People are demanding increased transparency and participation in government decision-making processes. Project Heart brought together people with lived experience, researchers, designers, and policy analysts to co-envision a way for engagement to be meaningful and bring about more caring and equitable futures for all. The findings are a rallying call for governments to change common practices and move towards co-designing policies/programs as a path to (re)building community relationships.
Innovation Summary
Innovation Overview
Engagements are no longer a "nice to have": roundtables, working groups, committees and councils that include persons with lived experience (PWLE) are becoming more common across governments and other sectors. Yet, when we do engage people, we often focus on what we (as engagers) need and is achievable —we have little understanding of the needs and desires of those being engaged. The project goal was to learn about the current states of engagement and then innovate how we go about engagement when developing healthcare policies and programs.
During the first phase of the project (using design thinking and design research methods), we learned that when PWLE speak of ideal engagements, they often speak about trust, collaboration, partnerships and relationships. But when they speak of their actual engagement experiences, they often speak of feeling tokenized and that their participation was inconsequential. Furthermore, policy analysts leading engagements spoke of feeling that they were stuck in a process that didn't serve them or the engagement participants. It was clear that engagement wasn't working for either those leading it or participating in it, and, based on the data collected, the ideal engagement experience communicated by PWLE pointed towards a co-design approach.
To test this assumption, we designed the next phase of the project to use co-design to refine and develop engagement recommendations, as well as test the co-design approach as a way to engage. The co-design sessions included: co-designing the co-design sessions; co-envisioning desired futures of engagement; prioritizing these futures; ideating paths towards this ideal future state; gaining feedback on the experience of co-designing. The results from the pilot communicated to us that collaborative approaches like co-design feel impactful to both PWLE and policy analysts and work to build trust and strong relationships. Through co-design we were able to co-develop four preferred approaches to engagement as well as four organizational mindsets that can lead to more meaningful engagements.
Since completing our findings and socializing around the Department, it is clear that there is an appetite for doing engagement better and embracing a co-design approach. We've hosted many training workshops on how to use this approach in various health policy files. While our project centered on engaging PWLE, there are other applications as well, such as co-designing with industry partners, provincial governments, and citizens in general.
Next steps for the project team are to co-design with PWLE and policy analysts a specific training on collaborative mindsets that focuses on how to facilitate engagements through the lens of “nothing about us without us." We will use iterative prototyping with multiple rounds of feedback and testing. Currently, we see training and capacity-building as central to scaling the co-design approach throughout the Department.
Innovation Description
What Makes Your Project Innovative?
This project is innovative because:
- Engaging persons with lived experience (PWLE) at the federal level is still a novel practice. There are not many opportunities to have policy analysts and PWLE at the same "table", and the use of transparent, collaborative tools is still uncommon. The kind of engagement we are calling for pushes the boundaries of current practices (e.g. consultations, surveys) and requires more accountability, transparency and relationship building.
- The project team attempted to embody a collaborative, partnership approach with PWLE throughout the project, including shared decision-making and authorship (both uncommon in government). This required the project team to pivot based on feedback from PWLE and be reflective about our traditional work processes.
- This project also highlighted the importance of qualitative data in a typically quantitative data-heavy organization. Changing mindsets on this particular point is an interesting challenge.
What is the current status of your innovation?
As of this submission, the project has completed a pilot of using co-design as a way of engagement and is currently diffusing lessons around the Department to promote others to attempt this method in their policy work. The project team is working on a funding proposal to co-design (with policy analysts and persons with lived experience) a training prototype specific to the findings. This will allow us to once again test the use of co-design, as well as develop a training product to support implementation of this approach throughout government.
Innovation Development
Collaborations & Partnerships
Numerous project collaborators were involved, including:
- Advisory committee that consisted of policy analysts, engagement specialists, persons with lived experience
- Persons with lived experience and Engagement specialists across Canada that participated in interviews about engagement experiences
- Co-designers who planned the co-design session (persons with lived experiences, policy analysts, design researchers)
- Co-design participants (policy analysts, persons with lived experience)
Users, Stakeholders & Beneficiaries
This approach to engagement has the potential to: build trust in communities and humanizing people as active and valued contributors; ensure that PWLE experiences, including those from historically marginalized or underserved groups, are reflected in policies and programs, resulting in better health outcomes for all people living in Canada; increase the chances of policies being relevant and useful for those it is intended to serve, helping to circumvent misplaced investments.
Innovation Reflections
Results, Outcomes & Impacts
This project employed open-ended qualitative research methods. The goal of the co-design stage was to use what we learned about engagement from interviews and an environmental scan to co-design desired futures of engagement, prioritize them, and ideate paths toward this preferred future state. By using this approach, we were also able to test what engagement might look like when it prioritizes collaborative and meaningful relationships. To do so, we designed a series of co-design sessions as a pilot. We learned through participant feedback that bringing people in as collaborators builds trust and makes engagement more impactful. This initial but powerful data signals to us to continue test trialing and prototyping this approach more broadly
Challenges and Failures
This project required a shift in established mindsets in the organization around expertise, failure, and risk, and it surfaced tensions around existing decision-making structures. There was a learning curve for employees for trialing and adopting new technologies and ways of working. Overall, we are learning that the implementation of our findings is not straightforward as it requires change at a deep level (ways of working, mindsets). We are addressing these challenges by sharing them broadly across the Department in order to inspire reflections and conversations on how we can evolve our organization to be more risk-tolerant and innovative.
Conditions for Success
This project was funded under a specific innovation program (the Solutions Fund) which gave the project team funding, time, space, support to explore this problem and pilot a potential solution. Without this program, and the related rules, leadership, guidance and resources, this project would not have been possible. It points towards advocating for more "sandbox" spaces for policy work so we can ideate and test innovative ways of working prior to implementation.
Replication
This model can be replicated in a variety of organizations nationally and internationally. The approaches, mindsets and pilot that we share are written in a way that provides guidance yet honours the principles of co-design, which will be unique to each context and situation. We've presented this work in our organization and externally, including international audiences, and audience members have been keen to learn more and apply the work in their organization.
Lessons Learned
This project taught us that meaningful engagement was about a lot more than the engagement session itself — it was about embodying new ways of showing up for each other grounded in collaboration, humility, and trust. Specifically, the project:
- Redefined engagement from the perspective of PWLE;
- Tested a different engagement approach grounded in co-design and relationship building;
- Explored new ways of working and outlined mindset shifts that can help teams collaborate differently to create meaningful change.
The project findings are an invitation for the public sector to relate to engagement as a path to building more meaningful relationships with communities and each other, leading to more caring and equitable futures for all.
Status:
- Implementation - making the innovation happen
- Diffusing Lessons - using what was learnt to inform other projects and understanding how the innovation can be applied in other ways
Files:
- Project Heart Future of Engagement Report Full project report
- McMaster Co-Design Hub Workshop Co-design workshop based on project findings
- Executive Summary (1) Project executive summary
Date Published:
27 June 2024