S7 EP 8: Professor Stephen Reay, Summer Series

As a Professor in design at Auckland University of Technology, Stephen discusses the importance of collaboration and consultation for design thinking principles. 
If you'd like to learn more about the AHDC, please connect with us on our website www.aushdc.org.au or on LinkedIn at linkedin.com/company/aushdc.

If you'd like to learn more about the AHDC, please connect with us on our website www.aushdc.org.au or on LinkedIn at linkedin.com/company/aushdc.

Transcript

[00:00:00] David Cummins: G'day and welcome podcast series Health Design on the Go. I'm your host David Cummins and today we're speaking to Professor Stephen Ray. Who is a Professor of Design within the School of Art and Design at Auckland University of Technology. Trained as an ecologist and product designer, Stephen has a unique view on design and how it improves community involvement whilst also educating future generations.

[00:00:39] Stephen explores the use of design to bring people together and explore how health, design and community knowledge can be what are some of the what are some of the combined to refresh, revise, or restore spiritual, social and emotional health. 

[00:00:53] We look forward to speaking to Stephen today to hear more about design and what's happening in New Zealand. 

[00:00:58] Welcome, Stephen. Thank you for your time to be here. 

[00:01:00] Steven Reay: Great. Thanks for having me, David. 

[00:01:02] David Cummins: I suppose I should ask with the easy question, or I think it's the easy question. What is your definition of design, being a professor of design?

[00:01:10] Because in my head, it could be anything. So what's your definition of design? 

[00:01:15] Steven Reay: Oh, that's a shocker right off the bat. I guess it depends on the context in which you're operating and I don't have an easy answer for you because I don't like putting a stick in the ground. 

[00:01:26] David Cummins: A professor of design that won't define design.

[00:01:29] Steven Reay: Yeah, yeah, yeah. Too many, it creates too many arguments. Let's back away from that corner, I say, David. 

[00:01:36] David Cummins: What, generally speaking, do you think people think design is then? 

[00:01:40] Steven Reay: I think what people think design is and what we think of design and what every designer thinks of design, there's probably a lot of similarities, but there'll also be differences.

[00:01:48] So I think, From my perspective, our focus is on using design as a creative process to engage people, to think differently, to solve problems or more so much now thinking about how we can use design to rather than focus on problems, but also to look for things that are going well and how we can give more oxygen to those things.

[00:02:09] David Cummins: So how important is good design and inverse? How easy is it? to have bad design in a community and health setting? 

[00:02:18] Steven Reay: Well, I think good design is critically important and particularly important for those who are most underserved or have been most marginalised by society and the systems which have built around the majority. 

[00:02:32] In terms of the inequity that those communities have experienced yeah, design's critical to help us to support them have what they need. 

[00:02:43] And bad design arguably, is what they might experience on a day to day basis now. At a general kind of social level.

[00:02:51] There's no shortage of bad design in healthcare, but there's some really pretty, pretty neat things too that go on. 

[00:02:57] David Cummins: So what would be some of your definitions in your world (especially New Zealand) of good design in the world of health? And more importantly how it impacts stakeholders and those using that care. 

[00:03:09] Steven Reay: we saw probably great examples in COVID where the largest systems, the health systems, they responded well. And I think as a country, we did an extraordinary job. But 

[00:03:21] where 

[00:03:21] it got interesting, I think, was hearing the stories about, and , I don't have an intimate knowledge of it, but hearing stories about those, communities that were out of the main centres that had been possibly historically reasonably distrusting of government and systems that had failed to meet their needs, having to fend for themselves and doing incredible jobs at protecting and looking after and supporting each other.

[00:03:46] And I think those are the things that are pretty interesting and show that actually, , communities know what they need, they know how to get them, they have the solutions, they're there, what they don't have is always, or seldom is the resource to implement and build on those solutions.

[00:04:01] And in part, I think governments, et cetera, don't trust them. Or haven't trusted them. 

[00:04:06] David Cummins: That was going to be my point in reference to government, especially predominantly public health, how important is it for governments and the public health services to understand the community needs and exactly what they need versus what they think they need.

[00:04:21] Steven Reay: The health system has been built in a particular way, I guess, and , it's served many people really well, but as our populations increase and the costs go through the roof, we become more complex and we have very different needs.

[00:04:35] I think lots of people, their needs aren't being met. So it's absolutely critical that they. Are able to work with communities and be okay about handing power back to those communities. And probably, it is a power thing, it's a mindset thing. 

[00:04:50] And one of the challenges is that, I suppose, for government is of scale and of cost.

[00:04:56] So much more targeted, nuanced kind of approaches for different things, different problems and issues. But working with communities, you see... which is design, right? Working at smaller scales in much nuanced ways. But that's probably in contrast to big systems that we live in, which is focused around efficiency and scale and scalability.

[00:05:19] Yeah, wonderful complex challenges of complex worlds, . 

[00:05:23] David Cummins: Yeah, exactly. I think that's one thing that draws us all to this industry, the complex nature of it, but also the ability to find a solution. 

