HARNESS THE COLLECTIVE
What is Co-Design?
Co-design is a process of co-creating new designs and solutions through harnessing the collective creativity and knowledge of stakeholders and users – Sanders and Stappers, 2008
Co-Design is about formulating and delivering community services and interventions in a partnership – an equal and reciprocal relationship – between funders, service providers and the people using services (and often their carers, families and others in their community). Working together in this way is a better way to get things done and to really meet people’s needs. – WACOSS
Co-design changes the way we think, behave and work together, as well as the steps and actions we take throughout the process of engagement and design. – ACI NSW Health
That means we need new tools to enable our people and organisations to more effectively engage with others. If we are informing others of our intent, that can be a significant process which needs a plan. Co-design is far beyond simply providing information. It is even more complex than consultation. This typically involves stakeholders providing advice about how to tweak a plan, product or service. Co-design involves co-creating ideas using democratic principles where power and information are shared. The result can lead to co-production where various organisations pool resources and assets to jointly delivery the required solution. Our 4D Framework will ensure that your process of co-design brings the relevant players together and harnesses their ideas and resources to build better services, solutions and products which meet real rather than assumed needs.
That means we need new tools to enable our people and organisations to more effectively engage with others. If we are informing others of our intent, that can be a significant process which needs a plan. Co-design is far beyond simply providing information. It is even more complex than consultation. This typically involves stakeholders providing advice about how to tweak a plan, product or service. Co-design involves co-creating ideas using democratic principles where power and information are shared. The result can lead to co-production where various organisations pool resources and assets to jointly delivery the required solution. Our 4D Framework will ensure that your process of co-design brings the relevant players together and harnesses their ideas and resources to build better services, solutions and products which meet real rather than assumed needs.
Informing
Consultation
Co-Creation
Co-Production
Co-Design
ENGAGING SUCCESS
Introduction to Co-Design
Co-design is about looking forward. Through participatory approaches it brings stakeholders together to look at what is needed now and into the future. Engagement and empowerment of participants in the process is critical to the success of the co-design approach. Unless there is mutual input and trust, stakeholders will not take the time to generate and implement better solutions.
The Griffith University MATE model, helps to assess the level of engagement of stakeholders to your project.
When preparing to apply co-design within your setting there are a few frameworks that can help to set you up for success. We have included three to consider in planning for implementing co-design:
FRAMEWORK FOR GUIDANCE
Are you ready for Co-Design?
The co-design maturity framework helps you understand where you are at as an organisation regarding applying meaningful co-design. More time might be required to develop the culture, systems and engagement necessary to do co-design if your organisation is used to merely informing your audiences of your intent.
Emma Blomkamp’s co-design maturity model articulates the 5 stages of co-design maturity that can occur within an organisation.
Credit: Emma Blomkamp 2022.
BEST SOLUTIONS EMERGE
Principles for GOOD Co-Design
When preparing to apply co-design these principles can be used to guide the practice and approaches to ensure the best outcome is achieved. This will help to ensure participants feel heard and the best solutions emerge.
1. Equal partnership
2. Respect and Trust
3. Data Driven
4. Comprehensive
5. On-going
6. Clarity of Purpose
7. Inclusiveness
READY FOR CHANGE?
Activate People’s Agency
In order to sustain the change needed through new solutions we must also understand the adaptive side of change. This harnesses the power of people and their motivations to advance and sustain improvement. The IHI framework helps to better understand and respond to these needs, ensuring the sustainability of solutions.
1. Unleash intrinsic motivation
2. Co.Design people driven change
3. Co-produce in authentic relationships
4. Distribute power
5. Adapt in action
Co.Design4All
Our 4D Framework
Co.Design4All is a comprehensive approach to developing solutions tailored to your clients, community and patients. It leverages the resources available locally to deliver better solutions.
The approach is made up of four key components:
1. Overarching Framework
The four core phases of the toolkit include: Discover, Design, Decide, Debrief.
