Watch the film of David Kester on Vimeo.
Jeremy Myerson
Ladies and Gentlemen: David Kester.
David Kester
Right…what an entrance. Um…our vision at the Design Council is to place design at the heart of social and economic policy. And over the last six years or so, we’ve been running a number of experiments up and down the country, which are about what that really means and trying to put that into practice. And of course, during that period the world has been changing. The whole world of policy making has been reacting to the very different world that we’re living in. And we hear words like ‘nudge’ and ‘pro-social behaviour’ and so we’ve been looking at that in terms of our practice. And I wanted to share with you a little bit about what we’re learning from that based on a couple of our projects.
Um…this is firstly me. That’s my mum who’s a designer, my wife who’s a landscape architects, my two little boys who are now very grown up – you can’t really tell what they look like. That’s me with my dog. I’ve worked 25 years in the creative industries, seven of them at the design council. We’ve got loads of associates, we work with about 500 companies every year, and we run programmes in healthcare, security, communities, um… the environment…and we also some pretty cool education projects.
Um…now! Some of you will be thinking, he just showed us that picture of his dog and himself because he wanted to show a little bit of Cornwall, because some of you might know that that was taken just outside the Godrevy Lighthouse on Gwithian Beach. Um…or others might be thinking, that was just a very shallow attempt to win over the audience by showing a picture of his dog and his kids. But the social psychologists among you will be saying, he’s been using a priming technique. In other words, trying to change subsequent behaviours by exposure to visual clues or other sensations.
Now, you know social psychologists have been identifying lots of these, sort of clues and ways to change our behaviour as we’ve got to know how the brain works. I mean this is a very good example for employers here: If you serve somebody a warm drink when they come to an interview, they’re more likely to want to work for you than if you serve them a cold drink. It’s just statistically proven. Similarly, if you sit people down with a bunch of words and you put them down and they have words like ‘fitness, health, lean, running, athletic’ and you tell them to make sentences with those words, and then you send them off into a building, they’re more likely to run up the stairs than take the lift. Again – it’s statistically proven.
Now – why is this? Well, of course, you know without giving the full lecture on it, but we have…you know, our brains are fundamentally two different systems. There’s the limbic system which is very instinctive and automatic and, you know that’s where if the lion came into the room it’s, you know flight or fight. Er…it’s very, very instinctive and fast. And we have a cognitive system, which is reflective and it’s deductive and of course, when it comes to policy matters, we like to like to think that, you know if it’s about our, you know what sort of financial services we’ll use, we’ll be using our deductive, reflective system. But, sadly, actually we take most of our decisions based on our instinctive and much more sort-of primordial, primeval limbic system.
Now, what does this…you know, why has this become so interesting lately? Well it has become very much a sort of a popular theme. Um, some of you will know this book by Richard Thaler and Cass Sunstein, but the whole area of ‘nudge’ and using social behaviour at the heart of policy making has become very current. The Obama administration has placed it at the heart of the way that they’re thinking about policy making. And indeed our own government at the moment, the coalition government has set up a behavioural insight team within the cabinet office. And, you know other governments are doing the same thing. Why is it?
Well, you know I’d suggest that there are probably two big reasons why this has become such a popular issue currently amongst policy makers. I think the first is…and yes this is a photograph from Egypt, erm from the recent Jasmine Revolution… I think one of the reasons is that people want generally more self-determination in their lives. They don’t want to be told what to do - they want to define their own futures. And so…and we’ve been hearing a lot about that today.
But there’s also, you know another very big issue. Yes there are seven billion of us on the planet and that’s increasing, and that’s seven billion mouths to feed, that’s seven billion healthcare problems, that’s seven billion perpetrators or victims of crime. And of course, when you’ve got to think about, actually the cost of those issues when you’re a policy maker, then it really concentrates the mind and it concentrates the mind even more when you’re in a recession. So, you know if you can as a policy maker maybe nudge social behaviours towards, say away from eating unhealthy foods to eating healthy foods, you get less obesity, less diabetes etc etc.
Similarly, you know with criminal behaviour, if you can nudge people, say away from binge drinking and alcohol and drugs abuse, then not only are you…you’ve got less cases in hospital, but also less victims of crime and also less to pay for within the criminal justice system. So policy makers are naturally looking at these issues, both because we’re interested in what they’re… in this, sort of whole issue of choice architecture but also to save money as well.
Now, as we’ve been hearing today, designers of course have known this for many years because actually that’s what designers do for a business. They’re constantly tapping into the deeper psyche and, sort of real the inner needs of people to try to shape behaviour. Of course, that’s what Apple did to shift 90 million people off brick phones and onto iPhones. So we thought ‘well, what might that look like when you apply that to social policy, so take a design approach?
