Liberty Resources: 2012 MiD Collaboration

Collaboration with Liberty Resources, Inc. Fall 2011

University of the Arts Masters of Industrial Design + Liberty Resources, Inc.

Kelly Babcock Tian Cai Ben Farahmand

Lonnie Petersheim Alaina Pineda

Liberty Resources, Inc.

Published by

211 South Broad Street, 5th Floor Philadelphia, PA 19102 Copyright Š 2012

Copyright © 2012 by Kelly Babcock, Tian Cai, Ben Farahmand, Lonnie Petersheim, and Alaina Pineda Illustrations copyright © 2012 by Kelly Babcock, Tian Cai, Ben Farahmand, Lonnie Petersheim, and Alaina Pineda Photography credits: All photography created by © 2012 Kelly Babcock, Tian Cai, Ben Farahmand, Lonnie Petersheim, and Alaina Pineda unless otherwise noted.

All rights reserved. No portion of this book may be reproduced–mechanically, electronically, or by any other means, including photocopying–without written permission of the publisher.

Cover design by Kelly Babcock, Tian Cai, Ben Farahmand, Lonnie Petersheim, and Alaina Pineda Book design by Kelly Babcock, Tian Cai, Ben Farahmand, Lonnie Petersheim, and Alaina Pineda Masters of Industrial Design at The University of the Arts 212 South Broad Street, 5th Floor Philadelphia, PA 19102 First printing April 2012

Table of Contents 07 15 41 65 95

Chapter Chapter Chapter Chapter Chapter

1 2 3 4 5

| | | | |

Appendices A Key Terms B References

Introduction Research + Synthesis Point of Entry Prototype + Test Final Presentation + Feedback

01 Introduction 08 09 10 11 12

Section Section Section Section Section

1 2 3 4 5

| | | | |

Our Client Contacts at Liberty Resources Our Role As Designers The Design Process Key Design Tools We Used Project Timeline

8 | Introduction

Our Client Contacts at Liberty Resources

norma roBertson-daBrowskI Director, Specialized Transitioning Services

nancy salandra Director of Independent Living

Introduction | 9

alaIna PIneda Birmingham, AL Art History

Our Role As Designers Our role as designers is not a top-down approach, where we stay in our studio and think of the best possible solution for our client, but instead come to that through on the ground exploration. Our multidisciplinary teams bring together different ways of thinking and allow us to come up with much more creative and innovative approaches. We work through the process of synthesis, or sense-making to identify unique opportunities for design intervention. We always make our prototypes and proposed solutions tangible. This does not necessarily mean that it’s a product, but what it does mean is that it’s visual. This makes the information more accessible and understandable while also providing a way to get feedback. Lastly, to further communicate our recommendations, we formulate narratives and scenarios to further model our ideas.

Ben farahmand Los Angeles, CA Aerospace Engineer + Philosophy

lonnIe PetersheIm Greencastle, PA Interdisciplinary Arts

kelly BaBcock Cincinnati, OH Graphic Design + Marketing

tIan caI Shanghi, China Integrated Design

10 | Introduction

The Design Process

research

synthesis

Prototype

Test

iterate

Gathering qualitative data with a human centered approach by considering ethnography and outliers.

Making sense of the qualitative research gathering through abductive thinking, visualizing information, and sorting data. This process allows for producing generative thinking.

Develop a concept that was informed from synthesized research into a model or system that is able to be tested and observed.

In this step we observe the successes and failures of the prototype in a real situation that may reveal that more research or synthesis is needed.

Take observations from testing and develop new versions of the prototype.

Introduction | 11

Key Design Tools We Used

Guided Tours

flow diagramming

storytelling

Contextual Interview

concept map

scenarios

Secondary research

stakeholder map

co-creation

Activity analysis

time-lapsed video

Shadowing

experience prototype

iterate

12 | Introduction

Project Timeline

Introduction | 13

02 Research + Synthesis 16 21 22 26 28 34 38

Section Section Section Section Section Section Section

1 2 3 4 5 6 7

| | | | | | |

Getting to know Liberty Resources, Inc. Previous Project Work Kick-Off Meeting with Our Client Key Interview with Glenda Reference Research Internal Observations: The Advocate Meeting External Observations: Nursing Facility Visits

16 | Research + Synthesis

Getting to Know Liberty Resources Guided Tours Our team observed Liberty Resources’ environment and interviewed Theresa about the history of the organization.

The tour was our groups initial chance to see the Liberty Resources office and network with Liberty Resources employees. We began by simply observing the building from the outside while waiting. We observed many people in chairs using public transportation and we had a chance to walk through the Liberty Resources’ store. When we first were introduced we became a little uncomfortable. This would be our first experience being around people with disabilities. Continuing on the tour we noticed that many of the offices were empty and the building felt more like a doctors office. Liberty Resources has a “sterile like” feeling inside.

During the tour we had a chance to meet the Director of National Advocacy & Policy. We learned that 43% of Liberty Resources’ staff was recently cut because the state and federal budget for CIL’s was cut drastically. Also, in this interview we observed a particular language that the employees use.

Liberty Resources uses a distinct type of language that our team framed as “fighter language.”

All the employees have to Advocate for people with disabilities. People with disabilities feel like an oppressed group and are willing to fight to get what they need. Therefore, they decide to use a common language that is aggressive and often defensive.

After the tour of Liberty Resources, our group came back to the studio and brain dumped what we observed. Mapping out our observations on a whiteboard allowed us to be on the same page. As well as make sense of our assumptions. The mind mapping tool also lead us in our next direction. We needed to do more reference research on Liberty Resources to get a better understanding of legislation and policy.

