Designing Healthy Organizations: Education and Transparency in XD Consulting Work

Service Design

Orchestrating experiences in context

A column by Laura Keller
October 7, 2013

Imagine that you’re checking into a hospital to receive medical care. You don’t really know what’s wrong with you, but you know something isn’t right. You feel light-headed, short of breath, and have a severe headache. You could have waited to see whether you improved on your own, but you’re worried it might be something serious, so you seek expert advice sooner rather than later. Doctors and staff come in to see you and go out. They’re polite, but answer your questions curtly, and you don’t know exactly what’s going on. You wonder, What is wrong with me? What are they testing for? Will I be okay? When will I go home? When they discharge you and you’re ready to leave, the staff finally give you your diagnosis, along with written instructions explaining what you need to do. As the hospital staff proceed to treat other patients, they leave you to figure it out on your own, and you head home.

Can you imagine such a hospital experience—being kept in the dark about your own diagnosis and prognosis, until you’re about to be discharged? Can you imagine a medical staff expecting you to change your behavior based on a few brief interactions with them and a set of written instructions? Luckily, the healthcare industry has figured out more effective approaches to treating patients and achieving better outcomes. Unfortunately, those of us in experience design (XD) consulting have not. In this column, I’ll first explore why the typical XD consulting approach is not healthy for our client organizations. Then I’ll look at what I think should be the ultimate goal of an XD engagement: educating our clients and being transparent about our XD methods and approaches.

Champion Advertisement
Continue Reading…

XD Consulting: Designed for Stagnancy

The typical XD approach is fairly formulaic:

  1. Doing up-front planning and engaging with the stakeholders to help them understand the project goals and discuss project administrivia.
  2. Conducting some form of user research to gather insights about the core audiences who will interact with the product being designed.
  3. Providing a set of recommendations and design concepts.
  4. Doing additional phases of validation with the core audience, which may continue iteratively into implementation.

Throughout this process, XD consultants engage stakeholders at major milestones to get their input and approvals. If appropriate, we encourage stakeholders to observe the insight-gathering activities themselves, so they can see what we’re seeing, or we share videos or other research artifacts that capture what we’ve learned. All along the way, our clients blindly nod and agree, maybe asking a few questions here and there for clarification. But they generally caveat their comments with “You’re the experts.”

At the end of an engagement, we present our recommendations and deliver a final set of design assets, which could be anything from design concepts, to a prototype, to even an operational solution. We also likely share our ideas for change management with the client and, most important, how to maintain and optimize the solution over time through measurement and analytics. Then, we leave. We move on to our next big thing and hope our clients have taken our recommendations to heart. But what do our clients do after the consultants leave? The stakeholders and the organization continue on as before, owning some beautiful new deliverables and concepts, but wondering, Now what?

I am always shocked and disappointed by how much good XD consulting work lies stagnant and remains unused—and by how organizations continue to create bad experiences. Sometimes the reasons are beyond our clients’ control—such as budget cuts or stakeholder changes. But all too often, the explanation is simply that the organization was incapable of putting into action the great ideas they garnered from the design process. I believe they really do attempt to carry through with the work. We’ve heard feedback such as, “The insights and the design work were great, but then, when it came time to implement them, I don’t know, we just couldn’t make it happen.” Or “We just couldn’t translate the deliverables into what we actually needed to do.” I believe our client organizations have a much greater chance of creating good experiences when they can see first-hand what it means to do experience design and begin internalizing our practices themselves.

XD Consulting: Not Unlike a Bad Medical Experience

Let’s compare the aforementioned hospital experience to XD consulting. Imagine that our clients are the patients and we, the consultants, are the hospital staff. Our interactions with our patients are transactional and without true meaning—much like those of the medical staff that I described. Vacuous statements such as, “We’re going to take your blood work today” and “We’re just monitoring your heart rate” are not so different from “We need your approval of the site map before doing wireframes.” With each interaction, the patient needs to know what’s going on, but the hospital staff doesn’t feel comfortable sharing information before they know exactly what is wrong and what they can do about it. XD consultants frequently act covertly, exposing their methods and deliverables to clients only at predesignated milestones. We are notoriously uncomfortable with requests to see our in-progress thinking. So instead, our interactions become very transactional—intended to elicit only what we need to do our jobs and move the project forward.

In the hospital example, when the staff finally feel comfortable sharing the details of the diagnosis and prognosis—it’s just stress, by the way—they tell the patient he’s ready to be discharged and provide him with some information about what to do when he’s at home. That’s it. The closing conversation is just as transactional as the previous ones because they’re now readying the room for the next patient to arrive.

In consulting, when we share our final findings and recommendations, this presentation usually marks the end of the project. We’ve likely given our client some deliverables along the way, but typically, we don’t consider them final until the very end of the project. Unfortunately, this usually occurs when the consulting team is ready to move on to a new project, so we’ll provide minimal support and not much of a transition.

Emphasizing Transparency and Education

Fortunately for us, as patients, the sort of hospital experience that I described earlier is happening less and less frequently. Studies have proven that medical care should focus on education and provide transparency throughout the process rather than consist of transactional touchpoints whose intent is to protect staff integrity rather than address patient needs. Now, doctors and staff explain complex medical concepts in easy-to-understand terms rather than clinical jargon that demands simple trust from patients. They reveal their clinical decisions to patients rather than keeping them secret. They encourage patients to practice healthy behaviors while they’re in the hospital and explain the benefits of these behaviors rather than speedily giving patients written instructions at the end of their hospital stay. Staff also follow up with the patient after the visit rather than assuming the patient’s primary care physician will address the patient’s need, as was previously common.