[00:05:31] Having said that, knowing that you just talked about power and governance, what can designers do, or what can we do to try and emphasise that point for change, knowing that generally speaking, the government will be our client and we're wanting to make change to be more inclusive and to ensure that, certainly the majority of the all community benefits from, from good and better design.

[00:05:57] Steven Reay: I think that's probably easier than the questions you've asked me so far, or at least I like to hope it is. 

[00:06:03] I mean, what designers do is they make things visible and they communicate. And I think the responsibility for us or for designers is to advocate on behalf of those users that have been underserved and actually to take their voices and their stories and to genuinely and authentically, partner with them and make that visible and advocate for what their needs are and to hold a pretty hard line where possible and just constantly remind why we're here and what we're doing.

[00:06:35] Because without that, you see how powerful advertising is, that's the power of design. And I think that's one of our most important roles, I think. 

[00:06:43] Not just to help, to use our creative methods and processes to help those people in communities, et cetera, to think differently and to understand and see possibility with regard to their future, but then to take that and package it up in a way that's compelling and tells a great story and speaks of the importance.

[00:07:01] David Cummins: I've got a background in physiotherapy and we were always taught, and still today, I always challenge, what does the research say?

[00:07:07] Because I'm actually not smart enough to have an opinion about something, but I'm smart enough to know what the research says about a topic I'm looking towards because if there's evidence to support a principle, then ultimately, I'm quite comfortable to go towards that or lean towards that principle in our design in healthcare.

[00:07:24] I know Your University and yourself do a lot of research. So how important is it with research to provide evidence to support these findings to try and get important and better design across? 

[00:07:37] Steven Reay: Yeah, research. I mean, you're right. What do they say that the knowledge mobilisation gap is 17 years from research to implementation and health.

[00:07:46] I mean, it's pretty alarming. 

[00:07:48] And I suppose I think about that's what we work really closely with quite a few, researchers in health and I think that's our strength is how do we support them to make their research more visible in the process of doing it so that you start to shrink those, those gaps between discovery and implementation.

[00:08:07] And part of that's working alongside in a collaborative way with the communities and with, the providers, et cetera. 

[00:08:13] Obviously the research is important. you know

[00:08:15] One of the things that we come up against quite a lot is around what evidence is and what that looks like in different disciplines.

[00:08:22] So evidence and design is 

[00:08:24] often 

[00:08:25] quite different probably than your clinical gold standard randomised trial that's normally looked for into health. And I think one of the things that we do as disciplines as we go back to our foundation or our core when we're challenged. And I guess you could argue that where we got to now, we got to by thinking in a certain way.

[00:08:47] And I think it takes a lot of courage and bravery to step back and say, "Oh, perhaps there's a different way of looking at things or thinking about things or doing things". And I think you see that with the increase in the valuing of indigenous knowledge and ways of knowing, et cetera.

[00:09:01] Obviously there's a long way to go, but I think for some things there's a really great opportunity for everybody to be open to different ways of thinking. 

[00:09:08] David Cummins: Yeah. I do think as well, these podcasts I've noticed already and heard a lot of people are starting to use some of the principles from these podcasts.

[00:09:15] In design of future health care, because it does take 15 to 20 years to become fully implemented from evidence to commercial success. So I'm a big believer of trying to get the research out there as much as possible, because ultimately, the more people that know the best principles, the sooner then we can actually improve better design and obviously better clinical outcomes, which is great.

[00:09:34] And it's something that I find research in this world is, there's a lot of studies on it as well, hasn't really been talked about for at least, certainly not the last 40, 50 years, it's more recently last 15, 20 years, if not the last 10, where people are really putting their efforts and understanding the importance of research into this. 

[00:09:52] so I just want to talk about you as a Professor in New Zealand, you do a lot of teaching for students at the moment. What are some of the main principles that you're teaching students and what are some of the things that you'd like them to learn and leave from your teachings as they explore future careers after design? 

[00:10:08] Steven Reay: that's a great question. I teach at a range of areas from undergraduate, product design through to mostly my teaching is course with post grad students and we run a design for health pathway and our master of design, et cetera.

[00:10:22] And that's pretty exciting for us. And I think pretty exciting for the school to be looking to the future and thinking about, well, what is the impact of design more generally in the world? , from a student perspective, I think working in health, it's certainly an environment for them to get match fit when it comes to, working in the complex kind of world. 

[00:10:42] And our work has really applied and I think that's possibly reasonably unusual as well, so, , most of our student projects or all of them are generally in partnership with people in health or either researchers and other academics or mostly with outside organisations outside of the university.

[00:11:01] So we're dropping our students real world projects. And so what we're training them to do, which I think is a big step up for them is actually, how to work with people. 

[00:11:10] And the value and the role of what you need to do to have authentic, trusting relationships with the people that you're designing with.

[00:11:20] So really starting them to move from that kind of human-centred design, where you're designing for somebody to designing with somebody. And then from a design perspective, what do I know, and why do I know that, and why do I think in that way, and then what, how might I need to change my thinking in order to the classic kind of, what biases do I have, what privilege do I have, and how do I change my thinking in order for those that I'm working with, that their voices are able to to speak clearly and that's a fascinating challenge.

[00:11:55] And really tricky for a lot of our students to get their heads around. 

