Radically self-organized care: what can designers learn from the evolutionary dynamics of cooperation

Julia Schaeper, Glenn Robert

Research output: Chapter in Book/Report/Conference proceedingConference paperpeer-review

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For many years, top-down performance management systems have strongly influenced organizing structures in the health sector (De Blok, 2010). Recently, new organizational forms based on self-governance have begun to emerge where authority is more widely distributed amongst healthcare staff and work is conducted by decentralized, self-managing teams or networks. In this paper we aim to develop a better understanding of the distinctive design properties of these highly collaborative organizational structures and to reflect on the designer’s role in this context. We are interested, firstly, in exploring how service and system designers can best support health organizations to advance in such a changing environment, and, secondly, how design practice might help to address the inevitable tension between (a) formal bureaucratic controls and mechanisms for accountability and (b) continual adjustments and distributed authority. Elinor Ostrom’s Core Design Principles, founded on her Nobel-prize winning work in the management of Common Pool Resources, have advanced to describe the evolutionary dynamics of cooperation more generally. We propose that combined with insights into humanisation these principles may provide a sustainable approach for the future design and delivery of care provision. Investigating a healthcare case study characterized by self-organisation, we aim to facilitate a collective reflection and inspire further experimentation in the field.
Original languageEnglish
Title of host publicationProceedings of the 6th European Conference on Design4Health
EditorsK Crister, C Craig, P Chamberlain
Place of PublicationAmsterdam
PublisherSheffield Hallam University
Number of pages7
ISBN (Electronic)978-1-8381117-0-0
Publication statusPublished - 3 Jul 2020


  • Co-production
  • Co-design
  • Healthcare services
  • Design thinking
  • Service user experiences


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