by Michael Eckersley, HumanCentered Design Management Review Winter 2008

1. PRODUCTION
Designing Human-
Centered Services
by Michael D. Eckersley
ithin an expansive view of options and possibilities, Michael Eckersley
W demonstrates how in-depth market and strategic trends research is instru-
mental in pinpointing what should be developed and why. Projects in the fast-food
and healthcare industries suggest the subtleties of his methods and the opportuni-
ties they can reveal for innovation and more effective competitive branding.
“I’m hungry, mom. What’s to eat?” asked op new concepts targeted to improve
four-year-old Isaac. Beth mentally the customer experience. Over the
searched the refrigerator and couldn‘t course of the assignment, we spent lots
come up with a thing.“Whaddaya say we of time with families and other key cus-
go out for lunch today?” she offered. tomer types, as well as with restaurant
Instantaneously, the kids’ eyes lit up. Isaac employees—all of which yielded a
and his younger sister and brother (twin wealth of information to guide the
two-year-olds) were almost out the door Michael D. Eckersley, design planning process. Though our
before Beth could pack up all their para- HumanCentered initial project focus was the physical
phernalia and grab the car keys. Five QSR environment, the research data
minutes later, we were all piled into the broadened our attention to incorporate
minivan and turning onto Route 434 service and system issues. This, in hind-
toward Oviedo. sight, is not particularly surprising,
It was Tuesday morning, summer because many sophisticated business
2005, the second day in a five-day field offerings today are hybrids of product,
research study conducted mostly with service, and setting. Increasingly, every-
young families around the Orlando area. thing is connected. Consider a recent
Our sponsor was a major fast-food com- New York Times headline: “You’re Not
pany. The assignment had three aspects Buying Gadgets, You Are Subscribing to
to it: first, to describe in some detail the Them.”1 We would only add: “You may
dimensions and patterns of the quick also be sitting comfortably in one right
service restaurant (QSR) customer expe- now drinking coffee.”
rience; second, to diagnose possible gaps
1. Saul Hansell, “You’re Not Buying Gadgets,
or discontinuities in the customer expe- You Are Subscribing to Them,” New York Times,
rience; and third, to prescribe and devel- January 18, 2008.
Design Management Review Winter 2008 59

2. Designing for the Service Industry
Design in the services ecosystem tion, we are often staffed to advise in that
Our firm, HumanCentered, came to services process.
through the side door of technology. Since 1997, Because services comprise most of all com-
we had been developing web-based reservations mercial activity in advanced economies today,
and financial services applications for Premier there is bound to be growing market demand
Resorts and for Sybase. We had no particular for sophisticated and systematically designed
expertise or formal training in services, but we services. However, services tend to be under-
soon found that we had considerable influence optimized, generally. In fact, many services actu-
over the nature and expression of that aspect of ally contribute to a widening gap that separates
our clients’ businesses. With that influence came people (consumers) from the latent value that
greater responsibility and risks. Fortunately, brands could provide if only they could decode
some of our design process, problem-solving, salient customer needs and fill the gap with
and systems expertise was readily transferable. smart, sustainable offerings. As socio-techno-
But because our assignments soon crossed over economic systems, services are complex. How to
into diverse industries, including healthcare, innovate them is not well understood. This is
enterprise software, and consumer products, get- ironic, in that better-designed services are gener-
ting up to speed on new, domain-specific ally regarded as more useful, usable, and eco-
knowledge has been a constant. nomically valuable.
