Merging Theory and Practice in Service Design

Part 6: Attributes of recursive relationships — what are they and how are they helpful?

Building on the theoretical foundations laid out in parts 2 through 4, and the redefinition of the three elements of the Triality Framework in part 5, we now turn our attention to the specific characteristics of each relationship between these elements. These characteristics are essential for creating and designing complex services in complex contextual environments, tailored to diverse user groups.

We refer to these characteristics as ‘attributes’. For each attribute, we’ll explore its significance, look at a supporting example, and introduce a series of 54 questions. These questions are intended to stimulate reflection, in-depth analysis, and assist service designers in assessing the alignment between the service design, user needs, and business requirements.

Let’s start by looking at the attributes of the context-service relationship.

A. Context-service relationship: enhancing service responsiveness and relevance

The attributes of this relationship highlight the need for services to be dynamically aligned with changing contextual needs.

By focusing on these attributes, service designers can ensure that their offerings are efficient, scalable and capable of evolving with the context. Furthermore, it means that the services are robust against shifting user expectations, and are built for longevity and impact. There are 6 attributes to consider, including:

1. Flexibility and adaptability: balances the envisioned capabilities of the service with real-world needs, addressing challenges such as regulatory constraints and ensuring the design supports user and business expectations, learning, and feedback provision. An example includes a telehealth platform that adapts to different population healthcare needs in various regions while being flexible enough to integrate different regulatory requirements and feedback from both patients and healthcare providers in these regions.

2. Efficiency and effectiveness: measures how services enhance productivity by aligning system and individual benefits. Consider a remote patient monitoring system that streamlines data collection, its analysis and reporting to align it with defined metrics such Key Performance Indicators (KPIs).

3. Optimality and equity: balances costs against benefits, ensuring services are distributed fairly. For instance, a telehealth platform that ensures equitable access for all patients, including those in underserved areas.

4. Demand and scalability: examines if the service meets the real needs of users within a given context and can expand efficiently to meet growing demands. An example would be a telehealth service that scales as the number of patients increases, maintaining performance and accessibility without compromising service quality.

5. Sustainability: considers if the service supports long-term operational and environmental goals. For instance, the telehealth platform that adopts sustainable practices, such as energy-efficient data centres, to support long-term environmental goals.

6. Legitimacy: ensures that the service complies with relevant laws, regulations, and ethical standards. For example a telehealth service that complies with local healthcare regulations and data privacy laws.

Each of these attributes, help us to posit important questions when thinking of mapping, designing, implementing or evaluating a service.

Key questions include:

1. Is the current service meeting the contextual needs? Both affirmative and negative responses will need exploration.
2. Is the service addressing inefficiencies within the practice in a given context?
3. How are efficiency gains measured against predefined KPIs?
4. What improvements in service delivery and outcomes have been observed?
5. How is the balance of cost against benefits monitored and maintained?
6. Are there any new needs emerging from the context that the service could address?
7. Has the ecosystem map been created to map the various actors and dependencies?
8. Is the service dependent on other actors within the ecosystem? If so, how, and what is the impact on its offerings and operational setup? Also, what is the impact on other actors?
9. Is the service accessible to all user groups equally or is it marginalising some of them? If so, what is the reason and is there a contingency plan?
10. Is the current or proposed service adaptable to changes that may impact the context in which it is embedded?
11. Can the service scale effectively to meet growing or changing demands within this context?
12. What technological supports are in place to facilitate scaling?
13. What are the long-term sustainability challenges for this service in its current operational context?
14. How efficient is the service in using local resources and integrating within the existing infrastructure?
15. What sustainability standards does the service adhere to?
16. How are environmental impacts measured and minimised?
17. Does the service adhere to local regulations and social expectations?
18. How are compliance and ethical standards periodically reviewed and updated?
19. How is user feedback integrated into ongoing service adjustments?

B. Service-user relationship: creating co-value, and building trust

This relationship is about enabling user to accomplish their intended goals. It includes crafting experiences where users feel valued, understood, and supported throughout their interaction with the service.

Service designers can use these insights to create services that are useful, easy to use, adaptable to users emerging needs, transparent, trustworthy and meaningful. The 6 attributes of this relationship include:

1. Expertise and interaction: emphasises the skills and knowledge needed to effectively use the service, noting how service innovations can transform interaction patterns. An example would be training modules and intuitive design elements in a telehealth platform that helps healthcare providers and patients alike to become proficient. This transforms their interaction with the tool and facilitates completion and achievement of intended goals or tasks.

2. Trust and transparency: ensures that the service is perceived as trustworthy and transparent. For example, consider a remote patient monitoring app that clearly communicates its data privacy policies and provides transparent information about data collection during health monitoring processes. These practices help to build trust among its users – clinicians and patients alike.

3. Flexibility and adaptability: questions how adaptable the service is to changing user needs and feedback, including that of different user groups. For example, a telehealth app that is flexible enough to accommodate different health conditions and user preferences, and adaptable to user feedback.

4. Effectiveness: evaluates if the service delivers what it promises, from the user’s perspective. An example includes a remote patient monitoring platform that effectively tracks patient health metrics and provides timely alerts and insights, ensuring better patient outcomes.