Research + Synthesis | 17

18 | Research + Synthesis

Research + Synthesis | 19

CONCEPT 2.0

20 | Research + Synthesis

My Map Specialized Services

respond synthesis

Living and Receiving Services In The Nursing Home

Community Services Program for People with Physical Disabilities

Major Service Options

Additional Services Available at ALL times

Living in a Nursing Home

Transitioning Services

Living and Receiving Services In The Community

Housing Found

Housing Advocacy

Additional Services Available Once Transitioned

Multiple options based on specific needs or choice

Information And Referral

Advocacy

Liberty Wheels

Retreads

Peer Support

Attendant Care Program

Independent Living Skills Training

Major Goals

Medical Support Unit

Fiscal Management Services

Environmental Modifications

Academy

Where You Are

My Services

My Steps Time to Complete Days

Time to Complete Days

Time to Complete

Time to Complete

Days

Time to Complete

Days

Time to Complete

Days

Days

Time to Complete

Time to Complete Days

Days

Time to Complete

Time to Complete

Days

My Progress Map The Road to Independence Tools for Understanding & Planning Choices

Days

Research + Synthesis | 21

Previous Project Work Contextual Interview To get a better understanding of the work that had been done with Liberty Resources in the past, we interviewed students that had collaborated with them previously.

Our research continued by looking at the work that past teams have done. It was very helpful having tangible designed objects to reference and look at. It was useful observing Liberty Resource’s branding and identity. We interviewed several of the students on these past teams. respond They explained to us about the Independent Living Services Department and how people go synthesis through the process. The problems they run into are not understanding where at in they are and what they need to do next. Therefore, the past MiD’s project was to visualize and simplify this process with a book and map. It is a step by step process that is very simple and accessible for people with disabilities.

CONCEPT 2.0

The Road to Independence Tools for Understanding & Planning Choices

Service Details & The Steps for Reaching Your Goals

22 | Research + Synthesis

Kickoff Meeting with Our Client Contextual Interview Since our team had little understanding of Liberty Resources, we relied on an interview with our client contact, Nancy, to get a broad overview of the issues they deal with.

Our next step of research was our first meeting with our clients. It was a round table discussion consisting of our professor, Michael McCallister, our clients, and the MiD team. Our clients gave us very beneficial insights early in the conversation. A quote from one of our clients became a statement that we would hold on to for the rest of the project.

“America is not ready to see disabled people fight for their rights.”

This quote conveyed much about Liberty Resources and their relationship with the community.

We observed many times throughout the semester that people are not willing to listen to stories of people with disabilities. People seem to overlook people with disabilities and it is always an uncomfortable subject. Liberty Resources also has problems at getting the medias attention and when they do the main issue is often over looked.

The state passed a 16% cut on the Medicaid budget for community-based services (CBS). This cut eventually lead to a 43% staff cut of Liberty Resources’ employees.

The meeting continued and our clients brought up the current cut of Liberty Resources employees. Due to the recent cuts Norma and Nancy no longer have staff to help transition people from nursing homes. They now rely on part-time employees who can only work 8 hours a month. We also learned that 51% Liberty Resources’ staff and board members have a disability. They strive to employ people with disabilities and to have people with disabilities work for people with disabilities.

Research + Synthesis | 23

24 | Research + Synthesis

Research + Synthesis | 25

Kickoff Meeting with our Client (Continued) At the end of the meeting we noticed a wall of framed papers with pictures of individuals with disabilities. We asked client what the significance of the wall was. They explained that each was a story about someone who transitioned from a nursing facility recently. Here was a wall of meaningful stories of people who managed to transition from a nursing home to living independently. Ultimately, becoming an active member of their community and giving back instead of feeding off government funds. Only to be contained within Liberty Resources and not for the public to see.

Secondary research After hearing about the many complex issues facing Liberty Resources, we used secondary research to expand our understanding.

After the kick-off meeting the MiD team came back to the studio and began to mind map what we observed and learned to synthesize the data. We soon realized that everyone was feeling overwhelmed with the wealth of information we gathered. Each piece of data holds a significant value and opportunity to design. It became very tough to choose what direction we wanted to continue. Furthermore, after a collaborative mind-mapping session we realized there was more research to be done. We each separated the work tasks and did some reference research to better test our assumptions and understand the complex problems.

26 | Research + Synthesis

Key Interview with Glenda Contextual Interview Interviews with Liberty Resources Consumers were a vital part in our design process.

Our interview with Glenda was our first chance to hear first hand about the stories of people living in nursing facilities. She opened up about the living conditions of the nursing facility where she lived for sixteen months. She explained that the nursing home takes all your money that you receive from medicaid as well as other sources. Most facilities only give you a thirty to forty dollar allowance monthly. She also told us that the nursing home opens your mail.

Most of the nursing facilities in Philadelphia open the mail without the permission of their Consumers.

They do not have legal permission to open you mail, however, they require you to sign over your incomes. Therefore, they will open your mail to take your money. She lead us into a new direction as well and spoke about the roadblocks with finding attendant care while living independently. Moving out of the nursing facility is tough enough let alone finding someone to help you with living on your own. We continued after the interview by mind mapping, as a group, the information gathered from the interview. After mapping out the interview and having a collaborative discussion we did some more reference research to better understand pensions and medicaid.

Research + Synthesis | 27

28 | Research + Synthesis

Reference Research Secondary research Additional secondary research became necessary as we worked deeper and deeper into the complex systems.

The tour, interview, and kickoff meeting lead us in the direction of doing reference research.

Reading articles, books, and news publications became vital in our process to better understand the problems that we were facing. The problems that Liberty Resource’s and people with disabilities face are very complex and hard to understand. We looked further into Medicaid by trying to understand its significance of legislation and flow of money. The money begins at

The company, Maximus, slows down the process significantly for people to live independently. flow diagramming To better visualize how the company, Maximus, operates, we created a flow diagram (seen on page 30).

the Federal Government level then flows to the State level. It is up to the State to decide how it will be distributed locally. Currently they have been trying to consolidate the State’s services.

