Rhode Island Department of Health

When confronted by a sour note… the [musician] gets nowhere by forcing. The mistake has to be treated as an interesting fact; then the problem will eventually be unlocked.

—Richard Sennett

Public health is a high information content arena. It involves both deep expertise in narrowly prescribed, often quantitative information and broad understanding of qualitative dynamics that evolve from the shifting landscapes of communities. In this complex mix of information formats, hard and soft constraints, and variable information decay rates (i.e. some information stays true longer than others) understanding what the problem is or what outcome should be worked toward is fraught.

Most professional disciplines and project management methodologies are organized around the idea that what must be done is known either on the basis of expertise or carefully assembled evidence. This belief has its origins in the scientific management movement that modernized industry at the turn of the 20th Century and before that in the Enlightenment.

As a result, it can be hard to understand that problem framing (i.e. describing what the precise nature of an emergent challenge is and how it should be addressed) requires process, time and resources to be done well and to set the conditions for later success. It is tempting to label this kind of “front end” activity as inefficient; that what is needed is a plan that can then be implemented. But Abraham Lincoln put it well when he suggested that if he were given six hours to chop down a tree he would spend the first four sharpening his axe.

Problem framing and outcome description are capacities that need to be learned and honed, especially in the complex environments endemic to the 21st Century. They require teams to navigate in the spaces in-between time and desire, opportunity and ambition, resources and constraints.

These spaces of uncertainty and imprecision are familiar to designers and other creative practitioners.

This Design & Public Policy Studio introduced public health leaders to the key concepts of problem framing and outcome description, how they can organize teams to effectively engage in front end work to improve workflow, launch initiatives that are more relevant to stakeholders and develop more resilient policy frameworks. While this studio was only an introduction, it enlivened the critical, creative and systems-oriented mindsets of the participants to strengthen their professional practices.