The foundation mainly relies on income as a subcontractor to the public sector, offering education within the ‘special planned youth education programme’, thus a key stakeholder is the municipalities using the program. Other stakeholders are the customers of the social enterprises and other organisations that are part of Grennesminde’s network. The key beneficiaries are the young people, but to some extent also the municipality, since Grennesminde as subcontractor offers a public service.
The way Grennesminde functions today is based on a development process initiated by a change in legislation that the organization needed to respond to. Hence co-creation of the public service has developed over time, both due to systemic changes and due to a hiring process focusing on recruiting candidates with a business mindset.
No digital transformation process is going on.
Despite being evaluated upon the measurement and quality criteria in the formalised inspections, the managers of Grennessminde furthermore distinguish between impact at a micro or macro level. At a micro level, the managers stress all the little success experiences during the everyday life at Grennessminde. At a macro level, the success is also understood as two-fold. On the one hand it is to support or trigger a cultural change in the municipalities where the employees (as representatives of the system) meet the youngster with respect and in this manner open up the doors of the system. On the other hand, it is believed a success criterion to push and actively engage in the debate on social economy in Denmark.
A main driver that eases collaboration is clear expectations from the municipalities, transparency in the referral and assessment process, and trust from stakeholders and partners. In opposition, a key challenge has to do with navigating in diverse realities with different quality parameters; the public sector and the third sector. Also, the aspect of clashing logics is also mirrored in structural settings, where it becomes hard to operate and change practices due to municipal silos and silo thinking. This can e.g. be between different administrative bodies or between different groups of professionals.
The case in itself is not easy transferable, but the idea of establishing work integrated social enterprises is not new, and as such the case can be an illustrative example.
The overall aim of Grennessminde is to create a meaningful life for young people with special needs. To be part of the job market is perceived key in this regard, which is why Grennessminde supports the development of their social and collegial skills. Hence the value lies in the experience of the youngsters as being important relative to colleagues and their job function. Thus, the success is not measured in people getting a job, but rather in empowering the young people.
An overall challenge regarding the understanding of success criteria and measurements is that, in Grennessminde’s view, most municipalities focus on the degree of youngsters that have entered the job market – despite not being able to undertake ordinary jobs. A circumstance, which is especially in a long-term perspective hard to identify, since it is illegal to keep civil registration numbers and hence Grennessminde cannot know, or show, how the young people are doing after e.g. a two years period. Therefore, Grennessminde urges the municipalities to make as specific measurement parameters as possible, while the youngsters are at Grennessminde, e.g. to be able to do a bus ride alone and hence support that the youngsters become ready for the job market – whether as an employee at Grennessminde or at another work place.
Stakeholders & Beneficiaries
A key stakeholder in a Danish context is the municipality, and more specifically the managers and employees at care centres and home care. The service of the bike ride cannot be outlived without these. Another key stakeholder is thus the politicians, who have been part of pushing the idea forward. Besides the public sector stakeholders, a key actor is the volunteers and the beneficiaries are the elderly.
The idea and the service of getting a bike ride is not the outcome of co-creation, understood as deliberative innovation processes. Anyhow the idea has been developed and tailored to countries outside Denmark, where the public sector is not the main provider of elderly care.
Digital Transformation Process
CWA offers a digital booking platform, but the interviews revealed that for some care centres it was easier to use a manual calendar. And in the cases using the platform, it is not transforming practices and procedures.
Results, Outcomes & Impacts
It is difficult to highlight specific results and outcomes of the bike ride in itself (see success criteria), but the success of CWA as a foundation and the many countries that now also offer bike rides for elderly can be seen as evidence for impact regarding the service/idea.
Challenges & Bottlenecks
The public managers stress that fiery souls are key when it comes to implementing the initiative – either positioned in the administration or within elderly care, and these need managerial back-up. Another barrier relates to the operation of CWA. The public managers tell how they are left alone with the initiative after the implementation phase. This experience is both related to the awareness from the municipality and from the CWA secretariat. To exemplify, it is the responsibility of the care centre/home care to maintain the trishaws and they are not granted any funding for repairing or buying new bicycles if they are damaged.