This creates many problems like significantly slowing down the States services. Maximus is a consolidated state service company that hands out housing vouchers to people moving out of nursing facilities. The current process takes more than a year. By visualizing the process we realized why it takes time and how Maximus is like a human factory.

We also did research about Pennsylvania’s institutions comparing them with living independently.

Pennsylvania, compared to all other States, currently has the highest ratio of people living in nursing facilities versus living independently. The price for someone living independently is much less than living in a nursing facility. In addition, Philadelphia has a population of 150,00 people with disabilities which is twice as much as the next highest population. This means that Philadelphia has a significant role on people with disabilities rights.

research + synthesis | 29

Follow the Money: Financing Home and Community-Based Services Follow the Money: Financing Home and Community-Based Services Joshua M. Wiener, PhD Wayne L. Anderson, PhD

Pennsylvania Medicaid Policy Center University of Pittsburgh 2009

Joshua M. Wiener, PhD Wayne L. Anderson, PhD Pennsylvania Medicaid Policy Center University of Pittsburgh 2009

2

2

30 | Research + Synthesis

$

Public Housing Authority

Eligibility paperwork

Maximus

Find housing

Find housing

Find housing

Research + Synthesis | 31

$

Nursing Homes

Maximus Process $ Shareholders

Maximus was implemented by the state to consolidate the housing process. Its intention was to maximize the flow of individuals, however it did the complete opposite and has slowed the process down significantly. Individuals have to wait up to a year, if not longer, just to be accepted and find housing.

32 | Research + Synthesis

Medicaid Expenditures This visual allowed us to compare Pennsylvania with all fifty states.

It shows that Pennsylvania puts most of its medicaid dollars into nursing facilities. Why does Pennsylvania have so many more people living in nursing facilities compared to the other most populated states.

Research + Synthesis | 33

1 - 5000 5001 - 15,000 15,001 - 50,000 50,000 +

Erie

Warren

Crawford

McKean

Susquehana

Bradford

Tioga

Potter

Wayne

Crawford

Forest

Wyoming Cameron

Elk

Venango

Sullivan

Lackawanna Pike

Lycoming

Mercer

Luzerne

Clinton Calrion

Jefferson

Monroe

M

on

Lawrence

to

Clearfield

Butler

Union

Centre Armstrong

Snyder

Columbia Carbon

nd humberla

Shuylkill Indiana

Mifflin Cambria

Alleghany

Blair

Perry

Berks

Dauphin

Bucks

Lebanon Mon

tgom

Washington

Cumberland

Somerset

ery

Lancaster Chester

Bedford Fayette

Lehigh

Juniata

Huntington

Westmoreland

n

pto

ham

rth

No

Nort

Beaver

Greene

ur

Philadelphia Fulton

Franklin

Adams

York

Delaware

120,591

People with Disabilities on Medicaid In comparing the graph to the left with the one above. You will notice that the largest amount of people with disabilities in Pennsylvania live in Philadelphia. Meaning, Philadelphia has a significant role on people with disabilities living in nursing facilities instead of living independently.

34 | Research + Synthesis

Internal Observations: The Advocate Meeting Activity analysis We observed the actions, process, and system of the Advocates in the Independent Living Services Department.

The Advocate system at Liberty Resources was implemented to help Consumers move out of nursing facilities. The Advocates are given four Consumers, a month, to help transition and can only work a maximum of eight hours in that month. The Advocates role is to keep track of the Consumers process. The Advocate meetings are very loose and unstructured. Which makes everything very confusion. The individual Advocates are required to gather the necessary materials from the Consumers. For example, every Consumer requires a state identification.

The Advocate has to take the Consumer to a local location to attain a state identification. We observed that the individual Advocates lack the material to document. Several individuals forgot what they needed to do and much information had to be retained from their visits to the nursing facilities. In addition, we observed that each Advocate is very different. Some Advocates can handle more work than others and some have trouble concentrating on the work task.

The Advocate meeting allowed us to do initial networking. It gave us a chance to meet individuals who have already moved from nursing facilities and have experienced it first hand.

Each Advocate has a inspiring story about moving out of the nursing facility. They all are very passionate about Liberty Resources and value their services greatly. We began to realize how important Liberty Resources is for people with disabilities to survive.

Research + Synthesis | 35

36 | Research + Synthesis

Research + Synthesis | 37

38 | Research + Synthesis

External Observations: Nursing Facility Visits Shadowing Shadowing Advocates as they visited Consumers in nursing facilities helped us to better understand how the nursing home transition process was being communicated.

After the Advocate meeting we set up visits to shadow Advocates at the nursing facilities.

We shadowed Advocates at the Inglis House, Care Pavilion, Philadelphia Nursing Home, and Cheltenham Nursing Facility. Our visits informed many of our design decisions. We had a chance first hand to observe Consumers who are transitioning out of a nursing facility. The Advocates run into problems dealing with the employees and social workers of the facilities.

They nursing facilities are not willing to work with them. Also, we learned that each Consumer has different needs. Someone may have a physical disability and another may have a mental disability. These disabilities became very problematic in our process and we were forced to think about the Consumers needs.

Our main concern for our clients were for us to look at the transition process. Therefore, we concentrated more on the process when researching. The Consumers also have no way of tracking where they are in the process and what they need to do. This is all in the hands of the Advocate to educate and inform the Consumer.

Research + Synthesis | 39

03 Point of Entry 50 56 58 60 61 62

Section Section Section Section Section Section

1 2 3 4 5 6

| | | | | |

Identifying Design Opportunity in Key Interactions Understanding Our Point of Entry Point of Entry Client Presentation Storytelling as Tools for Change Prototypes and Levels of Development Initial Prototype Client Presentation

Tian sharing Marsha’s story: “In terms of Marsha, the most impressive thing is her addressing how her life changed because of the Liberty Resources picnic, by seeing those people with even more limitation living an energetic life in community, she uttered “How stupid of me. Being that pessimistic and upset with my disability in the past.”