Services can involve design on at least three Among designers, the growing interest in
different levels: strategic design planning, design services is understandable—not necessarily
planning, and design implementation (Figure 1). because service design offers a forum for creative
Over the years, we have gravitated to the level of validation or for professional publicity (the prod-
research-based design planning. As social scien- ucts of service-based design are usually anony-
tists, our bridging expertise has long centered on mous and the closely guarded intellectual prop-
humans and human behavior, complemented by erty of the sponsoring organization). Rather,
the requisite market and strategic trends services pose inherently interesting design prob-
research. As interaction designers working in a lems and contexts for design thinking. This has
design planning capacity, we are intent on consistently pushed our own firm beyond exist-
answering the question: Of all the things that ing capabilities and challenged us to take on
can be developed, what should be developed, assignments of the widest manageable scope.
and why?2 Because design can grow to involve
many broader and narrower considerations, we Service and the quick service restaurant
have chosen to specialize here. (QSR) model
Not all our design programs get implemented Some telling deficiencies in the fast-food experi-
subsequently, of course, at least as presented. But ence were not hard to spot, beginning with a
that is largely beside the point; they do tend to good deal of waste in the QSR model. No, not in
be influential. Companies use us to show them the hyper-efficient restaurant operation itself,
which concepts and offerings are possible, and but in the customer’s own expenditure of time,
how these might yield customer and business attention, and energy spent interacting with it.
value. Concept simulations and experience pro-
2. cf. Karen Christensen, “The Power of Design: Questions
totyping are critical to representing such value. for Patrick Whitney.” In Rotman, the Magazine of the
As funded concepts move toward implementa- Rotman School of Management, Spring/Summer, 2005.
Model business, market, cultural and resource
STRATEGIC DESIGN What subjects and oppor-
SDP PLANNING tunities should we pursue?
contexts. Articulate strategic goals and business
rationale
RESEARCH
Develop, validate and prototype the concept
DERIVED
INSIGHTS
DP DESIGN PLANNING What should we develop?
and related offerings in context
DESIGN Design, produce and test the actual products,
DI IMPLEMENTATION
What form(s) should it take?
services, systems, environments
Figure 1. Strata of design activity, from strategic to operational. From Charles L. Owen, “Design, Advanced Planning, and Product Development,”
International Symposium: Nuevos Metodos & Tecnologias para el Diseno de Productos, Santiago, Chile: Nov. 12, 1998.
60 Design Management Review Winter 2008

3. Designing Human-Centered Services
Natural human patterns around food and eating volume. Operational challenges to this approach
(for example., sample tasting, personalization, are not trivial, but the first QSR brand to design
watching the preparation, serving oneself, sec- and implement such a reflexive system will
ond helpings, after-meal sweets and desserts, probably enjoy real competitive advantages by
hosting, socialization, and conviviality) are vir- offering customers better and more flexible
tually ignored in the industry. That blind spot options for ordering.
means that such variables go unrecognized, Another behavioral pattern we observed
unmeasured, unmanaged, and unmined for among QSR customers involved issues of germ
innovation opportunities. Sure, customers have anxiety, restroom convenience, and hygiene. It’s
gotten used to modern fast-food conventions, a good bet that most fast-food customers eat
but the sacrifices—conscious or otherwise—of with dirty hands. Only a small percentage actu-
impersonalized dining are real. ally wash up before eating. Moms with young
Fast food is intended to be fast. But at peak children tend to avoid the restrooms altogether
lunch and dinner times, the customer experience if possible, concerned that they or their kids will
is all about waiting. Most QSRs still process cus- exit the restroom dirtier than when they went in.
tomers on a serial, undifferentiated basis, with We saw a lot of user work-arounds in response
newbies and “super-users” all together in the to this concern. These included changing diapers
same line. Burgeoning, hard-to-read menu in the car rather than in the bathroom, using
boards place an additional cognitive load on napkins or toilet tissue to open restroom doors,
those unfamiliar with the various food options. and sterile wipes for the kids packed along in a
Asking questions about the menu is treated as bag of convenience snacks, books, and toys—
slowing down the process, so ordering is often just to manage the experience of going out for
rushed, and done without a clear idea of what fast food with the kids. These findings inspired
food will show up. Unfortunately, various tech- subsequent design of convenient hand-washing
nological options for customer self-service face alternatives separate from restrooms and adja-
stiff internal resistance. But the design opportu- cent to the QSR dining area.