Transferability & Replicability
The initiative has been easily transferred to municipalities in Denmark and to other settings internationally.
The impact of the initiative is not perceived by CWA and public managers in traditional quantitative metrics but rather in qualitative aspects, such as the general enhancement of the joy of life among the elderly. Another positive aspect of the visibility of the elderly in the local community is an increased awareness of elderly, dementia etc. among citizens in general. Still, CWA is working on more concrete evaluation criteria to professionalise and legitimise the bike ride as a method and an approach to increased life quality among the elderly.
The case of CWA is interesting due to the high degree of positivity that surrounds the movement. The initiative and the foundation do not seem to meet a lot of resistance concerning the cause per se; to ensure that elderly stay mobile and part of society. Thus, it seems that if the cause is perceived highly legitimate the room for manoeuvre increases. Externally, since it becomes easier to engage in strategic collaborations and to recruit volunteers, and internally because the organization, based on trust in their own raison d’être and main objective, becomes flexible in regards to development and organizing, as long as the main objective stays the same. Another key aspect is how the innovation is positioned in the eco-system of public elderly care services. CWA is mainly an add-on to formal elderly care, since the foundation does not overtake tasks or roles of the public sector. In this manner they are not subject to competition regarding resources and legitimacy, making it less problematic for the municipalities to engage in collaboration.
Stakeholders & Beneficiaries
Regarding the actors most relevant in the process of value creation, clearly the purpose of policymakers is to create value and co-creation is a means for them to do their job better. However, the value created by having more insights helps not only the strategic level, but also at the operational one. Therefore, the elderly people are the centre piece in value creation: they are involved in the service design phase, as in the evaluation phase as testers, who give directions to the companies and the city administration to adapt product or services to their special needs.
Regarding the concept of co-creation, interviewees stressed the fact that users and companies involved provide specific insights can help for the design of the project and of the public services. For instance, in ZorgLab people involved in the co-creation activity provided their own insight on which are the tools most useful for everyday life and how it is become more difficult for them to use such tools. Also, they provided their insight on how the house should be organised, also taking into account the necessity to keep a rich social life. An interesting aspect of co-creation is also mediation, as different individuals do not share the same idea of what is a liveable and sustainable neighbourhood. For what concerns the kind of value created in the service, as afore mentioned the initiative from one side wants to enable elderly people to stay longer at home in an independent way. From the other side, people involved in the co-creation activity have an experiential value, as they can give their contribution and still be active in the society. In the respect, for them it is very important to have a true recognition of their effort on the side of the policy makers. Interviewees reported some cases in which policymakers consult but do not follow the insights in the end. Apart from participation aspects, co-creation is also seen as a mean to increase democracy and social cohesion, like the example provided Bologna City of Commons project, where citizens can take initiatives to organise their lives together. On the other hand, such initiative has also a clear economic value, as it brings more companies in the healthcare sector so it can be an economic differentiator for the city. In fact, in the ZorgLab facilities, companies can test their innovation, make better products and have a real economic impact. So, Aalst is really becoming a city based on the healthcare sector and ZorgLab of course has been an advantage in comparison to other cities. Value is created in every stage of the initiative, but especially in the beginning where the insights are extracted from the participants to the co-creation activities. It is crucial to be able to extract such insights combining people working alone and in group: there rarely is a Eureka moment when you do co-creation. So clearly it is the interaction that creates the most value, even though the same value it is delivered at the end of the project (e.g. improved living condition for the elderly). Regarding the actors most relevant in the process of value creation, clearly the purpose of policymakers is to create value and co-creation is a means for them to do their job better. However, the value created by having more insights helps not only the strategic level, but also at the operational one. Therefore, the elderly people are the centre piece in value creation: they are involved in the service design phase, as in the evaluation phase as testers, who give directions to the companies and the city administration to adapt product or services to their special needs. In this regard, the service experience/relationship is paramount in the creation of tailor-made products and services for the elderly, especially for what concerns the interaction between front-line staff and the service user. Front-line staff are linking all stakeholders together, so that they can meet and create value. A continuative relationship reinforces also the co-creation activity as individuals get really motivated and experienced so that the feedback you get from grows in quality. It is very important to work closely and to have proofs the approach is working since from the beginning. Also, it is crucial not to have an academic approach, but to work closely with the participants learning to really listen carefully and understand exactly what they need, in order to gain their respect and to get relevant information from them. Considering the contribution of citizens or communities to the process of value creation, there is a clear distinction between participation (sharing ideas and taking part to decision) and co-creation (really being part of the process of creation). In that respect, only the most motivated citizens really provide great effort. In that regard, it has also to be considered that individuals taking part to co-creation activities are also the most cultivated and well-off, as it is very complicated to motivate marginalized individuals.
