Designing for care together: Enhancing future practices through newspaper-driven co-design

With rising healthcare costs, increasing demand for personalized services, and heightened awareness of government services, the healthcare sector and academia have recognized and embraced the more active role of customers in co-creating healthcare service experiences (Gill et al., 2011; McColl-Kennedy et al., 2012). However, healthcare is a complex industry, with multiple stakeholders (from users to frontline staff, managers and insurers) interacting with multiple services (from primary care and networks of academic organisations to medical technology systems) across multiple sectors (from clinical practice to government) (Jones, 2013).

In this complex medical environment, many healthcare-related technological studies have begun to explore design thinking and methodologies (Villalba et al., 2021). Participatory design methods, by including all nursing-related groups in the design process (Du Preez & De La Harpe, 2019) and even co-designing and improving tools (Galabo & Cruickshank, 2022), attempt to address the challenges of complexity in nursing. Over the years, Sanders and Stappers (2008) defined co-design, emphasizing the co-creativity of designers and non-professionals in design development. Ultimately, scholars from various fields have gradually reached a consensus in the exploration of design thinking: the design process focuses not only on products and predefined functional services to meet customer preferences or achieve measurable performance goals (Strokosch & Osborne, 2023). Instead, design understands multi-level interactions, experiences, and values with an open, participatory, and inclusive mindset, exploring the long-term impact on social change (Kurtmollaiev et al., 2018).

However, some have questioned the idealized view of participatory design. While design helps promote democracy and support better living and experiences for users (Righi et al., 2018), new service concepts often fail to be implemented long-term, and organizations remain perplexed by complex systemic problems. The slow adoption of collaborative design in businesses is due to threats to existing professional hierarchies, fear of novelty, risk aversion, and bias against unconventional methods (Bason, 2014; Kurronen, 2014). Moreover, the design language differs from other departments, and service departments unfamiliar with it do not see the benefit of learning design language and tools for their work (Clark, 2019). Therefore, to adopt new solutions created through collaborative processes, designers must respect and understand the habits and thinking of organizations (Junginger, 2014), internalizing the design process into a narrative style they are familiar with. Secondly, design is often seen as a phased activity, including classic stages of analysis, design conceptualization, implementation/development, and the use of various design tools. However, this view of design is quite limited. More people realize that design continues when people use and apply technology in life (Righi et al., 2018). Without a long-term perspective, it may be difficult to argue whether key values in practice development research, such as mutual learning, empowerment, democratization, and practice change, have been realized (Balka, 2010; Bossen, Dindler & Iversen, 2016; Bratteteig & Wagner, 2016).

In fact, facing these questions, participatory design activities are still rarely viewed from a long-term perspective. Most PD research focuses on design activities and tool use, paying little attention to changes that may occur after the design project ends and how design internalizes into a language used by users long-term. In the public service sector, some scholars have proposed using serious games or future newspapers to bridge this gap. The concept of future newspapers, an innovative PD process, transforms design concepts from just the implementation phase of a project into a familiar mechanism in the social and political media landscape, providing a platform for community members to discuss and imagine the future together (Lin and Wu, accepted). This offers a new perspective on how participatory design can use organizational cultural heritage for long-term design. Therefore, inspired by future newspapers, this study will continue to explore other characteristics of newspapers and their contributions to the design process, ultimately considering how to establish a long-term common language in participatory design and the role of participatory design in building organizational design thinking capabilities.