nities for multiplying the number of ordering In all, we spotted five latent opportunities for
points throughout the QSR offer the potential innovating the QSR model. One was the idea of
for expedited order processing during peak peri- “brand channeling” the dining room (Figure 2).
ods, not to mention shorter service queues, This insight derived not so much from some-
reduced customer stress, and increased order thing we saw in the QSR environment, but from
Figure 2. Brand-channeling the QSR dining room
Design Management Review Winter 2008 61

4. Designing for the Service Industry
something we did not see: conscious human seems unusual, or if she doesn’t understand some-
engagement. Many fast-food customers undergo thing.) The nurse said the tests were normal this
the fast food experience as if in a virtual stupor. time. But Viola had had a couple of contractions
We found many customers apparently unen- during the procedure, and she was concerned. The
gaged, sensorially or cognitively, in the QSR din- nurse took her blood pressure and mentioned that
ing area after ordering and during the meal. This it was a little high, but gave no explanation or
gap of “attention space,” we determined, could reassurance that it was acceptable. When the doc-
be intelligently managed by the brand in the tor came in, he indicated his intention to induce
same way airlines manage the in-flight experi- labor the following Monday. But when Viola
ence. It’s not hard to imagine 6,500 flat plasma expressed surprise over the date, he checked his
screens in existing restaurants across North records again and realized that he had gotten the
America feeding a regular stream or periodically date wrong. She still had some weeks to go. Viola
updated loop of music, entertainment, and asked both the doctor and the nurse about the
offers to a live customer audience. A live news blood pressure and the contractions, but they
crawler and an updated list of order numbers seemed distracted and offered no comment. The
would run below and to the side of the screen. nurse explained that the contractions were “proba-
Done imaginatively, the experiential and eco- bly just Braxton Hicks.” The doctor and the nurse
nomic benefits of brand-channeling the QSR use technical terms like this with little or no expla-
dining room could be significant. nation of them, and they don’t ask her if she
Customer expectations of the fast-food expe- understands....
rience are generally low. Our design recommen- Viola (not her real name) was a 25-year-old
dations for expanding the versatility and Hispanic female in the third trimester of preg-
ambiance of the QSR keyed on variables of nancy, a special-needs patient in the maternal
information, time, and space, and deemphasized fetal medicine program of a large American
issues of matter and energy (Figure 3). In other healthcare system. She was in acceptable condi-
words, we identified ways of making the system tion, considering that she had had a liver trans-
smarter and more adroit in serving the cus- plant and splenectomy just two years earlier.
tomer, rather than simply adding more overhead Viola’s pregnancy was unplanned, and she did
cost in terms of material and energy. Most suc- not become aware of it until she was a full 20
cessful fast-food brands are highly engineered, weeks along. Viola and her husband had plenty
efficient machines. But their models are subopti- of reason to be concerned.
mal, at best, when it comes to important human Healthcare is a personal matter. But health-
touch-points. Having largely mastered the care is often served up in the most impersonal
mechanics of food delivery, innovative QSR manner. For those Americans fortunate enough
brands will have to win customers and market to be covered by some form of health insurance,
share more on the basis of customer experience dissatisfaction rates run high,3 having doubled
than on cost. since 1998. Cost is the biggest reason; insurance
3. Ruth Helman, Mathew Greenwalk & Associates, and
Serving moms and newborns
Paul Fronstin, “2006 Health Confidence Survey:
“But why did I have the contractions?” Viola asked Dissatisfaction with Health Care System Doubles Since
the nurse anxiously. (Viola worries if anything 1998,” EBRI Notes, vol. 27, no. 11 (November 2006).
low med high
time
space
information
matter
energy
Figure 3. The QSR low-energy, high-information program—making the system more efficient in serving the customer, rather than simply adding more
overhead cost.