2. Iterative process
The arrows indicate the iterative process that needs to take place within each phase of the framework. New information should always be used to review what is known and what needs to be known to create a better solution. Taking the time to unearth all that is needed to dimension a problem will be gold when it comes to analysis of options and planning for implementation.
3. Key stages
The stages of activity under each phase of the framework unpack the actions necessary to do co-design. Co-design is not linear. However, the outputs from each stage will enable progress through the model.
4. Reflect and Plan
Working on complex problems with lots of people requires reflection. Is the plan needing more attention before you move to the next phase? Are you confident you know everything you need to know and stakeholders share that knowledge? If not, take the time now to bring them closer to the action. This will be supported by key questions related to each reflect and plan point. Your answers help keep sponsors on board with the time being taken for the project. Better planning improves the chances of success.
Our framework guides you through tools, specifically created for each of the 4 phases across the 14 stages of our CD4A model.
There are over 100 tools currently available so that you have choice as you need to plan the approach to different projects. More tools are being added all the time as the literature and practice related to co-design improves. There are nearly 100 tools currently available and we will be adding more as we rollout the model.
Co.Design4All
Our 4D Model
The overarching framework of the toolkit includes 4 key phases:
Our model guides you through tools, specifically created for each of the 4 phase across the 14 stages of our CD4A model.
There are over 100 tools currently available and we will be adding more as we rollout the model.
DISCOVER
DISCOVER is the phase of the framework used to explore the key issues, discuss the current state with stakeholders and research potential solutions
5
Stages
32
Tools
DESIGN
DESIGN is the phase of the framework which involves the recruitment of participants to work on the design of solutions and plan the core activity of co-design
3
Stages
34
Tools
DECIDE
DECIDE is the phase that involves analysing the co-design outputs and deciding on the best solutions
2
Stages
21
Tools
DEBRIEF
DEBRIEF phase includes building an evaluation plan, reflecting on practice and planning the exit process
4
Stages
21
Tools
TRANSITION GATES
Gates to Reflect & Plan
The reflect and plan component of the framework has been designed to provide a point to review what has been achieved, then based on this review process, plan for the next stage of implementing the toolkit.
There are a set of outcomes or questions that should be considered at each Gate as your initiative transitions from one Phase to the next.
Reflect
on Outcomes from the current phase
Plan
asking the right questions to set your project up for the next phase
Reflect & Plan
Reflect & Plan
Reflect & Plan
CO.DESIGN4ALL
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Co.Design4All is a growing community of practitioners, project leads and stakeholders from across many sectors who all deploy a similar model of co-design. Whether you are new to group facilitation, a novice at managing engagement or a seasoned change project leader, you will find amongst our Members and Founders people facing the same challenges and opportunities as you. Benefit from their decades of expertise.
TESTIMONIALS
What our clients have to say
Anna Hebron
Managing Director and governance expert
Championing Patient-Centred Approaches
Tracey Johnson is one of those special people who light up a room with her energy and passion. She inspires those around her by her drive to make a real, positive difference. What’s so incredible about Tracey is how deeply she lives her values – always championing patient-centred approaches and empowering communities. She’s a true innovator and has a treasure trove of stories from her decades of experience leading change and reform across all kinds of sectors. Honestly, she can tackle any challenge you throw at her – whether it’s big-picture strategy or hands-on problem-solving, Tracey moves effortlessly between both. She has an amazing ability to bring people on the journey – when she speaks, people believe that better futures are possible and with Tracey leading the way, they absolutely are!
Tracey Silvester
Executive Officer
Engaging, Successful, Credible
I have been witness to Tracey Johnson’s knowledge of the health care system and her exceptional group facilitation skills. She is a master at understanding the complexities in which health services operate; an understanding that is reflected in the quality of the co-design tools and resources that have been developed. Her ability to clearly communicate complex concepts and engage diverse audiences ensures the success and credibility of her work. I am confident that these attributes and Tracey’s commitment to making a difference will make the website a valuable resource for all users.
