Tactile Tools Co-design Method

The Tactile Tools comprises a set of design artefacts used by interdisciplinary teams to ‘map’ the experience of an individual as they navigate a complex healthcare situation. The toolkit is composed of acrylic ‘tiles’ that represent elements of the healthcare experience (goals, roadblocks, workarounds, empathy, stakeholders and pathways).

The iterative design process followed Donald Schon’s Reflection in Action model, which entailed developing tools and supporting materials; using these in co-design settings; reflecting on the affordances of the method in these scenarios; and iterating the toolkit for the next round of testing.

The Tactile Tools method was iteratively developed over four years in response to a number of complex healthcare challenges:

• 2017: initially, the toolkit was developed for mapping the lived experience of cancer treatment in collaboration with the Olivia Newton-John Cancer, Wellness & Research Centre
• 2018: the method was refined in response to the challenge of redesigning end-of-life experience with Bolton Clarke Aged Care
• 2019: we built upon the toolkit to address the challenges to people seeking to access Voluntary Assisted Dying, with the Victorian Healthcare Association
• 2019: with Young People in Nursing Homes we refined the method to understand the lived experience of consumers with acquired brain injury as they navigated the NDIS and NSW health system
• 2019: method utilised to understand lived experience of disadvantaged families expecting a low birthweight baby with North Western Melbourne Primary Healthcare Network
• 2020: Tactile Tools Digital Toolkit developed to enable researchers from across 7 QUT Schools to visualise the practices and spaces for Health Futures
• 2021: Tactile Tools Digital Toolkit adapted to map the lived experience of consumers seeking care in the Alfred Health eating disorders residential facility

At the conclusion of each of these engagements the method was reflected upon through surveys and reflective practice and iterated for the next challenge.

The Tactile Tools methodology enables diverse stakeholders to map complex journeys of care while keeping the lived experience of patients in mind and heart: addressing systemic healthcare issues while empathising with the individuals who are seeking care.

The activities are co-created with healthcare professionals and the toolkit adapted to diverse challenges. The method demonstrates key features that evidence design excellence:

• Collaboration: The experience invites people from a variety of backgrounds ‘to the table’ to meaningfully contribute to collaboratively evolving models of care, rather than these being developed solely by clinical groups.
• Mobility: The method reframes complex problems in terms of mobility and performativity, enabling teams to address challenges in a playful and interactive way.
• Power equalising: The affordance of 'sliding' helps participants bypass traditional power hierarchies and supports the equality of all voices. E.g. sliding the tile of a superior is less confronting than moving their post-it note.
• Sustainability: The toolkit is infinitely reusable, cleaned after each workshop and reframed for the next challenge, saving wasted post-it notes and butcher’s paper.
• Personas: these are co-created with industry partners and healthcare experts to guide explorations and ensure participants are focused on lived experience.
• Empathy: The method encourages healthcare providers to keep the individual experience of patients at heart by using the empathy tool.
• Adaptability: The method has been used by over 300 experts from healthcare, aged care and education and informed the creation of Victorian’s Voluntary Assisted Dying Guidelines.

North Western Melbourne PHN CEO Associate Professor Christopher Carter suggested using the Tactile Tools method: “help(ed) ensure that the reforms and changes we make, and the programs we fund, always have the needs of individual people in mind. That is after all why we exist – to create better care for all of the more than 1.7 million individuals living in our region.”

The Tactile Tools method is used in the complex spaces of healthcare, including death and dying. It helps align collaborative efforts, promotes reflection, supports questions and enquiries, equalises power relations and enables teams to document workshop processes.

Each workshop also encourages empathy, inclusiveness, and a sense of comfort to help people share experiences and discuss challenges that are related to strong emotional experiences such as illness or death.

The ‘sliding’ affordance of the tiles is playful and helps participants conceive of roadblocks and their related work-arounds as temporal and changeable, no longer immovable obstacles. Sliding also helps to bypass traditional hierarchies as the action of sliding the tile of a superior during a workshop is less confrontational than moving a post-it note or writing over a comment on butcher’s paper.

Matiu Bush, Founder One Good Street, suggests: “Solving wicked problems requires new methodologies, which help aggregate information from diverse stakeholders, and this leads to better solutions. Tactile Tools challenge the highly synchronized behaviour of traditional mapping workshops.”

The method supports the creativity of all users. As Barbara Horn, Project Manager, Strategic Integration Projects North Western Melbourne PHN suggests: “The opportunity to use the (Tactile) Tools to map goals, roadblocks, work-arounds and, perhaps most powerfully, points of empathy, generated wholistic, sensitive and challenging design solutions from a group of health and community care practitioners and managers who may not previously have felt confident to approach a design-driven project.”

The Good Design Awards Jury commented: “This helpful toolkit enables diverse stakeholders to map complex journeys of care while keeping the lived experience of patients in mind and heart...The tool is used in healthcare to address various complex problems successfully and advances boundaries of co-design practice. It's a thoroughly researched, helpful toolkit, that helps to manage and support collaboration when exploring complex problems.”

Used by over 300 people, the Tactile Tools method has supported social change by assisting government organisations, NGOs and healthcare providers to address complex issues including: redesigning end-of-life experience, implementing Voluntary Assisted Dying in Victoria; understanding acquired brain injury; improving cancer care; and, understanding the lived experience of disadvantaged families with low birth weight babies.

It encourages organisations to have a human-centred approach to the development of services and supports all stakeholders to better understand the complex experiences of patients and improve their quality of life.

Exceeding expectations, the method informed Victoria’s Voluntary Assisted Dying guidelines. Project coordinator Cate O’Kane shared: “The Tactile Tools methodology was used to develop the model of care for voluntary assisted dying in Victoria. The innovative methodology informed the model of care by co-designing with consumers and people with lived experiences of life-limiting illnesses.

The Tactile Tools allowed participants to break down the issues/steps and work through to a solution. By using an inclusive collaborative approach as part of the Tactile Tool process, the design was solution-focused and resulted in the development of a person-centred model of care, which was our primary aim.”

Participant feedback evidences the method enabling them to break down complex problems, “Allowed us to iteratively mindmap the issues and their interrelationships”; promote equality, “Was a positive way to give the whole group a voice”; and encouraged empathy, “In this activity Vera’s life is in our hands.”

In addition to having impact on the lives of health seekers, and on the teams that utilise the method, the Tactile Tools also contribute to co-design knowledge and literature on the use of tactile co-design methods (physical and digital) in coalescing interdisciplinary teams to address complex healthcare challenges; and, prototyping and testing how co-design processes can help teams to collaboratively inform models of care.