62 Design Management Review Winter 2008

5. Designing Human-Centered Services
premiums have risen 87 percent since 2000— not relevant to us in our planning and design.
more than five times the rate of employee com- The information is mostly generalized and has
pensation. Despite these endemic problems, we no texture. It never deals with exceptions.”4
find working in the healthcare industry gratify- We conducted in-depth contextual research
ing. The issues are complex, the people are with expectant mothers and families in their
smart and well-intentioned, and—put simply— homes and in healthcare environments, begin-
healthcare matters. ning from their second trimester visits and
If you happen to have spent substantial time onward through labor, delivery, and postpartum.
at a typical clinic or hospital recently, the seams Our team was small—just two skilled colleagues,
in the healthcare customer experience are appar- Judy Rice and Hillary Leonard, and myself. But
ent: labyrinthine policies and payment systems, we learned a great deal, identifying four general
duplicative documentation, inconsistent care patterns or themes driven by the research data.
formularies, and to-the-bone cost-cutting. For These, in turn, inspired a design program com-
perfectly healthy pregnant women and their prising seven key concepts.
families, a healthcare system that is essentially One theme from the research involved the
engineered to treat the sick does not always sup- role of expectant mothers. We wanted them to
port their special needs. have greater control in co-managing the experi-
Between 1994 and 1995, we researched the ence with care providers. Pregnant women and
experiences of mothers and families as they couples enter the healthcare system seeking the
engaged with a complex healthcare system dur- safest, most humane, and most affordable prena-
ing pregnancy and childbirth. Our assignment tal, delivery, and postnatal infant care. The sys-
was to develop design recommendations to tem can treat these women and their families as
improve the quality and value of healthcare faceless, temporary occupants of waiting rooms,
environments and services. Sponsoring the beds, and wards. Expectant mothers and their
research was a large and highly respected inte- partners are often anxious and not clearly
grated healthcare system based in the western informed about the experience they are under-
United States. Our work would inform the plan- going. Nevertheless, they do not check their
ning and design of a new hospital for women minds or autonomy at the door when they vir-
and newborns. Our client’s motivation for using
4. John Rich, vice president, facilities planning and devel-
a firm such as ours was simply stated: “We get opment, Intermountain Health Care (personal commu-
market research reports all the time, but they’re nication with the author).
Figure 4. Program of mother/family control.
Design Management Review Winter 2008 63

6. Designing for the Service Industry
tually move their families to the hospital for two tions that should not be ignored, but could con-
to five days. Disappointments and affronts hap- ceivably be honored, by design. To this end, we
pen at this emotionally charged time, even in the developed a program to assist families in making
best of systems. Empathy can be in short supply. meaning from the experience. An element of this
This kind of naturalistic data informed the sub- program, called Recording and Remembering,
sequent design of a program for the family, as involved a branded remembrance book with
well as the mother (Figure 4), geared to provide ideas and examples for assembling thoughts,
information, choices, and a better sense of con- photos, ultrasound recordings, digital files, birth
trol over such things as food, snacks, privacy, announcements, and other artifacts. Another
telephony, lighting, entertainment, and sleeping element of the program engaged with architects
options. The program extended to facility plans in phases of site and facilities planning to create
for a family day-room area adjacent to the themed environments and interactive exhibits
maternity ward for immediate family and guests for children and families to use and enjoy during
to gather. Plans also included dedicated life- the long hours and days of semi-residence at the
management facilities for special-needs families hospital (Figure 5). A capstone of our design
with infants receiving intensive or long-term, program, Legacy Affiliation, was meant to enrich
monitored care. Other design requirements and extend the mother’s relationship with the
involved ways of “smoothing the corners” in care hospital long after her stay. It included a mem-
interactions and transitions, facility affordances, bership affiliation program with opportunities
amenities, and send-offs. for volunteer service, topical discussion groups,
Another theme that emerged from our educational offerings, and news. The program
research involved what we later called transfor- would introduce expectant mothers to the pro-
mation and rite of passage. We learned that gram and facilities months before the scheduled
women, couples, and families undergo various birth and would be gently reinforced with taste-
obvious, and subtle, kinds of transformation as a ful welcome and goodbye gifts at the hospital.
result of the experience of pregnancy and child-
birth. Some mothers and families today do not Design infiltrates organizations (and is trans-
have the same kinds of cultural support that was formed in the process)
available to past generations processing this In a 1993 interview, Peter Coughlin described
experience. In fact, this experience has physical, the work of IDEO’s Transformation by Design
emotional, cultural, and even spiritual implica- group this way:
Figure 5. Transformation and rites of passage—themed environments.