And one of the first issues that we looked at was the issue of healthcare acquired infections. Now, these are the latest stats from the World Health Organisation. Erm…they’re pretty stunning. These healthcare acquired infections are - basically, I went in for one problem and I caught some nasty bug like MRSA or C Difficile when I was in hospital. And in Europe that’s 37,000 deaths per year. As you can see, these figures are astronomical. And although we don’t have all of the statistics for the rest of the world, what the World Health Organisation do tell us is, that it’s easily double the figures in the developing world and probably more than that so, a really significant issue.
So the project that we set up was called Design Bugs Out. And I’m just going to…let me just give you a really quick snippet of how that worked. We started by sending designers to go and actually have a look at the way hospitals operate. Now we’d already gathered a lot of the statistical information together, we had the research, we had some of the best clinicians and advisors all around us but then the designers were there to go in a take a fresh look. To say, lets go and follow the lives of real people, of nurses, of doctors, patients, and just take a fresh look a the problem. And they came back with a very simple but a very important insight, which was that hospitals don’t just need to be cleaned more (which was what the current and prevailing orthodoxy was) but actually hospitals need to be easy to clean and easy to keep clean. And actually wasn’t there a way, everyone was asking, to design some of that environment and provide the clues, the visual clues that might just say ‘clean me’. Just in the same way as when you pick up your iPhone, you just rub it against your pullover to clean it. So could not the same sort of principals apply within a hospital?
Well a lot of briefs were formed, we opened it up, very much open innovation, to manufacturers and designers to team up and come up with ideas and some really groundbreaking ideas came through. Now here are just some of them…I can’t take you though all of them, but you know, one initial observations was, why is it that bedside cabinets need to be made of MDF with bits of plastic actually sort of glued on where quite clearly, nasty bugs and so-forth are going to linger? Why couldn’t we actually have something that’s very easy to wipe down, that doesn’t have a lock or anything in but actually does have privacy because you can have an RFID tag to lock it with a magnetic system in there? And this was created actually by South West design firm, Kinneir Dufort, working with Bristol Made and they’ve gone on to create a whole range of these products for the market.
Here’s an example that was actually created by Jeremy’s unit at the Royal College of Art working with Imperial and this one’s responding to issues directly from nurses. Nurses told us that people were getting C Difficile from mattresses. When they get punctured or damaged in some way it’s at that point that human fluids can enter and that can store up C Difficile. So why not put some hydro-chromic ink under that first layer so that it gives a visual clue to the nurse and says, hey – why not change the mattress? A very, very simple idea, a small innovation but of course, very much and very quickly shifting behaviour.
Here’s another example: A really lovely example also of an innovation combination, because this was Pearson Lloyd, who are the team that designed the Virgin Sleepseat working with a British manufacturer. And here what they did was, they took the standard commode, which normally doesn’t look anything like that – it’s a hideous looking affair, often with about over 200 working parts and usually has to be cleaned with a toothbrush and, you know no fun to clean I can tell you that if you’re a nurse. And here, reduced it down to around 15 working parts, it’s stackable, it all pulls apart, it goes into a sluice room and it takes a nurse under a fifth of the time to clean. And again, their whole principal was, let’s create something that says ‘clean me’ but also, that can just be cleaned with a wipe or as I said, go in a sluice room.
Now, with project like this I think that it’s actually too early to really know the full economic impact. But we already have some very, very powerful proxies of success. Now one of them is that between the two main healthcare projects that we run, Design Bugs Out and Design for Patient Dignity, we now have already been able to document over £25 million worth of sales and sales is actually quite a good proxy of success because you know that actually if the healthcare system is actually buying this stuff both in the UK and around the world, that’s quite a good proxy. The Department of Health has said this is a good exemplar of what they’re calling QUIPP, Quality, Innovation, Productivity and Prevention.
But we’re saying, in the context of policy making, that it’s a win, win, win. That, yes on the one hand it’s delivering a life-saving idea, an innovation, it’s providing savings back into the system, both in productivity saving and also in the saving of lives, but it’s also at the same time…and I think this is the really key bit for us, in terms of why we’re saying this is more of a shove than a nudge, that it’s not only nudging social behaviour, but it’s actually creating an economic boost at the same time. And the products are of course selling and creating revenues back into the UK. So actually we start with a nudge – we end up with a shove.
I’ll just give you one other example and this is around alcohol abuse. Now this is, I think a startling statistic. Again, this is this year’s statistic from the World Health Organisation: 4% of all deaths, worldwide are attributed to alcohol. That’s actually more than HIV AIDS. And 12% of those deaths are associated with intentional injury. So that’s things like domestic violence and also a lot of that is where people get caught up in a fight based…because they’re drunk and often on a Friday or Saturday night.
And unfortunately, it has pretty nasty consequences. Now we’ve set up a programme here called Design Out Crime with the Home Office. Um… I was saying nasty consequences, this is Blake Goldind, he…you know as ever we took a similar approach with this. Here the lead research team was, again was actually Jeremy’s team at the Helen Hamlyn. And…you know we worked with people at the front line. Blake’s mother actually contributed to the research findings. This is Blake, photograph taken by his mum. He nearly lost his eye, he didn’t, he did loose four pints of blood and had 50 stitches. He was working as a doorman in a pub and he got a glass shoved in his face.