Ben sharing Michael’s story: “Michael Bencrowsky, when I first met him, he told me that it costs three times as much for tax payers to support people with disabilities living in nursing homes as opposed to supporting them to live in the community. He told me about the protests he went to, and how he Advocates for proper policy at the governmental level.”

Alaina sharing Sue’s story: “To be reunited with her children she lost when she first acquired her disability, Sue has re-entered a nursing facility across the country to be closer to them. It is the only way to receive the services she needs without being placed on a two year wait list for what she needs to live independently..”

Lonnie sharing Vincent’s story: “If the Mayor were to move into a nursing home, he would understand what it was like to live in one. His view is that he mayor/public does not understand what it is like to live in a nursing facility.�

Kelly sharing Glenda’s story: “Glenda told us about how nursing facilities unjustly take a resident’s money. She talked about a couple who was ‘tricked’ into moving in to the nursing facility. When the wife got sick, the husband missed her so much that the facility convinced him that he should move in as well.”

We believe...

By leveraging Liberty Resource’s powerful stories as tools, and sharing them with the right audiences, we can affect positive change for people with disabilities.

50 | Point of Entry

Identifying Design Opportunity in Key Interactions In making sense of our collected research, we noted five key interactions among the project’s stakeholders. Each relationship contains an unmet need, and an opportunity for design to intervene.

The following pages will highlight some of our key research findings and how they relate to these interactions.

Consumer

Consumer

Advocate

Consumer

Consumer

Liberty Resources

Liberty Resources

Government

Liberty Resources

General Public

Point of Entry | 51

Consumer

Consumer

Key Research Finding: Lack of support network After interviewing many of Liberty Resources’ Consumers and Staff, we noted that many lacked a solid support network of friends and family and relied on each other for friendship, motivation and hope.

Consumers at an ADAPT event

52 | Point of Entry

Advocate

Consumer

Key Research Finding: Confusion about the transition process While shadowing Liberty Resources Advocates, we identified a significant opportunity for design among their interaction with the Consumer. There was reoccurring confusion about the nursing home transition process, and a desire to know more.

Sue with a Consumer at the Philadelphia Nursing Facility

Point of Entry | 53

Consumer

Liberty Resources

Key Research Finding: Documentation of the Consumer’s transition process As we observed Liberty Resources’ internal processes, we noted an opportunity to improve how the Consumers’ “success stories” were collected, presented and later archived.

Currently, they were not being utilized to their full potential.

Norma showing our group the wall of Consumers’ stories

54 | Point of Entry

Liberty Resources

Government

Key Research Finding: Lack of political response When considering the greater systemic view of Liberty Resources, we identified an area of need among their activism and advocacy efforts. A lack of political response from recent actions revealed opportunities for improvement.

Michael in front of the White House

Point of Entry | 55

Liberty Resources

General Public

Key Research Finding: “Americans are not ready to see people with disabilities fight for their rights.” Nancy Salandra, 2011 As we were interviewing our client, we captured this revealing quote about a nuance in American culture that inhibits Liberty Resources’ messaging from penetrating and affecting change among the general public–this exposed an area of possible design intervention.

Nancy explaining the relationship between Liberty Resources and the general public

56 | Point of entry

Understanding Our Point of Entry By extracting our key research findings from our interviews, shadowing, paper research, etc., we were able to map the many stakeholder interactions and corresponding needs. Through this sense-making, we discovered how storytelling could be used as a tool to help prototype solutions for the different design opportunities.

flow dIaGrammInG To help our team identify the stakeholder interactions and understand how storytelling could be used as a tool we used a flow chart to show relationships.

Storytelling

Point of entry | 57

The “Story” and Power of Storytelling 9 3 LRI tries to document but it is an afterthought/ too busy in the moment.

4

Mayor Nutter

What isn’t being told that needs to be told?

“Americans aren’t ready to see people with disabilities fight for their rights.”

Re-humanizing 1. 4. 7. 8.

Philadelphia Inquirer

7 Glenda tries to get outside everydayrain, shine, snow.

Documentation of Individuals/ Successful Transitions

8

2

1 The Mayor doesn’t understand the problem with Philadelphia Nursing Home.

The media doesn’t “get it.”

2. 9.

3. 7. 8.

How do you tell the story of what it’s like living out in the community?

The Power of Storytelling Understanding Nursing Homes

Infographics Tools for Activists and Advocates 5. 8.

5. 8. 10.

10

5

Why is a nursing home the entitlement?

Corruption?

Why wouldn’t someone want to leave the nursing home?

6 People living in a nursing home might not have family to take care of them.

The 5th Core of the CIL 5.

Support Networks

5. 6.

The Power of Storytelling| 10.03.1

MiD@UArts | GRID 603/703 Studio | Liberty Resources | October 10, 2011

58 | Point of Entry

Point of Entry Client Presentation At this point in the semester, our team was ready to present the emerging insights from our research and propose a point of entry for our project with the client. We synthesized the data we had collected and identified key stakeholders that interact with Liberty Resources’ various divisions at different points in the nursing home transition process. The unmet needs among these interactions exposed opportunity for design to intervene and for our project’s focus we felt that one key design method could be applied to address each–storytelling. To demonstrate storytelling as a point of entry for our project, we structured the presentation storytelling To present our point of entry, we decided to use the key design tool we were proposing– storytelling, to communicate our idea.

concept map The visual appearance of the concept map we used in our presentation helped viewers to better understand and identify connections as we described them.

