Design thinking - a critical analysis.

The latest buzz phrase to enter the world of design research is “Design Thinking”. But is this anything new and does it really have any practical or theoretical relevance to the design world? Many sceptics believe the term has more to do with business strategy and little to do with the complex process of designing products, services and systems. Moreover, many view the term as misleading and a cheap attempt to piggyback the world of business management onto design. This paper seeks to ask is design thinking anything new? Several authors have explicitly or implicitly articulated the term “Design Thinking” before, such as Peter Rowe’s seminal book “Design Thinking” [1] first published in 1987 and Herbert Simon’s “The Sciences of the Artificial” [2] first published in 1969. In Tim Brown’s “Change by Design” [3], design thinking is thought of as a system of three overlapping spaces rather than a sequence of orderly steps namely inspiration – the problem or opportunity that motivates the search for solutions; ideation – the process of generating, developing and testing ideas; and implementation – the path that leads from the design studio, lab and factory to the market. This paper seeks to examine and critically analyse the tenets of this new design thinking manifesto set against three case studies of modern design practice. As such, the paper will compare design thinking theory with the reality of design in practice.

Intensive care survivors’ experiences of ward-based care: Meleis’ theory of nursing transitions and role development among critical care outreach services.

Aims and objectives. To explore the psychosocial needs of patients discharged from intensive care, the extent to which they are captured using existing theory on transitions in care and the potential role development of critical care outreach, follow-up and liaison services. Background. Intensive care patients are at an increased risk of adverse events, deterioration or death following ward transfer. Nurse-led critical care outreach, follow-up or liaison services have been adopted internationally to prevent these potentially avoidable sequelae. The need to provide patients with psychosocial support during the transition to ward-based care has also been identified, but the evidence base for role development is currently limited. Design and methods. Twenty participants were invited to discuss their experiences of ward-based care as part of a broader study on recovery following prolonged critical illness. Psychosocial distress was a prominent feature of their accounts, prompting secondary data analysis using Meleis et al.’s mid-range theory on experiencing transitions. Results. Participants described a sense of disconnection in relation to profound debilitation and dependency and were often distressed by a perceived lack of understanding, indifference or insensitivity among ward staff to their basic care needs. Negotiating the transition between dependence and independence was identified as a significant source of distress following ward transfer. Participants varied in the extent to which they were able to express their needs and negotiate recovery within professionally mediated boundaries. Conclusion. These data provide new insights into the putative origins of the psychosocial distress that patients experience following ward transfer. Relevance to clinical practice. Meleis et al.’s work has resonance in terms of explicating intensive care patients’ experiences of psychosocial distress throughout the transition to general ward–based care, such that the future role development of critical care outreach, follow-up and liaison services may be more theoretically informed.