[00:11:58] They've been trained in particular ways around how design has worked and to step back and think differently. I mean, it's interesting. I'm just going through that process at the moment in one of our papers and I think one of the really interesting things for me at the moment is that design, we focus on problems and we focus on experiences of individuals a lot, and where they really struggle is the idea that there are structural factors in society, , the social determinants of health that impact the experiences of communities and then those themselves have impacts on individuals. 

[00:12:31] They really struggle to recognise that there are higher level structural factors.

[00:12:36] And so if you had a public health student, for example, that's their bread and butter and that's what their degrees train them for. 

[00:12:42] But in design, they're not being exposed to that kind of thinking throughout their degrees.

[00:12:49] David Cummins: Yeah. And I think what I like to hear about that is the real world problem with the real world community as opposed to certainly when I was at university, it was very much, you do your research and have minimal interaction with patients.

[00:13:02] But certainly now I know a lot more people do have a lot more interaction with patients. There was a person we interviewed a while ago, an architect, and they were saying how. They, as a student, this is in the 70s, they used to literally have to be a patient for a day, where they were admitted, they went through all the processes, just to experience what it was like to be a patient and understand their needs and also their pain points, because it's very easy to design for someone when you've never actually spoken to them.

[00:13:29] I mean, it just doesn't make sense these days. So that's really, really important. And I think using empathy and understanding of the patient journey and also the staff journey is extremely important as well, yeah? 

[00:13:40] Steven Reay: Yeah, absolutely. But I think there's another thing, many university students or certainly many that we work with, have a level of understanding of English etcetera.

[00:13:49] There's a level of education that may make certain things a lot easier than a lot of other people. So again, I'm always very cautious for people to go through these kind of exercises and think that, oh, well, I've had an empathy exercise or I've done something and I have enough information now to make decisions on the behalf of others who really, actually, you don't know anything about their experiences and what their challenges and struggles are.

[00:14:14] And I think that's the part that's valuable, but that's the part that takes time and to build relationships and research relationships with people that who are different than you are, takes an enormous amount of time. And the challenges of not only just healthcare, but also , academic degrees is that there isn't the time that it often takes.

[00:14:37] So we might work with people for a year or two years to build relationships before we're able to actually do the research. 

[00:14:44] David Cummins: Yeah, I 100 percent agree. Taking that extra time to understand, you get so much more positive outcomes for so many more people. I know it's hard in public health and even private health because everyone wants everything done now, but I always say 90 percent planning, 10 percent execution.

[00:15:01] Just take that little bit of extra time to plan and to understand, and then you'll have less problems in the future and it'll be more future proofed as well. 

[00:15:10] Steven Reay: Yeah, I think the other thing is that what we do in health is that they try to fix last week's problems rather than going actually what's it going to look like in 10 years time.

[00:15:18] And I think we're all really good at that. It's hardwired into what is the problem right now and how can we fix it. And I think yeah, I don't know, maybe there's Just a consequence of budgeting and election cycles and all of the kinds of things in our jobs.

[00:15:35] We can't imagine being here in five years time or, I don't know, I guess as we get older we start to appreciate that a bit more. 

[00:15:41] But time, it certainly rushes by pretty fast and ten years actually isn't that long and I think things are going to be really, really different so we need to be thinking about it now.

[00:15:50] David Cummins: I totally agree. Especially when it comes to sustainability, we're in a lot of trouble already. So how projects are getting off the ground without having strong sustainability principles is beyond me still. Just before we go, is there any take home message for people listening?

[00:16:04] Is there something you would like people just to, to focus on? Because obviously there's a lot to digest in the last 20 minutes. 

[00:16:11] If people just want to get stronger and better design, what is the one thing that people can take away and try and improve design for the world of health.

[00:16:20] Steven Reay: I think if you're getting involved in a project and you're in as a designer or in fact, as anybody, and you're in a position of power or control, is to just pause and step back and ask, what right do I have to be here?

[00:16:37] What might I need to do differently or think differently in order to have the best outcome for the person that we are designing for?

[00:16:47] And how do I know everything I need to know in order to most effectively work with them?

[00:16:53] I guess what do I need to do to create a safe environment for the people that we're working with to be able to express their vulnerabilities because if they're not able to do that safely, in a way that feels safe to them, you're not going to get the real story about what people need.

[00:17:13] David Cummins: Yeah, I think that's a very good take home message. I just want to say thank you so much for your time. I know you're very, very, very busy and I love the fact that you didn't limit the word of design to just a simple sentence because It's almost never ending and it's very almost a personal journey for what design is for the people you're interacting with and also the people actually doing the design.

[00:17:35] So I just think you're absolutely amazing and your level of smartness in this world is absolutely phenomenal. So I appreciate your time and being able to talk to us today and relay some of those messages to our listeners. 

[00:17:46] So thank you very much. 

[00:17:48] Steven Reay: Thanks so much for having me, David. 

[00:17:50] David Cummins: You have been listening to the Australian Health Design Council podcast series, Health Design on the Go.

[00:17:55] If you would like to learn more about the AHDC, please connect with us on LinkedIn or our website. Thank you for listening.