Results, Outcomes & Impacts
As already mentioned, the aim the case study is to investigate the concept and process of value creation and co-creation in the initiative. In this respect, value was defined by interviewees as any benefit for users or citizens stemming from the use of the public service as well as from the participation of the co-creation activity. In this specific context, value is conceived as the benefits of potential and actual users of the elderly home, who will be able thanks to the service to live longer and safer independently and to continue to be part of the society. On the other hand, the volunteers taking part to the testing keep being socially active and to provide their contribution to society with this project. So, they feel they are still having an aim in their life.
Challenges & Bottlenecks
A first obstacle is regulation hampering innovation, not only at local level, but also at Flemish, Belgian and European levels, especially for what concerns data sharing and assisted living. Furthermore, often private companies have a wrong estimation of co-creation, which is seen as a way to quickly get feedback on a developed product, rather than a way to co-create a product from the beginning. Clearly the latter process is more time and money consuming. Also, it is difficult to convince the elderly to test the house living there from 1 to 3 weeks: in that regard, direct contact with them helped. A final obstacle and drawback is the lack of structures to evaluate the impact of the initiative and to measure value. In fact, there are some evaluations of the Flanders living labs overall, but not for any of the local project. But in any case, how do you measure value? Measuring contacts and interactions face to face and on social media is not a really metric or indicator of value. On the other hand, value is not limited to the economic gains from an initiative. Overall, value can be measured only by mean of subjective reported impressions in questionnaires, so that generalization is difficult. Regarding the specific case, one possible bottleneck is also financial because if the product/service produced is too expensive or if people with low budget cannot really address the service the goal of the process is lost.
The most important mean to involve citizens in co-creating value is to recognize their effort and to show them that their views and insights have been taken into account. Another crucial aspect is a good definition of the objectives of the co-creation activity. In this respect, it would be helpful to teach individuals to work with design-thinking to some extent. Organisations and companies sometimes come with big expectations about co-creation, as they expect to come up with fully new products. However, only the small things can be innovated at a time and often small things make the difference in the end. Also, lots of organisations are coming too late in the co-creation process: they just want to quickly test their product, instead of testing their idea first and progressing along the way. Also, many of their ideas stem from technology itself, which is sees as a solution itself rather than as a mean to bring about change. Another important aspect is to pay attention to the quality of participants: projects need to involve a lot of professionals and future users of the service, because their insights are the most important part in the process of co-creation. For example, dignity is key element for future users, together with the fear of independence loss in the elderly home. An interesting idea concerning the selection of participants is to combine users and experts, and in any case to provide a benefit for the user /expert to participate in terms of moral recognition of their contribution. A final important element consists in the development of the right context for such kind of projects, based on a strict collaboration among caring facilities, hospitals, services and products providers, policy makers and civil servants. A follow up project could be to rethink the public elderly homes, as well as to influence the current culture of staying too long in our home, by convincing individuals to move to another more sustainable home.