Sustained Participatory Design: Extending the Iterative Approach

The authors describe an initiative in implementing Participatory Design in the healthcare sector in Denmark. They begin by outlining the salient features of Participatory Design ; their sustained approach uses iterations of design and implementation, emphasising improvisation, experimentation, and learning. 3 types of organisational change - anticipated, emergent, and opportunity-based - are noted, and they discuss how to move iteratively through the 3 change perspectives. Their experiment involved the implementation of an Electronic Patient Record (EPR) system, with the close involvement of both the vendors of the software and the regional health authority. The 4 steps identified for the iterative approach were: 1] identifying the required change; 2] accurate specification of the changes required through workshops with clinical staff and software designers, which listed essential clinical activities; 3] a 5-day trial period during which identified unanticipated changes; 4] evaluation of the trial period, including quantitative analyses verifying positive effects. The authors conclude by addressing the challenges for Participatory Design : establishing appropriate conditions; managing the interests of all the stakeholders in the process; managing ongoing implementation; and an experimental period during which the system is in use, but is still open to change.