These new medical practices are improving patients’ health outcomes. Patients are being exposed to the process and have an active role in it rather than being treated as though they’re simply on the receiving end of various medical activities without knowing how they pertain to their health. Similarly, to effect true transformation and enable our clients to realize our design recommendations, as XD consultants, we should emphasize transparency and education in their engagements with clients.

How to Create Healthy Organizations

With several of our clients during this past year, we have tried a few new approaches to increase the transparency of our process and enhance the educational value of our work to our clients. But before I outline these approaches, I have three important caveats:

  1. The goal is not to make people who aren’t designers be designers—just as an effective medical experience doesn’t mean that a well-educated patient could suddenly become a doctor. Our clients aren’t going to go from working in, say, Human Resources to creating wireframes or designing service prototypes. Rather, the goal is to help organizations start to learn and adopt good XD practices, so they can sustain these activities when the consultants leave.
  2. Not all organizations want to understand how we do what we do. Some clients are quite content with XD consultants being the experts and the magic staying behind the curtain. They don’t want to heap another burden on their own team.
  3. Similarly, not all organizations experience problems when embedding XD recommendations into their work. Some have in-house people who can carry the recommendations forward.

For every situation like those I mentioned earlier, where quality XD work has gone unused, numerous examples exist where just the opposite has occurred. The key is to discover early—during the proposal phase—whether a project and an organization are a good fit for one of the following approaches, by explaining the options and their benefits and assessing the client’s interest in pursuing them.

The Client as Team Member

Rather than conducting insight-gathering and design activities behind closed doors, we brought our project stakeholders directly into our project team, making what we did and how we did it completely visible to them. On one project, we were helping to redesign a self-service IT ticketing application. We conducted up-front interviews and created scenarios and personas. Our final deliverable was a prototype of the future system.

We solicited eight employees from the client team to be our evangelists, all of whom had suitable roles for owning these types of XD activities. With both these team members and their managers, we set expectations for the level of involvement they would have—the number of hours that would be required—and the benefits of including them on the team. They participated in our reviews, saw early drafts of various deliverables, and attended our team meetings. We also led training sessions for them on the use of personas, research methods, and conceptual designs. Near the end of the project, we gave these new design evangelists homework assignments. They were able to create research approaches and personas and moderate interview sessions, with us overseeing their work.

The Client as Student

On another project, the client wanted to get feedback on the employee experience of applying for a disability leave. They had recently changed their insurance provider and wanted to understand employee expectations of the new process. The client was familiar with doing interviews and wanted to own those activities, but they knew they weren’t the subject-matter experts on experience design, so wanted someone to help them along the way. We acted as their teachers and advisors, reviewing their deliverables, conducting interview run-throughs, and providing feedback on their interview sessions. This approach allowed the client to jump head first into their research activities, but with the safety net of our support and advice.

The Client as Colleague

For a few projects, we created engagements that focused less on multiperson consulting teams and more on resource augmentation, placing either a member of our full-time team or an external contractor at the client site. Usually, these projects were with clients who were about to start a large IT system redesign that would span years—or in one case, with an organization that wanted to create an internal XD COE (Center of Excellence).

The benefit of this approach is providing clients with ongoing, one-on-one access to an XD resource that has been vetted by our team, along with broader connectivity to and support from our full-time staff. For the organization that wants to create an XD COE over the long term, we can use these resources not only to support the engagement at hand, but also to provide reconnaissance and increase our understanding of the company, how they function, and how projects run. The insights that we have gained from the people who are working closely with the client have been invaluable to us in enabling us to assist them in creating a COE strategy and plan moving forward.

Why Transparency and Education?

If the idea of teaching our clients how to do the work of XD consultancies sounds like blasphemy to you, I understand. It kind of is. We’re not really accustomed to teaching our clients essentially how to do our work. However, I can no longer turn a blind eye and just hope that a client will actually follow through on our insights and recommendations. I’m far more excited by the prospect of actually teaching an organization how to adopt XD practices and skills to create good experiences for people.

As I have said to numerous clients, “I don’t want to be doing research with you again in two years. I’d rather enable you to do it yourself.” Part of me realizes that I am potentially consulting my way out of a job. The irony, however, is that clients who engage in this more educational and transparent approach to consulting see it as evidence of a true partnership. We’re doing what’s right for their organization. They, in turn, trust us more, and that creates a more sustainable relationship, which has reciprocal benefits to the client and our consultancy. And, on top of the value that such an approach provides to both a client and a consultancy, the greatest benefit is to the people who get to experience good designs as a result. After all, aren’t they the ones to whom we have the greatest responsibility? 

Director of Strategy & Experience Design at NTT Data

Woodbridge, New Jersey, USA

Laura KellerLaura’s 10 years of experience have focused on representing the human element in any interaction with a brand through actionable, business-impacting insight gathering and design. At NTT Data, Laura leads cross-channel experience design strategy engagements for clients. Clients have included AstraZeneca, Hachette Book Group, GlaxoSmithKline, Prostate Cancer Foundation, Honeywell, and the NBA. In addition to her Service Design column for UXmatters, Laura has written articles for the Service Design Network’s Touchpoint: The Journal of Service Design, User Experience Magazine, Communication Arts, and Johnny Holland. She has presented on service design at SDN’s Global Service Design Conference, the Usability Professionals’ Association International Conference, IxDA New York City, and IxDA New Jersey.  Read More

Other Columns by Laura Keller

Other Articles on Service Design

New on UXmatters