A Design-led Complex Intervention for the Stroke Rehabilitation Service

Alastair Macdonald
School of Design, The Glasgow School of Art, Scotland

David Loudon
School of Design, The Glasgow School of Art, Scotland

Anne Taylor
School of Design, The Glasgow School of Art, Scotland

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Ingår i: ServDes.2014 Service Future; Proceedings of the fourth Service Design and Service Innovation Conference; Lancaster University; United Kingdom; 9-11 April 2014

Linköping Electronic Conference Proceedings 99:22, s. 226-236

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Publicerad: 2014-06-25

ISBN: 978-91-7519-280-2

ISSN: 1650-3686 (tryckt), 1650-3740 (online)


This paper discusses findings from the introduction and integration of design-led qualitative; research methods into the overall scientific methodology for the design and evaluation of a ‘complex intervention’ through a set of pilot random control trials (RCTs). A set of visualisation tools was co-developed with stakeholders to enhance patient-therapist interaction in the context of the stroke rehabilitation setting. The participative approach recognised the importance of mobilising lay knowledge and experience to drive innovation in the tools whose use helped reduce the ‘social distance’ between therapist; patient and clinical biomechanist. The visualisations aided understanding for patients; enhanced communication between patient and therapist; and provided an objective tool for therapists to monitor progress and communicate this to patients. The implications for service improvement and redesign resulting from involving designers in pilot RCT design are discussed.


RCT; physical rehabilitation; complex intervention; design approaches; visualisation


Bate; P. & Robert; G. (2007). Bringing user experience to healthcare improvement: the concepts; methods and practices of experience-based design. Radcliffe Publishing: Abingdon; UK.

Bjögvinsson; E.; Ehn;P.; & Hillgren P.A. (2012). Design things and design thinking: contemporary participatory design challenges. DesignIssues 28(3); 101-116..

Cottam; H.; & Leadbeater; C. (2004). Health: co-creating services. London; UK: The Design Council. Retrieved from http://www.designcouncil.org.uk/Documents/Documents/Publications/RED%20Paper%2001_Design_Council.pdf

Craig; P.; Dieppe; P.; Macintyre; S.; Michie; S.; Nazareth; I.; & Petticrew; M. (2008). Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 2008;337:a1655. doi: http://dx.doi.org/10.1136/bmj.a1655

Envisage. (2013). Envisage project website. Retrieved from http://www.envisagerehab.co.uk

Evenson; S. (2011). Case study 4 driving service design by directed storytelling. In: Meroni; A. & Sangiorgi; D. (Eds.) Design for Services (pp. 66-72). Farnham; UK: Gower Publishing Ltd.

Freire; K.; & Sangiorgi; D. (2010). Design and healthcare innovation: from consumption to coproduction and co-creation. In Proceedings of 2nd Service Design and Service Innovation conference; ServDes.2010. Linköping Electronic Conference Proceedings 60; (pp. 39-49).

Linköping; Sweden: Linköping University Electronic Press. Retrieved from http://www.servdes.org/

Greger; S.; & Hatami; Z. (2013). Reducing social distance through co-design. In: Keinonen; T.; Vaajakallio; & K.; Honkonen; J. (Eds.) Designing for wellbeing (pp. 25-129) . Helsinki; Finland: Aalto University Publication Series; Art+Design+Architecture 5/2013. Retrieved from https://www.taik.fi/kirjakauppa/images/e9dc83be6e40c9f223ab2b9c63b928ed.pdf.

Hempe; E.M.; Dickerson; T.; Clarkson; P.J. & Holland; A. (2010). Health and social care services for people with complex needs: the importance of context in the design process. In Proceedings of 2nd Service Design and Service Innovation conference; ServDes.2010. Linköping Electronic Conference Proceedings 60; (pp. 145-146). Linköping; Sweden: Linköping University Electronic Press. Retrieved from http://www.servdes.org/

Lewin; S.; Glenton; C.; & Oxman; A.D. (2009). Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. BMJ 2009;339:b3496. doi: http://dx.doi.org/10.1136/bmj.b3496

Loudon; D.; Carse; B.; & Macdonald; A.S. (2011). Investigating the use of visualisations of biomechanics in physical rehabilitation. In: M.M. Cruz-Cunha; J. Varajao; P. Powell; R. Martinho (Eds.); ENTERprise Information Systems Communications in Computer and Information Science; 221 (pp 30-39). Berlin; Heidelberg: Springer-Verlag.

Loudon; D.; Macdonald; A.S.; Carse; B.; Thikey; H.; Jones; L.; Rowe; … Baillie; L. (2012). Developing visualisation software for rehabilitation: investigating the requirements of patients; therapists and the rehabilitation process. Health Informatics Journal; 18(3); 171-180. doi: 10.1177/1460458212443901

Meroni; A. & Sangiorgi. (Eds.) 2011. Design for Services (p. 232). Farnham; UK: Gower Publishing Ltd.

MRC. (2000). Medical Research Council. A Framework for the Development and Evaluation of RCTs for Complex Interventions to Improve Health. Retrieved from

NESTA (2013). By us; for us: the power of co-design and co-delivery. Report. London; UK: NESTA Innovation Unit. Retrieved from http://www.nesta.org.uk/publications/us-us-power-codesign-and-co-delivery

Savory; C. (2010). Patient and public involvement in translative healthcare research. Clinical Governance: An International Journal; 15(3); 191–199.

Sibbald; B; & Roland; M. (1998). Understanding controlled trials: why are randomised controlled trials important? BMJ. 1998 Jan 17;316:201. doi: http://dx.doi.org/10.1136/bmj.316.7126.201

Simon; H. (1996). The Sciences of the Artificial; 3rd ed. Cambridge; MA: MIT Press.

Strickfaden; M. & Devlieger; P. (2011). Empathy through accumulating techné: designing an accessible metro. The Design Journal; 14(2); 207-230.

Stroke Association. (2014). Feeling overwhelmed. Report. Retrieved from http://www.stroke.org.uk/involved/feeling-overwhelmed

Wells; M.; Williams; B.; Treweek; S.; Coyle; J.; & Taylor; J. (2012). Intervention description is not enough: evidence from an in-depth multiple case study on the untold role and impact of context in randomised controlled trials of seven complex interventions. Trials; 2012; Jun 28; 13:95. doi: 10.1186/1745-6215-13-95

Winhall; J. (2011). Case study 11: designing the next generation of public services. In: Meroni; A. & Sangiorgi. (Eds.) Design for Services (pp. 131-138). Farnham; UK: Gower Publishing Ltd.

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