TBC2
TBC
Best Co-design Process
This has been the best co-design process I have even participated in……ACTUAL co-design.
Meredith Cummins
CEO Neuroendocrine Cancer Australia
Wonderful Co-design Workshop
Wonderful to be involved in this co-design workshop to ensure the model of care for all cancers benefits all cancers.
TBC 1
TBC
Fantastic Co-design Workshop
Fantastic to have been part of the codesign workshop with McGrath Foundation and Natasha Doherty.
Stacey Allerton
Patient Advocate
Compassionate Co-Design
Thank you to Natasha Doherty for a kind and compassionate session co-designing the McGrath Foundation model of nursing care for all cancers!
Cathy Baynie
Practice Consultant & Past President AAPM
Highly Recommend Co.Design4All
I highly recommend this resource as the necessary tool that will support and foster the needs of all stakeholders in the co-design process. Tracey and Nat have an in depth and lived understanding of what is required for a successful outcome. Their skills in working with groups and inspiring others are second to none.
Cathy Baynie, Registered Nurse. Practice Consultant & Past President AAPM (Australian Assoc of Practice Managers) Manager Advocacy and Health Workforce
Michele Smith
Australasian College of Dermatology
Excellent Co-Design – resounding success
The “Excellent Co-Design” training by Tracey Johnson and Natasha Doherty has been a resounding success. It not only enriched the skill set of the WNSW PHN Primary Care team but also instilled a culture of collaboration and innovation that will propel the PHN’s mission to improve primary health outcomes.
Freddy Ortega
WNSW PHN Primary Care Team
Transformative, Comprehensive Training
The “Excellent Co-Design” training, expertly delivered by Tracey Johnson and Natasha Doherty, has been transformative for the WNSW PHN Primary Care Team. This comprehensive training has equipped the team with vital skills in community engagement, service innovation, and program implementation—key components for addressing complex primary care challenges, especially in rural and remote contexts
Tracey Silvester
Executive Officer ACHSM
Quality Tools & Resources
Tracey Johnson is a master at understanding the complexities in which health services operate, an understanding that is reflected in the quality of the codesign tools and resources that have been developed. I am confident that these attributes and Tracey’s commitment to making a difference will make the Co.Design4All website a valuable resource for all users.
PLACE BASED CO-DESIGN
Who is Co.Design4All for?
Co-design is a way of working which applies as easily to health and social care delivery as to regional development or scoping major projects in the mining and infrastructure sectors.
Here are some examples of initiatives that have adopted Co.Design4All framework:
Health
- Creating local health pathways.
- Designing outpatient services in community setting.
- Creating integrated care solutions.
- Designing continuums of health and social care at life milestones like the first 2000 days.
Regional Development
- Creating regional economic development plans
- Forming industry clusters
- Supply chain projects
- Regional tourism initiatives
Property
- Developing masterplans for new communities.
- Community engagement for major developments
- Stakeholder input into mixed use developments
- Community engagement for change of use applications for heritage sites
- Gaining input into town plans.
Major Projects
- Completing regional economic planning around major investments in energy, manufacturing and ore processing facilities
- Engaging in community consultation around major infrastructure like new highways, stadiums, educational facilities and hospitals
- Ensuring legacy value from facilities associated with major events like staging the Olympics or international sporting events.
So, no matter your background, everyone trying to produce novel solutions which need to be endorsed by or involve others needs to be familiar with the core elements of co-design.
OUR PARTNERS
Who is using CO.DESIGN4ALL
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CO-DESIGN IN ACTION
Healthcare Case Study
Hospitals are finding that patients want choice about where to attend out patient appointments. For those with long-term conditions like kidney disease or hepatitis, the burden of attending a hospital campus each quarter for life is difficult. Time away from work, carparking costs and time spent waiting at the clinic are not acceptable in the modern age.