64 Design Management Review Winter 2008

7. Designing Human-Centered Services
We took IDEO’s core process, and added Increasingly, designers have the means, the
new tools and methods to help instigate orga- motive, and the opportunity to engage actively
nizational change. Our high-level operating in services at various levels and in various front-
theory is to engage with the client, do a end and back-end capacities. We can bring a
design project together. Use what you’ve uniquely integrative point of view to services
learned from that to learn about the organi- and service innovation. Parochial or narrow def-
zation. Then redesign the organization to initions of interests are no longer called for.
meet this offering you’ve created. So—design Leadership is. Which prompts the question:
the offering first, then design the organiza- What are the boundaries of design today, if not
tion to successfully deliver that offering. extraordinarily wide? We know that design
Most consulting says, here’s the new scales. We suspect that the future will favor
offering, delivered in a tome that lays out the designers and teams who can scale with it.
strategy. If the new offering fails, it’s because
you haven’t spent the time to change the cul- Suggested Readings
ture that’s supposed to deliver it. Our prom- Christensen, Karen. “The Power of Design:
ise is that we can help transform organiza- Questions for Patrick Whitney.” In Rotman: The
tions by giving them the capability to design Magazine of the Rotman School of Management,
experience from a human perspective.4 Spring/Summer, 2005.
That is a radical point of view of design, espe- Owensby, J., Maglio, P., Spohrer, J., Murphy, W.,
cially for a generation of designers trained in a “Services Sciences, Management, and
formalist tradition and used to performing in a Engineering (SSME),” Frontiers of Knowledge in
subordinate, work-for-hire, project culture. Science and Technology for Africa, University
Nevertheless, everything we have learned inde- Leader’s Forum. Almaden Services Research,
pendently about advanced design and service- IBM Corp., November 20, 2006
based offerings over the past 10 years ratifies
Coughlan’s assertion. Services are treated differ- Owen, Charles L., “Design, Advanced Planning,
ently than product-based offerings. But services and Product Development,” International
are central to what a company is, not just what it Symposium: Nuevos Metodos & Tecnologias
makes. By this logic, flawed services reveal seams para el Diseno de Productos, Santiago, Chile:
in the organization itself. Nov. 12, 1998.
Designing innovative services cannot be done
at arm’s length. We were inspired by embedding Pine, B. Joseph, and Gilmore, James H. The
ourselves firsthand in the operations of organi- Experience Economy: Work Is Theatre and Every
zations and in the lives of their customers. Business a Stage (Harvard Business School Press,
Success improved vastly when organizational 1999).
teams got involved with us as collaborators.
Because their detailed process and system Tergas, Leslie, and Karyn McLean, “Inland
knowledge always exceeds our own, their buy-in Revenue New Zealand: Service Design in a
has been critical in making change stick. Regulatory Context,” Design Management
Looking back, the popularity of Joseph Pine’s Review, Winter 2008.
and James Gilmore’s The Experience Economy,
in 1999, signaled a big turning point. The book Verma, R., Fitzsimmons, J., Heineke, J., and
gave tacit approval and a rationale for prepared Davis, M. “New Issues and Opportunities in
designers to touch virtually any kind of offering Service Design Research.” Journal of Operations
that would derive value from thoughtful analysis Management 20 (2002) 117–120.
and imaginative design thinking—services Reprint #07191ECK59
included. The only permission we needed was
from organizations willing to give us a shot.
4. Mark Hurst, “Interview: Peter Coughlan, IDEO,” good-
experience.com, September 2003.
Design Management Review Winter 2008 65