Designing the future of pandemic emergency response

By Emma-Lee Knape, Andrea Kobor and Michelle Joseph

The INITIATE2 core solution team in Italy
The INITIATE2 core solution team in Brindisi, Italy. Photo: WFP/Julian Civiero

What happens when you bring together the brightest minds of emergency health response into one room? A concept design of an infectious disease treatment module!

The United Nations World Food Programme (WFP) and the World Health Organization (WHO) launched INITIATE2, an innovative multi-stakeholder project, to enhance emergency response to health crises. INITIATE2 brings together partners who have field experience in emergency response, public health, patient care, and research to develop solutions that can be scaled across organizations.

We are pleased to share our key takeaways and lessons learned from the experience.

Step 1: Search for the brightest minds

The INITIATE2 programme was born out of the idea that to solve complex challenges (such as early response to a pandemic) one organization alone may not know all the answers. We need to come together to share collective knowledge and experience to create the best solutions. That is, there is huge power in co-creation.

INITIATE2 was set up jointly by the WFP and WHO as a five-year, multi-stakeholder programme that aims to develop health emergency response innovations. This year is the first year of the program, with a focus on designing an infectious disease treatment module. The innovative module would allow stakeholders to rapidly deploy, set-up and run treatment centers in the field when an outbreak emerges. Partners involved in this design process include, Medicine Sans Frontiers (MSF), Samaritan’s Purse International, Alliance for International Medical Action (ALIMA), Doctors with Africa (CUAMM), International Medical Corps (IMC). Academic institutions, such as the Polytechnic of Turin, and national authorities including the Ministry of Health of Malawi are also supporting the process. The project encourages diverse stakeholders to collaborate and leverage their comparative advantages. The broader INITIATE2 partner network, which currently counts over 20 organizations, is brought in regularly to provide inputs and to contribute to the project with their experience. All participating organizations were selected because of their previous role in emergency response and outbreak management, or their expertise in design and development of similar solutions.

Step 2: Plan a highly interactive design week

People in a workshop
Photo: WFP/Andrea Kobor

To begin the brainstorming of ideas, the group decided to come up with a week-long series of workshops.

Human-centered design (HCD) is the central innovation methodology adopted during the INITIATE2 workshops. The HCD approach brings the user to the core of the design process, by seeking to understand their needs at an early stage to ensure the solution’s relevance in addressing real needs on the ground. This can be used by any UN agency or nongovernment organization that is planning to design an ambitious solution involving multiple key stakeholders.

What we saw during the workshops is that, without question, collaborative design takes time as there are many opinions and experiences to consider. The HCD approach has shown to be an effective way to focus and enable collaboration, by looking at the needs of the people we serve as priority for design. By taking this approach, the chance for a multi-stakeholder design to be successful is so much higher because it ensures that the final solution will likely be adopted by the users.

One challenge in designing a participatory design session with multiple stakeholders is to make sure everyone is speaking the same language or using the same definition of certain keywords. It was the case for this project as well. We are using design terms such as key drivers, pain points and requirements which fit the specific use case. These were defined by the core project team before the workshop and validated by the participants in the beginning of the session. We also agreed on the key user profiles as a group in a virtual pre-workshop session and developed user personas. Therefore, we recommend investing time for the clarification of the terms and tools before the workshop as it will save time and avoid confusion during the session.

Step 3: Convene in person, use the design approach and let the debate begin!

The COVID-19 pandemic pushed us to virtually collaborate in new ways. However, when possible, in-person engagements are a powerful way to build human connections, and allow for creative and focused thinking without the need for laptops. The workshop was held at the United Nations Humanitarian Response Depot (UNHRD) in Brindisi, Italy, the first in a network of six strategically located hubs around the world which store and dispatch relief items on behalf of the humanitarian community. It was the perfect location, and certainly chosen not by accident; UNHRD will also hold future training sessions on the infectious disease treatment module once it is developed.

During the in-person workshops for INITIATE2, experts from each of the partner organizations were fully engaged and present for three days. Coming together in person was key for the success of this process.