Through combining access to the expertise of Physicians and specialist Nurse Practitioners with the doctors, nurses and allied health in primary care, new models of care are being developed around the world which mean patients can attend care closer to home. The integrated care models might involve using telehealth to bring physician input into patient consults being managed by their usual general practitioner. It could mean holding monthly clinics with a combination of hospital and general practice staff working together to deliver better care.
The emergent case studies around such integrated models of care are fairly consistently showing higher patient attendance and satisfaction and slower progression to end stage disease with lower costs to the health system. Designing such models of care means listening to patients and their families and carers about the supports they need to stay well. It involves working with clinicians to identify who can perform which task so that everyone is working to their top of scope of practice and in a manner which will be remunerated. It necessitates the creation of new systems and delivery of training to those involved and the patients making use of the services.
Evaluation models to ensure the change to a new model of care is safe need to be designed within the structures of siloed datasets and patient privacy regulations related to patient data. The infrastructure in community facilities needs to be able to accommodate different workflows and data exchange. This is all complex. It means overcoming fiefdoms, sharing funds and changing power balances.
Co-design is a consistent thread in the creation of all such projects. That is why in every country health innovation agencies are recommending co-design.
questions and answers
FAQ’s
Co-design has been explored in many sectors for about 50 years. Various co-design models have been documented. Many just focus on the way to set up meetings and consultations to ensure people feel comfortable sharing. The Co.Design4All Framework is more extensive. It asks for the collection of data and comparison of opinion from key stakeholders to a problem about whether a problem even exists and how they define it. Once the key funders and authorities are engaged, it then moves into planning of which users and community members need to be involved. The lens for doing this is around “place”. It is at a community level or region that certain assets can be found or funds and strengths leveraged. So rather than dealing at a macro level, this approach calls for working with meso system level stakeholders and those users at the micro level. This combination gets more localised designs. The 4D Framework spends time looking at evaluation and project handover. Ensuring implementation is well supported improves the likely success. Finally, and uniquely, the model asks those involved to reflect on their own performance along the way, provides tools to grow professional competence and focusses on the communication and conflict skills involved in managing diverse groups of people.
Co-design takes time. The exact amount of time will vary based on the situation and stakeholders. If a problem has been around and challenging for a while, more data might exist and organisations might be more willing to share and engage. That means the time in discovery might be shorter. The decide phase might be truncated if the options available are small and there is an obvious best choice which comes with sufficient funding. However, none of the phases is optional. All need to be undertaken and those involved satisfied that the project is ready to move on based on reflections at the three gates in the model.
Facilitators often come with skills in making people feel comfortable in group settings, holding and focussing attention during workshops, documenting agreements and overcoming conflict. They may have no sector specific knowledge but great process skills. The 4D Framework attempts to put the techniques and knowledge of professional facilitators into the hands of industry experts from a wide variety of fields. In the process, it can reduce the costs involved in getting groups engaged in new ways of working together. It also means that you can start using co-design even before you have official permission to do a co-design exercise. For anyone involved in creating coalitions supportive of change, co-design and the tools involved are a great resource which will speed up projects and reduce the stress involved.
Every problem arises in a context. That involves the people, institutions and histories of that area. Those same people, organisations and stories can be used to develop and implement better solutions. Taking a localised and strengths based approach is more likely to ensure that designs meet the needs of an area and resources outside of your organisation or department can be harnessed ensuring greater impact.
People like change they control and where there is a direct benefit. That is why creating a trusting, collaborative environment where everyone gets a say is important. Too often we design square pegs to fit into the square holes we are familiar with. This is not helpful for those used to round holes. Finding ways to scope the respective needs and inclusively develop solutions which meet those needs reduces conflict and improves the take-up of new solutions.
Sometimes we need to stimulate healthy conflict to ensure that everyone’s cards are on the table. We need to name the elephants in the room so that alternatives are visible and considered. This requires skilful manoeuvring by people who are trusted with having the best interests of the organisation, community or consumers at heart. Utilising co-design processes makes things visible and people more accountable for actions and results. That diffuses conflict and enables everyone to commit to better futures.
thought leadership
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