Jon Kolko, in ‘Exposing the Magic of Design,’ comments that storytelling is the process of knowledge transfer and the rapid immersion in the experience. around the idea of “show don’t tell.” We re-created our hand-drawn concept map that we had used to synthesize our research on large sheets of paper and pre-wrote on post-it notes the various audiences and key insights from our research. During the presentation, team members narrated our process while others filled in the map. We used this presentation style to demonstrate not only our process of synthesis, but also to model how an experience could be designed through storytelling. Reflecting on our presentation, we did not consider that the design process we were acting out would appear very foreign without more context around how we conducted research and extracted the main findings to arrive at the components in the map. We also observed that the combination of narration, demonstration and distribution of additional support in the form of infographics provided for too overwhelming of an experience. It prevented the client from feeling our excitement and the impact of our research findings and new insights.

Point of Entry | 59

60 | Point of Entry

Storytelling as Tools for Change With our point of entry approved by the client, we began designing prototypes for how storytelling may be used to fulfill the unmet needs in the identified interactions. Each prototype uniquely considers the project constraints of limited time and resources, as well as, the limited physical abilities of our end users. Prototypes 3–5 are more conceptual in their development, while 1 and 2 are further developed, tested, and refined.

Consumer

4

3

Consumer

Advocate

3

1

Consumer

Consumer

3

Liberty Resources

Liberty Resources

5

Government

Liberty Resources

5

2

General Public

Point of Entry | 61

Prototypes and Levels of Development Further Developed

1

Liberty Cards

A simple booklet of the step-by-step process for a Consumer to transition out of a nursing facility.

2

Fundraising Cards

A card with an inspirational story to encourage individuals to donate to Liberty Resources and support a Consumer transition to living independently.

Conceptual

3

iPad Application

An accessible tool used for Advocates to use when visiting a Consumer. It includes a map of the process and stories of hope to share with Consumers.

5

Come. Listen. Respond.

A tool to test the general public’s responses to stories, as a way to prototype different stories to eventually be told to WHYY.

4

Community Storybook

A book of stories to be passed between Consumers that builds community and allows stories of hope to continue to be told.

62 | Point of Entry

Initial Prototype Client Presentation experience prototype By allowing our client to experience the prototypes we had constructed, we were able to observe and reveal some unanticipated issues.

scenarios To help the clients imagine how the prototypes or services we were proposing could be feasible, we talked through possible scenarios of use.

time-lapsed video In order to communicate one of our more conceptual ideas, we created a time-lapsed video of the prototype being tested with real people, in a real environment.

To manifest our proposal to design storytelling as a tool for change, we developed five different prototypes to address the variety of interactions between Liberty Resources and the internal and external stakeholders. The prototypes were: the community storybook, the Come. Listen. Respond. stand, iPad application, Liberty Cards and Fundraiser Cards. We rapidly mocked-up the products with simple materials and created scenarios to demonstrate the proposed services to allow our client to mentally model how they may be implemented. At the meeting, we allowed the client to experience the prototype as we explained the research

“Reflecting on our presentation, we could have better facilitated the feedback we were receiving from the client.

This would have allowed for more informed ‘next steps.’” applied, the interactions it addressed and the production and distribution methods we envisioned. In the construction of these prototypes, we considered many design constraints that focused on the various needs of people with disabilities, the limited resources of money, time and support staff, and the realistic production and distribution channels available.

Additionally, to further communicate one of our more conceptual prototypes–the Come.

Listen. Respond. stand–we played a time-lapsed video to show how we tested the prototype among the user group. Reflecting on our presentation, we could have better facilitated the feedback we were receiving from the client. This would have allowed for more informed “next steps.”

Point of Entry | 63

04 Prototype + Test 67 77 83 89 93

Section Section Section Section Section

1 2 3 4 5

| | | | |

Further Developed Prototype: Liberty Cards Further Developed Prototype: Fundraising Card Conceptual Prototype: iPad Application Conceptual Prototype: Community Storybook Conceptual Prototype: Come. Listen. Respond.

Advocate

Consumer

Further Developed Prototype: 1 Liberty Cards This simple booklet shares the step-by-step process and assists the Consumer to transition out of a nursing facility and live independently in the community.

68 | Prototype + Test

Liberty Card Content Co-creation with Client

co-creation By engaging in a participatory design experience with our client, we were able to cocreate an artifact for us to reference when prototyping.

flow diagramming Visually representing the complex nursing home transition process allowed us to see the flow of the Consumer and the information through the many steps.

While focusing on the nursing home transition process at Liberty Resources, we quickly realized the complexity and extent of the steps needed to complete the transition. To create a better understanding and test some of the assumptions we had been making, we decided to facilitate a participatory design experience with our clients, Norma and Nancy. To make sense of this complex process, we used the physical design method of card sorting to show chronology and causality. Making this process visual and external encouraged us to zoom in and out to see the big picture as well as begin to distinguish smaller phases and categories

“The transition process is an ill-structured problem for Liberty Resources, and to make sense of it we used the method of card sorting to simplify the complexity.” that encompassed certain sets of steps. The result of our exercise took the form of a flow diagram that modeled how the most common Consumer would step through the transition process. This information was then transferred to our Liberty Cards prototype where it took the form of “what you need to complete this step,” and “how to complete this step.” This instructional writing would not have been accessible from an information perspective if we had not simplified it to the point we did. Reflecting on our participatory design experience, it was very successful. Additional opportunities for inclusion of the client in the process were not fully utilized, and now, we are able to see the benefit in interactions of that nature.

Prototype + Test | 69

70 | Prototype + Test

1 Liberty Cards: Design Opportunity Based on the research we had, we found that the Consumers in nursing facilities easily got lost in the complex transition process, and many of them didn’t have family support, which eliminated their hopes of moving out.

Group brainstorm about the construction of Liberty Cards.