Now glassings are…cost the NHS £2.7 billion a year. It’s quite startling. Blake is a statistic to them: he’s one of 87,000 incidents every year from glassings. So the question that we were asking was actually one that the World Health Organisation was asking, which is: if you can’t actually just change the behaviour around people drinking alcohol, could you reduce some of the consequences? And that’s what we responded to. And the big question that was being asked by the police at the time particularly, they were saying, we need to legislate. They were saying, for goodness sake, we know where the hot-spots are, let’s just give everyone plastic glasses on a Friday and Saturday night in these nasty hot-spots. And what the project said was, come-on surely there’s a way to innovate around this. There must be another way because quite clearly…back to that whole thing of self-determination, people really don’t want nanny state telling them to drink from plastic glasses, especially people who like their beer. But also the pub retailers, there are a lot of vested interests in not having plastic bottles and plastic beer glasses.
So the idea was ‘innovate’. And again we opened that up to designers and manufacturers and technologists and particularly we said, can we focus on whether there’s a way to create glassware that doesn’t create those nasty damaging shards?
And this is what Design Bridge came up with, which is a very thin bio-film that gets sprayed on to the inside of any glassware. Now, it looks very simple, it is very simple but of course there’s a lot of technology, a lot of thinking and a hell of a lot of experimentation that went on to actually make this work. And they did make it work and they’ve created the glass and again, there’s an early proxy of success here, which is that the IP has been picked by the two largest manufacturers of glassware in Europe and they’ve gone into production and they’re piloting that now in Britain’s leading pub chain. So we’ll see what the impact actually looks like. Again it’s quite early to say whether this is actually going to have a full impact all the way down the chain.
But what we do know now when we’ve looked, and we’ve looked at the evaluation of these sort of experiments and now we’ve run a few, theses are just some of them: Bugs Out, Patient Dignity, Design Out Crime and indeed Dott, because Dott in itself has been very much an experiment in how you can use design at the heart of local, social innovation. And what we’re finding from the evaluations that we’re doing is that for every £1 that we spend, we’re getting about £24 back within three years. That’s a pretty good return on investment, er…so and the return on investment then gets calculated both in the social return but also in that boost to the economy.
So I just want to finish with what we found were the five key ingredients of a ‘shove’ if you like. What are the ingredients that enable one to nudge to social behaviour but boost the economy at the same time? I think the first is, you’ve got to put the design bit up front. Design is part of the way that you actually go out and discover and define the problem itself. You don’t want to bring design in when you’ve already worked out the problem, it’s part of your discovery process. And the brilliant thing is…in design is it’s very good at finding out human insights. It’s a very intuitive science if you like, or art, however you want to view it.
The second is, and we’ve heard a lot this morning about Open Innovation is stay open throughout the whole process. And we’ve found that what’s been critical to the success of the project has been having all of the main stakeholders on board early, shaping and designing the whole project itself. So that when we run a programme on healthcare we have leaders, policy makers, scientists, we have the interest groups and so forth all round the table. And we have expert groups and leadership groups and that’s really, really key.
The third is providing a safe space for the innovation to take place. And obviously that’s the role that, in this case we’ve played but we’ve heard from IDEO earlier: lots of different people can play that role of being arbiter, that…that safe environment for innovation to thrive. I very much hope that Air for instance, can be a fantastic safe space for innovation here is Cornwall. Certainly we’d like to see that as one of the great legacies from this project – for Dott.
Um…fourthly…ooops, sorry…fourthly, hug a politician. Erm…what we’ve learnt here is that when you’re designing policy, the client is the politician. And it’s really key, just like as in any good client relationship the full ownership needs to be there with the politicians and the policy makers. They need to feel engaged it’s not something that happens at a remove, it’s something that happens because they’re…they want to make the change happen.
Fifthly and vitally, and so important, is no compromises. It’s about design quality. This is a picture of Ben DeLisi, the fashion designer, who’s more associated with creating very beautiful Hollywood gowns, through that Open Innovation process, he came to redesign the hospital gown. This is him at the Design Council, in front the advisory panel, demonstrating his first ideas, But what was so key was that he was a designers who is passionate about every little detail and, as I think most great designers are it’s all…you know they see God in the detail, not the devil in the detail. And Ben was the same, Pearson Lloyd were the same, others have been exactly the same in bringing that quality to the…of design right through the innovation process.
So that’s it really. That’s what we’ve been doing. We think that it has a great opportunity for policy making and we think there are lessons then here for other areas, whether that’s say on the aging population and dementia at the moment or on the environmental front. And it is very much what we’ve been doing here and in fact what Andrea of course has been leading through the Dott programme. Thank you very much.