By involving medical staff, architects, Ministry of Health representatives and other key stakeholders, the assumptions that people came in with were challenged. Each of the workshop participants came with different priorities and different challenges they would like to focus on. Therefore, aligning on the problem/s to be solved was key. The biggest achievement was that workshop participants were thinking about the problems and the solutions primarily from a user perspective which helped to create alignment.

Another challenge of multi-stakeholder engagement is aligned decision making. The power of the design process is quick decision making and it’s not perfect, but it’s very efficient and it shows priority directions.

People in a workshop
Photo: WFP/Emma-lee Knape

Here’s how the approach works:

First, we co-created a journey map, to define how clinicians, logisticians, and patients respond when a suspected case is identified in a community. The group brainstormed the pain points in the experience and the opportunities for improving the experience in the design.

We used the technique of dot voting to enable prioritization and narrow down the vast amount of challenges or potential approaches that the team can take. Each participant had a limited number of votes (i.e. dots). Typically, we suggest 3–5 dot votes per participant, depending on the number of items to vote on (i.e. if there are a lot of ideas you would allow participants more votes). Counting the votes allows us to eliminate lower priority ideas for the entire group. This was a useful way to facilitate ongoing debates that have been going on for a while between some of the participants who know each other well and think differently about the top challenges and have strong opinions.

Next, we used the priority-voted challenges to define challenge questions. These questions guided ideation to ensure we are solving the right problems.

Then came ideation, to identify new and existing opportunities to address our top challenges. We were then able to detail, visualize and assess our top ideas for alignment with key drivers, feasibility, viability, desirability, and impact. In the ideation phase, the visualization of ideas is essential, this is when we start thinking about how an idea would actually work. We assigned two participants to each idea to conceptualize their own versions, and later they were asked to present to each other and create one common visual of the same idea. This way different approaches were considered and incorporated.

Finally, based on the most promising ideas, we created a design brief that describes the problem we are solving, the solution and how it works, and the value we aim to create.

Step 4: Gather feedback to get the best out of the session

It wouldn’t be a design process without iteration and improvements based on feedback. At the end of each day, we captured feedback from the group and used it to tweak the sessions for the following day. Some feedback, for example, indicated that we needed to spend a bit more or less time covering a topic area. Others suggested that we had too many similar stakeholders in the same working group; based on this feedback, we diversified working groups for next sessions. By iterating on the approach for the day you can make sure to give the best participant experience.

Step 5: Find alignment on a high-level concept

People in a workshop
Photo: WFP/Andrea Kobor

Initially, we put a lot of emphasis and stress on having a tangible, full-blown solution crafted at the end of the three days. However, there is only so much you can do in a co-creation session.

Finding alignment on a high-level concept is a goal that’s more achievable. We suggest aiming to have the elements of a potential solution and not necessarily having all the pieces together immediately. These types of workshops should focus on alignment on priorities, which will guide more specific solutions moving forward.

There are numerous different problems a new infectious disease treatment module could solve and there are even more ways in which it could be done. The HCD process we followed during the workshop allowed us to map this wide range of problems (i.e. pain points) and land on priority areas. We also co-created a list of design principles which the final design must follow — and the concrete “what” that will require the involvement of engineers in the next stage of the design process.

Next up: Detail the concept

Following the workshop, the design leads came together to develop the concept in more detail, prepare for a review by the participants in the design workshop, plus a technical review before technical specifications are completed and a Request for Proposal is shared with potential solution providers.

During the next phase of the project, the infectious disease treatment module solution will be prototyped, then tested in a drill exercise. The final test for the solution will be a full-scale simulation exercise that will include a real-life based scenario involving an infectious disease outbreak. The simulation will also be key in testing how the different partners and the different functions work and respond together to a health emergency.

Find out more about WFP’s SDG Acceleration Programme.

The WFP Innovation Accelerator sources, supports and scales high-potential solutions to end hunger worldwide. We provide WFP staff, entrepreneurs, start-ups, companies and non-governmental organizations with access to funding, mentorship, hands-on support and WFP operations.

Find out more about us: http://innovation.wfp.org. Subscribe to our e-newsletter. Follow us on Twitter and LinkedIn and watch our videos on YouTube.

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