5. Acceptability and sustainability: looks at how well the service fits into existing job roles and work routines and how group and social factors affect user interactions with the service. For instance, take the remote monitoring tools that fit seamlessly into healthcare providers’ workflows and help different clinical user groups to interact – doctors, nurses, case managers etc. This ensures timely exchange of information and making informed decisions.

6. Legitimacy: refers to the alignment of the service with ethical standards, laws, and societal values. For example, the remote monitoring service that adheres to ethical guidelines and healthcare standards to ensure it is respected and trusted by users.

Key questions include:

1. How does this service meet the specific needs of users and those of different user groups?
2. What are the social or group dynamics that affect how the service is received and used?
3. Does the service align well with the cultural and social norms of the target user group?
4. What aspects of the service are most valued by users for its usefulness and ease of use?
5. Can the users see advantages of the new service over the current one?
6. From user feedback, how effective is the service in achieving its stated goals?
7. What are the users’ concerns regarding the new service?
8. How well does the service fit into the existing workflows and social structures of the user groups?
9. How does the new service change and impact the current processes, practices, and routines?
10. What are the processes and practices that need to adapt to the new service?
11. In what ways can we improve the flexibility and adaptability of the service to adapt to changing and emerging user needs over time?
12. How does the service facilitate skill development for various user groups?
13. What impact have the training and design elements had on user proficiency and task completion?
14. Have the routines and daily activities been effectively mapped as part of the process and incorporated into the service blueprint?
15. How transparent are we about the service functionalities, such as data usage, to users?
16. What strategies have been put in place to overcome the potential disruption and minimise it?
17. Who are the other actors within the wider ecosystem who may be impacted by the service and its use? What are the repercussions of this?
18. Are all stakeholders aware of the service implementation, use and the potential impact that might have?
19. Has the stakeholder map been consulted for who needs to be informed, when and why?
20. What strategies have been adopted to gain consensus among all relevant stakeholders, including road mapping and consulting an ecosystem map?
21. What measures are in place to continually assess and enhance service effectiveness?
22. Does the service comply with relevant ethical guidelines and regulatory standards?
23. How are changes in laws or societal values affecting the users perception and impacting the use of the service?

C. User-context relationship: navigating the influence of context on users and understanding broader service implications

The user-context relationship highlights the need to design services that are acutely aware of the nuances of the users’ surrounding environments. This ensures that services remain relevant and accessible, adapting to both internal and external shifts in conditions.

It involves predicting changes in processes due to shifts in organisational culture, societal norms, and user perceptions, to maintain alignment with the real-world scenarios of users. Here are the key attributes to consider:

1. Contingency and transparency: questions whether the role and impact of the service within the context is clear to users. For example, consider the rollout of a telehealth service at a national level, where, due to the scale of the operation, its implementation needs to clearly and comprehensively explain its overall impact on care delivery and potential disruptions.

2. Flexibility and adaptability: considers how well the context can accommodate changes in user behaviour brought on by the service. An example is a telehealth platform that adapts to users’ evolving health needs and preferences, becoming an integral part of their daily lives.

3. Stability and accessibility: ensures there is always a way to maintain basic and minimum access to the service, enabling users to use the service in emergencies. For example, a telehealth service designed with contingencies for sudden outbreaks of war, considering how such crises impact users’ ability to access care.

4. Relevance and timeliness: explores whether the service is important within the given context and necessary at the time it is offered. For instance, assess whether a telehealth service is essential and meets the immediate needs during an ongoing health crisis.

Key questions include:

1. Has the service’s relevance been established in terms of its necessity within the current context?
2. Are there contextual factors that particularly influence the timeliness and relevance of the service?
3. How does the broader environmental or societal context influence user interactions with the service?
4. Has the service blueprint been created to map end-to-end service, highlighting all the processes involved?
5. Does the implementation plan consider the impacts on immediate users and those who may be dependent on the service’s availability, including vulnerable populations?
6. In emergencies, such as wars, natural disasters, or other crises, how will users continue to access and use the service?
7. How do we ensure stability and access to our service during these critical times?
8. What changes in user behaviour might we anticipate as a result of evolving social or environmental factors?
9. How might the change in behaviour influence the contextual factors?
10. How flexible is our service in adapting to these changes?
11. How well does our service maintain transparency and foster trust among users within this context?
12. What contextual factors have been considered for service evaluation?

Conclusion

In this article, we identified key attributes and their accompanying questions, which when integrated into the service design process, can enhance the efficacy, resilience, and user-centricity of the service and its offerings.

This holistic approach does more than just refine design execution – it embeds a deep understanding of human and contextual factors into the heart of service design. It empowers service designers to think beyond traditional boundaries, designing services that truly resonate with users and thrive within their contexts.

In addition, using this approach, tools such as ecosystem maps, stakeholder maps, and service blueprints are transformed from mere design artefacts into strategic assets. These tools now capture the dynamic interdependencies within the service ecosystem and the impact on users, allowing designers to anticipate changes and adapt to the emerging challenges and opportunities.

We now approach the end of our journey, with the final stop being part 7, where we will reflect on all the steps taken and the future prospects of applying the insights gained.