Prototype + Test | 71

1 Liberty Cards: Concept In order to meet the immediate needs of speeding up the transition process at Liberty Resources, we designed the Liberty Cards as a tangible tool, which can provide the Consumers in nursing facilities with the first six steps of identities gathering which they would go through in the transition process. It seems that the Liberty Cards are the most feasible prototype that Liberty Resources can produce at a low cost and distribute to the Consumers effectively and quickly.

72 | Prototype + Test

1 Liberty Cards: Development Considering the physical limitations of the audience, we tried out different structures of our prototypes, for instance:

∞ Lamination–Recycled in production, lower cost

∞ Binding ring–Maybe more feasible to the Consumers with hand disabilities

Design versions for Consumers with different limitations.

Prototype + Test | 73

1 Liberty Cards: Production + Distribution After we identified the budget issue at Liberty Resources, the Liberty Cards were designed half the size of normal print paper, allowing the staff at Liberty Resources to easily print and cut. Meanwhile, we made all the content in black and white so as to minimize the cost of production.

We came up with the idea of setting up a phone line so that Consumers could respond with their feedback on the prototype we built.

Construction Process of the laminated version of Liberty Cards.

74 | Prototype + Test

experience prototype Observing and interviewing the users while they experienced the prototypes provided valuable feedback for us to use as we refined the designs.

Group testing out the Liberty Cards with Advocates in an Advocate meeting at Liberty Resources.

Prototype + Test | 75

1 Liberty Cards: User Feedback From our observation in the advocacy meeting, we found and concluded the pros and cons of the different construction forms of the Liberty Cards. For instance, in some version, cards easily fell to the floor. In other versions, it was difficult to turn the pages, and bound pages were too loose to control.

iterate By repeating the process of rapid prototyping and testing we were able to reach a version of the Liberty Cards that best fit the users’ needs.

Liberty Resources

General Public

Further Developed Prototype: 2 Fundraising Cards A card with an inspirational story to encourage individuals to donate to Liberty Resources and support a Consumer transition to living independently.

78 | Prototype + Test

2 Fundraising Cards: Design Opportunity We found there was an opportunity to make the use of the powerful stories told by Advocates and Consumers so as to raise fund for our client, Liberty Resources. However, the previous fundraising effort was based on sending out a letter or book containing a paragraph of text about what Liberty Resources was doing or how they were addressing the issues they were dealing with, which didn’t seem to affect much influence on the general public.

The QR code version of Fundraising Cards prototype and the packaging for the audio player version.

Prototype + Test | 79

2 Fundraising Cards: Concept The idea of the Fundraising Card is to collect more funding for Liberty Resources by distributing the stories of someone who has gone through the process. For instance, someone who has conquered the process and managed to escape a nursing facility, or someone who is still in the middle of the process, working towards becoming independent.

Their stories about how they have overcome the entire transition process is a means to give their voice some weight in terms of showing the struggles they encountered. It is a way to engage someone who has disposable income and can intervene in aiding Liberty Resources, fighting for the rights of the individuals to live independently in the community.

Testing the Fundraising Cards at MiD Studio.

80 | Prototype + Test

2 Fundraising Cards: Development Based on the target audience of the Fundraising Cards prototype, the general public, we designed two versions of the cards, which include an electronic recorder as well as a QR code card so that they can meet the various needs of different audiences.

The audio player electronics.

Consumer

Consumer

Advocate

Consumer

Consumer

Liberty Resources

Conceptual Prototype: 3 iPad Application The iPad Application is an accessible tool for Advocates to use when visiting Consumers.

It includes a map of the process and stories of hope to share with Consumers.

84 | Prototype + Test

3 iPad Application: Design Opportunity The problems that we found in the current Advocacy System can be addressed in two aspects; On one hand, all Advocates in the system possess different levels of physical or mental limitations. That said, based on various disabilities, each individual developed his or her own habit of documentation for the Consumers.

On the other hand, in terms of communication and coordination, the current system at Liberty Resources seems really outdated, very much paper based, and unsystematic. For example, a large quantity of the paperwork often gets piled and easily missed by the coordinator; The director of the transition process assigns the new Consumers based on only a piece of paper, which prevented Consumers from being consistent with their own documentation tools(notebooks, cell phones, etc.)

Sketching the wireframe of iPad Application.

Prototype + Test | 85

3 iPad Application: Concept The content and function of the application would contain the solid steps of transition for the Advocates to keep track of the Consumers’ current situation in the transition map. What’s more, it offers a way of interaction between the Advocates and the Consumers, as well as the Advocates and the other members in the Advocacy System, allowing the Advocates to exchange complete information for all Consumers at Liberty Resources. Also, it provides a progressive context in the interaction that enables the Advocates to share and pass on hopeful stories to the Consumers who may be stuck in the middle of a certain step in the transition process.

Building layout on Consumer’s data in transition process at MiD Studio.

86 | Prototype + test

3 iPad Application: Development Based on the target audience of the project, the Advocates at Liberty Resources, we designed the layout of an iPad Application, which can allow the Advocates to efficiently organize their Consumer documents, as well as digitize and share the database of current Consumers.

HOPES

LOG OUT

?

Social worker calls LRI about a potential consumer

Frank Johnson Gloria Kolata

The Road to Independence

Living in a Nursing Home

Display interest in moving out and name added to MDS

Individual calls Sue Smith

MDS list sent to LRI

LRI about

friend or family Ken Robinson member

Tim Arango

Consumers You Are Helping With

Name placed on wait list because little staff

Map Key

Major Service Options

Philadelphia Housing Authority

Multiple options based on specific needs or choice

Pre-service Process Major Goals Non-LRI Services and Agencies

Community advocate to nursing home

The Starting Point

Want nothing to do with LRI

Other Consumers

Housing Advocacy

Housing Found

Transitioning Services

Consumers in Community Already have housing

Specialized Services

Consumers in Transition

05:08

HOPES

LOG OUT

07:32

?

