result,
social institutions lack the social communities
that people need and this leads to some people
only having social relationships with people who
are paid to care for them. Another consequence
is that our social institutions become very isolat-ed.
When neighbours, friends and families are not
present on a daily basis, the care staff not only
loses the opportunity to gain the recognition they
deserve for their impressive work, they also lose
the benefit of being observed. Being observed not
only increases motivation but also makes working
more meaningful. When dealing with problems
that social institutions face, politicians normally
choose to increase state control and oversight.
Nevertheless, we could achieve the same results
by improving how accessible public institutions
are to the public by making them more hospitable
places to visit.
Hardly any Danes are aware of the fantastic work
that thousands of care workers perform every day
in looking after our fellow citizens. This in itself
threatens the legitimacy of the Scandinavian wel-fare
model and calls for change; a type of change
that designers can help facilitate and support.
At the same time, design clearly remains an
aesthetic tool that can make everyday life more
beautiful and functional for the weakest mem-bers
of society, as well as their staff and guests.

10. 10
CASE
The project Designing Relations shows how the conventional
political response to problems – the demand for “more control”
– could be changed to “more hospitality”. This would allow more
people to become part of places like Skansebakken and it would
give citizens with limited lifestyles the chance to experience the
basic human relationships that any human being requires.
In 2013, the project won the KL Innovation Award. The KL Innova-tion
Award is awarded by the Danish National Association of Mu-nicipalities.
The project was completed by Design School Kolding in collaboration with Vejle Mu-nicipality
and the National Board of Social Services, 2012-2013.
SOCIAL DESIGN
is welfare design
DESIGNING
RELATIONS

11. CASE
INTERACTION DESIGN
is welfare design
SOCIAL GAMES
AGAINST CRIME
Assistant Professor Eva Knutz and Associate Professor Thom-as
Markussen together with Delft Technical University, The De-sign
Against Crime Research Unit (London), and the Danish Pris-on
Services, have set up a research project entitled Social Games
Against Crime. The project addresses the delicate situation, which
occurs when inmates receive family visits in prison, especially from
their children. Markussen and Knutz believe that game design, fic-tion
and emotional design can mitigate the situation and give the in-mate
and the child a chance to experience their social condition in
a different light. The goal is to create a new type of game that uses
play and humour to detaboo imprisonment and the fact that ”Dad
is in prison”. The game will create a space in which the inmate and
the child can share emotions and enjoy each other’s company de-spite
the difficult circumstances. By strengthening the relationship
between the inmate and his family, the game enables the child to
grow a relationship with his or her father despite his absence.
Assistant Professor Eva Knutz and Associate Professor Thomas Markussen teach game
design at Design School Kolding and have previously initiated events where research-ers
meet to discuss issues of imprisonment; e.g. the workshop and seminar Designing
Emotions for Games and Narratives in 2012.

12. 12
VISUALISING THE SOLUTIONS
Designers and architects are trained to ana-lyse
wicked problems that are so complex that
rarely a single solution will suffice. As opposed
to other fields, designers are also able to visual-ise
solutions to which both investors and us-ers
can relate. At Design School Kolding, we
regard the latter as being of vital importance
for the functioning of a well fare (in Danish: vel
færden) whose many stakeholders need to see
the potential of welfare technology, rather than
being gripped by fear and conservatism. Design
can liberate man. Designers ultimately support
humankind to unfold its full potential: To be
creative.
DESIGN
AND
PURPOSE
Design School Kolding believes that design-ers
and design need to be more involved in
the development of the welfare state. We of-ten
see that the focus on welfare technology is
more on its ability to improve efficiency and re-duce
staff and less on developing the culture and
behaviour that makes it possible for people to val-ue
welfare technology in the first place. You could
say that the logos, that is direction and purpose,
in relation to welfare technology has been some-what
neglected; and indeed this represents the
focus for designers. While engineers tend to focus
more on ensuring that things work technically and
economists are preoccupied with businesses pro-ducing
a profit, designers think in terms of logos;
that welfare design has a purpose and gives the
users a sense of meaning. When he is at his best,
the welfare designer can create processes that
get technology, economics and human purpose to
meet and form holistic and meaningful solutions.

13. 13
NEED FOR
CONVINCING BUSINESS CASES
There are plenty of barriers that need to be
overcome before design is valued as highly as
technology and economics in the development
of the welfare society. The most significant barri-er
is that man’s need for purpose and meaning is
not traditionally factored in as a precondition for
growth and innovation. It is also not immediately
clear how to capitalise on the value of service
design. How do you earn money on making sure
that citizens are better at taking care of them-selves
and others? We need convincing business
cases.
DESIGN CAN
GIVE US A HEAD START
Still the possibilities are vast. Denmark and the
rest of Scandinavia have a proud tradition of pri-oritising
people, regardless of their social back-ground,
in society’s development. This tradition
can be used to differentiate us from our interna-tional
competitors who, thanks to lower wages,
can quickly defeat us on mere technological
development. Therefore, if we get even better at
including culture, social organisation, values and
meaning into the development of welfare and
well-being, we can gain a head start on the glob-al
market that is drowning in welfare problems.
This head start can also provide a significant tax
boost to support our own welfare. Scandinavia
can design meaningful welfare systems that
improve the lives of many, but it requires includ-ing
design and designers in more of the decision
making – particularly concerning the DKK 40
billion that has been set aside for new hospitals
over the next decade – in Denmark. To convince
the export market of the viability of our solutions,
we need a domestic market that is well function-ing
and developmentally orientated. Many places
are taking advantage of the ability to experiment
and try out new Danish welfare design solutions,
with a view to exporting the successes. For
example, the Region of Southern Denmark has
established living labs in its hospitals where staff,
patients, businesses and knowledge institutions
all work together to develop the welfare state
version 3.0 – but this time with the world in its
sights.