Social worker calls LRI about a potential consumer

The Road to Independence

Living in a Nursing Home

Next Time to Meet Sim: Individual calls 2011.11.13 Monday

Display interest in moving out and name added to MDS

MDS list sent to LRI

Consumers You Are Helping With

Name placed on wait list because litttle staff

Map Key

Major Service Options

LRI about friend or family member

Philadelphia Housing Authority

Multiple options based on specific needs or choice

Pre-service Process Major Goals Non-LRI Services and Agencies

Other Consumers

The Starting Point

Community advocate to nursing home

Want nothing to do with LRI

Housing Advocacy

Housing Found

Transitioning Services

Consumers in Community Consumers in Transition

Layout design of the iPad Application and Group discussion on iPad Application idea.

Specialized Services

Already have housing

Consumer

Consumer

Conceptual Prototype: 4 Community Storybook The Community Storybook is a book of stories to be passed between Consumers that builds community and allows stories of hope to continue to be told.

90 | Prototype + Test

4 Community Storybook: Design Opportunity Realizing that a lot of Consumers are by themselves throughout the process in nursing facilities, we found that the Consumers had a lot of confusion about what was going on in the transition process. Additionally, most Consumers were hesitant and lacked hope of moving out because of their long experience living in nursing facilities. They don’t know what the outside world looks like as well as not knowing what to hang on to continue the complicated long process.

Electronic items in the Community Storybook.

Prototype + Test | 91

4 Community Storybook: Concept The idea behind the Community Storybook is about providing people with the opportunity to hear the stories of what happened with the individuals. The storybook enables Consumers stories to be shared when one-on-one engagement is not possible, creating a sense of community around the object, transporting previous Consumer’s struggles and experiences in the transition process to the new Consumer. The Community Storybook is able to carry someone’s story to someone else who might be going through exactly the same process, conveying hope and encouragement to the new Consumers.

The Community Storybook empowers the individuals to recognize that there are other people who have been through this terrible process, and have been successful. On the other hand, the new Consumer is able to record the his or her own story which can encourage the other Consumers afterwards. The ability to record new success stories creates the value of the individual’s story, documents what the Consumer has been through, and encourages others to do the same.

Testing out the prototype at MiD Studio.

Liberty Resources

Government

Liberty Resources

General Public

Conceptual Prototype: 5 Come. Listen. Respond.

Come. Listen. Respond. is a tool to test the general public’s responses to stories, as a way to choose and edit stories to eventually be told to WHYY.

94 | Prototype + Test

5 Come. Listen. Respond.: Design Opportunity After interviewing several Consumers and collecting many stories, the Group felt that we had so much raw data that we didn’t know how to test our assumptions about how the public would respond to one of the stories we had recorded. Hence, we used simple shop materials and electronics to construct the stand for the Come. Listen. Respond. prototype and went out into the real world and test it out in the Rittenhouse Square in Philadelphia. While in the process, we encountered a humbling moment: a man in a wheelchair came by the stand and was not able to reach the headphones.

A man in a wheelchair couldn’t reach our stand prototype.

Prototype + Test | 95

5 Come. Listen. Respond.: Concept The goal of this rapid prototype is to test the stories to see what story content would elicit a response from the general public. It’s a process of observation about how an audience in one of our identified interactions would react to storytelling and content in the story.

“Reflecting on our the prototype of Come. Listen. Respond., we could have better constructed our prototype, which did not even accommodate people with disabilities. We were still unaware of our clients.�

Our record contains an edited interview from one of the Consumers who had horrible experience with her physical disabilities and tried her best to move on and begin to live a positive life. We packaged the story based on our consideration of how to inform what resonates with our audience, the government and general public.

Preparation and construction of prototype stand.

05 Final Presentation + Feedback 96 Section 1 | Final Client Presentation to Key Executives

98 | Final Presentation + Feedback

Final Client Presentation to Key Executives

scenarios To illustrate our prototypes and how they could be used in the future, we created scenarios featuring the different stakeholder interactions.

storytelling To model how storytelling can be used as a tool for change, we used our own storytelling in the presentation.

stakeholder map By communicating the various stakeholder interactions in the form of a stakeholder map, we were able to create understanding more quickly.

As our semester came to a close, we presented our final findings, prototypes and recommendations to the key executives at Liberty Resources. The majority of the audience had not been exposed to our collaboration prior to the meeting and the presentation required a holistic, research to recommendation structure that clearly communicated our role as Designers. By including both methods and processes with actual findings and recommendations, we were able to expose our unique process to demonstrate how the design methods and tools led us to our innovative concepts. Although this explanation of our

Our research findings and prototypes excited a brainstorming session of innovation following our presentation–we had created a space for creativity. process was effective in communicating how we worked over the semester, it could have been better employed as “transformative design� over the course of the semester. With more emphasis placed on co-creating with our clients, we could have provided them with the skills and tool kit necessary to employ design methods in their internal processes. Some of the main tools we used in the final presentation to convey our ideas were: stakeholder mapping, scenario building, and storytelling. All three of these tactics aided our communication by helping the audience members to mentally model the ways in which our proposed prototypes and recommendations could provide value and fulfill the unmet needs we had identified.

Following the presentation, there was a positive and excited response from the key executives.

This energy from the audience ignited a brainstorming of additional innovative ideas, and extracted varying perspectives and feedback from the different internal departments present at the meeting.

Final Presentation + Feedback | 99

“It would be great to extend this educational material and fundraising into the social media world–like on Facebook and Twitter.”

“What about a virtual advocacy kiosk? We could incorporate our social media as well as the ability to send a letter to your congressman, right then and there.�

“I would love to have the fundraising card to hand out at conferences. If there is something I can play with on my desk, I am much more likely to pick it up, look at it and do something with it.�

“This is all great. I would love to see the community storybook developed–it is so simple and easy to use.”

A Appendices 106 Appendix A | Design Toolkit 109 Appendix B | Key Terms 110 Appendix C | References

106 | Appendices

Research Tools Activity Analysis Studying in detail all tasks, actions, objects, performers and interactions involved in a process.

Ethnography A form of qualitative research that requires immersion in the natural contexts upon which work, play or culture are experienced.

Cognitive Task Analysis List and summarize all of a user’s sensory inputs, decision points and actions to identify potential bottlenecks where errors may occur.

Extreme User Interview Identify individuals who are extremely familiar or completely unfamiliar with the product or system and ask them to evaluate their experience with it.

Contextual Interview Conducted in the environment, or context, in which the service process occurs allowing interviewer to both observe and probe the behavior they are interested in.

Cultural Probes Information gathering packages based around the principle of user participation via self-documentation that reveal perceptions and behaviors within or across cultures.

Draw the experience Asking participants to visualize an experience through drawing and diagramming which can debunk assumptions and reveal how people conceive of and order their experiences or activities.

Empathy Tools Create tools that alter your experience to understand the abilities of different users.

Guided Tours Asking participants to lead a guided tour of the project-relevant spaces and activities they experience to help them recall their intentions and values.

Personal Inventory Document the things that people identify as important to them to catalog evidence of their lifestyles.

Secondary Research Supportive information including published articles, papers and other pertinent documents to develop an informed point of view on design issues.

Shadowing Involves researchers immersing themselves in the lives of people in order to observe dayto-day routines, interactions and contexts.

Appendices | 107

Research Tools (Cont.)

Time Lapsed Video Recording movements in a space over an extended period of time to be later viewed at an increased speed. This provides an objective, longitudinal view of activity within a context.

Unfocus Group Assemble a diverse group of individuals to encourage rich, creative, and divergent.

Synthesis Tools Affinity Diagram A method of data organization intended to define categories based on likeness of information.

Customer Journey Map A structured visualization of a users experience with a system.

Flow Diagramming Visually representing the flow of information or activity through all phases of a system or process.

Mental model A cognitive representation and simplification of a complex system.

Personas Fictional profiles developed as a way of representing a particular group based on their shared interests.

Social Network Mapping Discovering different kinds of social relationships within a user group and map the network of their interactions.

Card Sort Asking people to organize cards spatially, in ways that make sense to them, revealing expectations and priorities about intended functions.

Stakeholder Map A visual or physical representation of the various groups involved with a particular service.

Concept Map Graphical method for organizing and representing knowledge supporting meaningful learning through associative and hierarchical connection forming.

Zoom Out A method for understanding and visualizing the larger system of people, products, services and environments within which a particular design exists.

108 | Appendices

Prototype + Test Tools Co-creation Engaging people with different backgrounds and roles to work corroboratively as part of the same team, in order to examine and innovate a given experience.

Experience Prototype Simulation of the experience using the product revealing unanticipated issues or needs.

Role Playing Identify the stakeholders involved in the design problem and assign those roles to members of the team for them to enact activities within a real or imagined context.

Scenarios Illustrate a story line describing the context of use for a product or service.

Storyboarding A series of drawing or pictures that visualize a particular sequence of events.

Storytelling A method for sharing insights and new concepts through the use of compelling narratives.

Appendices | 109

Key Terms Advocate Person with disabilities living in the community, who provides services and mentally supports to the Consumers with their transition process.

Consumer Person with disabilities in the transition process from the nursing facility to the community.

110 | Appendices

References “Accessible, Affordable, Integrated Housing.” ADAPT: ADAPT’S Platform. Web. 24 Sept. 2011. <http://www.adapt.org/housing/platform>.

“ADA Bathroom Design Guidelines.” Wheel Chair and Mobility Resource Guide... Live More Independently. Web. 24 Sept. 2011. <http://www.mobility-advisor.com/ada-bathroom.html>.

“ADA Home Page - Ada.gov - Information and Technical Assistance on the Americans with Disabilities Act.” ADA Home Page. Web. 19 Sept. 2011. <http://www.ada.gov/>.

“Americans with Disabilities Act of 1990.” Wikipedia. Wikimedia Foundation. Web. 19 Sept.

2011. <http://en.wikipedia.org/wiki/Americans_with_Disabilities_Act_of_1990>.

“Benefits.gov - Pennsylvania Medicaid Program.” Benefits.gov. Web. 11 Apr. 2012. <http://www.benefits.gov/benefits/benefit-details/1148>.

“Disability Resources.” U.S. Department of Labor. Web. 19 Sept. 2011. <http://www.dol.gov/ dol/topic/disability/ada.htm>.

“Fair Housing Accessibility FIRST.” Fair Housing Accessibility FIRST. Web. 24 Sept. 2011. <http://www.fairhousingfirst.org/>.

“Home.” Home. Web. 11 Apr. 2012. <http://www.dpw.state.pa.us/>.

Appendices | 111

“Houston Handicap Wheelchair Accessible Home Construction, Handicapped Home Modifications and Remodeling in Houston, Texas Can Make Life Easier for the Elderly and People with Disabilities.” Home Changes. Web. 24 Sept. 2011. <http://www.adaptiveaccess. com/home_changes.php>.

Kane, R. L., and B. Friedman. “State Variations in Medicare Expenditures.” American Journal of Public Health 87.10 (1997): 1611-619. Print.

“National Council on Disability.” National Council on Disability. Web. 19 Sept. 2011. <http:// www.ncd.gov/>.

“Philadelphia’s Accessibility Compliance Office - Welcome.” Document Moved. Web. 24 Sept.

2011. <http://www.phila.gov/mcpd/>.