14. 14
11
RECOMMENDATIONS
FOR
IMPROVING WELFARE TECHNOLOGY
1.
SET CLEAR GOALS AND A
COMMON DIRECTION
Many initiatives are developed in isolation and are not prepared for being connected to larger strategic priorities. Every initiative needs to contribute to the strategic direction and have clear goals so that everyone is on the same page. You need to be able to answer the questions: Why should we introduce welfare technology? What do we hope to achieve? Who will it affect?
2.
KNOW YOUR TECHNOLOGY
The greatest barrier in the use of welfare technology is technology that does not work. It is vital that technology is tested in a real context in order to determine which technologies best address the needs. Support and maintenance – both during and after introducing the technology – are vital in the perception of the technology. Good solutions are based on a total experience.
3.
AVOID PRECONCEIVED NOTIONS
Many welfare technology initiatives are too focused on the individual products without taking the actual needs of the user into account, or identifying potential areas of improvement. It is therefore important to gather sufficient information about the technology and the people you are developing for in order to develop a secure knowledge base.
4.
CHALLENGE HABITUAL THINKING AND SUPPORT NEW THINKING
The introduction of welfare technology often stands in contrast to the belief that real people could do the job better. Technology challenges the professionalism and abilities of the staff and fosters insecurity about their abilities and future. It is therefore important to create a new narrative around care and support and involve staff in developing a new profile.
The Lab for Social Inclusion at Design School Kolding works with welfare technology. The LAB has come up with 11 recommendations for people starting out with welfare technology.

15. 15
5.
CITIZENS CAN’T LOSE OUT
People are not all the same and the needs of citizens and patients can change as fewer hands become available to perform the necessary tasks. That’s why we need to reduce complexity, create a flexible system that takes individual needs into consideration and which give users a consistent experience that cuts between the layers.
6.
FIND YOUR ETHICAL POSITION
Ethics often becomes visible when technology replaces existing solutions but creating general guidelines is one thing; putting ethics into practice is something entirely different. Decisions often have to be chosen from several options – decisions that impact people’s lives. The relevant question is therefore not simply what is it that we can replace with technology, but what can technology not replace?
7.
HELP USERS RETAIN WHAT
THEY’VE LEARNED
Giving people qualifications through a course is not the same as developing and applying new skills in a real context. It is important to not merely change work processes, but also completely change a culture. This cannot be taught in a classroom.
8.
GIVE USERS ONE ENTRANCE
The welfare system is complex and it is often difficult to develop an overview and figure out where to get the skills and knowledge you need. To ensure a good user experience it is important to create transparency in the system and establish a self-explanatory frame of reference as well as ensure that the right knowledge is readily available.
9.
COMMUNICATE WITH THE
APPROPRIATE PEOPLE
If people use or are affected by an initiative, they should remain informed about its development and results. Involvement requires following up. Good communication can also foster success and increase the satisfaction of those involved, which will avoid surprises and resistance along the way.
10.
INVOLVE USERS IN THE
WHOLE PROCESS
If users are not sufficiently involved in the entire development process, it can affect the sense of ownership that people feel toward these new solutions. It is also important to be aware that there may be large differences in expectations within the same professional and user groups. That is why you cannot expect that an initiative, which succeeds in one place, necessarily will everywhere.
11.
EVALUATE AND SHARE
YOUR EXPERIENCES
Projects are often evaluated by their impact on a specific target group. However, often the things that do not work are not sufficiently registered. That is why it is important to evaluate the process with the ambition of learning from your errors and experiences. Experiences mean nothing if they are not shared and communicated.
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16. DESIGN SCHOOL KOLDING
Aagade 10
DK-6000 Kolding
T: +45 7630 1100
E: dk@dskd.dk
W: www.designskolenkolding.dk
INQUIRIES
Laila Grøn Truelsen
Head of LAB for Social Inclusion
T: +45 9133 3012
E: lgt@dskd.dk
Editor: Marianne Baggesen Hilger
Fotography: Katrine Worsøe Kristensen
Proofreading: Lotte Eggert Kiil
Design: Kristian Lykke Larsen
Print: inprint
This booklet first appeared as a feature article in the magazine ‘Arkitekten’ May 2014.