Leave the desk and strengthen well-being

Our welfare society is under pressure and we urgently need to rethink together the way we have set up the welfare system. There has never been a greater need than now to rethink and create new pathways to welfare if we are to ensure cohesion at local, municipal, regional and national levels. But how do we do this in practice and what methods do we have that can be used? In this article, I want to strike a blow for the increased use of qualitative data to complement the focus that has been on quantitative data in recent years due to the increasing digitisation and access to quantitative data.

Depth vs. width

The other day I ran into an old friend on LinkedIn. The friend is a model I have used many times when I have had to convince clients, partners and decision-makers why they should always supplement questionnaires and other quantitatively data-heavy statistics and explanations with qualitative insights. And especially when it comes to understanding and developing welfare.

The model shows, quite simply, the difference between what kind of knowledge qualitative and quantitative studies provide. Quantitative studies can show how something relates, from what can be counted and measured. Qualitative studies, on the other hand, uncover contexts, needs, understandings, and causes. In short, the quantitative tells about what, while the qualitative tells about why. Both have their value because quantitative studies provide a wide insights, as they often cover up the answers of many people, while qualitative studies provide a deep insight on the basis of fewer people. The quantitative can validate what we assume. The qualitative can open up new perspectives.

On discovery

Qualitative approaches are about going out into the world and observing or questioning people's experiences, habits and behaviors in a given field. This could be, for example, to gain insight into citizens' experience of home care in the municipality, young people in activation and their experiences of being outside the labour market, or employees' understandings and approaches to, for example, cooperation across the organisation. Instead of sending a questionnaire, you go out and meet them where they are and live their lives and let them narrate more nuanced than a questionnaire ever can.

My experience is that there has been a shift in focus over the last few years in the way the public develops their welfare, moving from being preoccupied with putting the needs of the citizen at the centre to basing welfare development on how we can get the most out of the money. There is nothing wrong with the latter, but if it is done primarily on the basis of quantitative studies on how to save on welfare and not supplemented by qualitative insights into the experiences and needs of citizens — and how employees use their professional skills most meaningfully and appropriately, I am unfortunately quite sure that this will be more about liquidation rather than welfare development.

Quantitative data provide a valuable overview of where challenges may lie in broad views—but rarely a deep human or clear picture of what needs or potentials lie behind these challenges.

System and experience

A few years ago I helped a Danish municipality introduce a triaging system in their home care. Triage is a tool for assessing and classifying citizens according to their health status in green, yellow and red through a digital platform, so that citizens who are most in need receive increased attention and targeted care. By triaging the nursing staff, the aim was to prevent a high number of short hospitalizations due to, for example, lack of fluids. This could save the municipality a lot of money — and also the citizens from the discomfort that often accompanies fluid shortages and hospitalization. The municipality achieved a reduction in the number of short admissions. Fortunately, the municipality chose to supplement the quantitative knowledge about the number of hospitalizations before and after the introduction of the new system, with qualitative interviews with both citizens/relatives and employees, about how they experienced the new triaging system in their everyday lives. Not only in terms of effect, but also in terms of behaviour and the relationship between citizens and the welfare system. Their experiences were translated into developing greater awareness of how citizens could be more involved through questions and conversations in assessing how they feel — and thus it strengthened both the professionalism of the employees and an experience of more involvement and presence for the citizen. It is a good example of how qualitative knowledge complements quantitative impact measures.

From them to us

When I started working in welfare development 10 years ago, the approach was often that we, as the qualitatively specialized consultants trained as anthropologists or ethnologists, went out into the field, gathered knowledge through interviews and participant observation about them, analyzed in a specially designed analysis room and finally presented the client with the deep qualitative insights.

Today, fortunately, I find that more customers themselves are doing small and large qualitative studies in their own organization. That many municipalities themselves have the capacity to make smaller qualitative studies. Recently I had a meeting with a municipal welfare director, who often takes himself “into the field” on participant observation of citizens and employees when there are challenges or strategic decisions need to be made about the future. Her next step is for more bosses and managers to be able to do the same, because she is sure that it creates better solutions and higher quality when decisions are made with insight into the complex reality in which they have to operate. It is not about serving everything the citizens want, but actually creating smarter solutions that work better because you have invited reality in — and thus spend the money in the best possible way.

Design of welfare

In work with welfare development, design thinking is an obvious approach that uses several qualitative and exploratory methods. Design thinking is a concrete method of innovation and change, where one understands the problem in terms of human needs — be they users, citizens or customers. In practice, this means starting with understanding the challenges and opportunities from the citizen's perspective. Qualitatively. For example, to identify the needs of parents of children with learning disabilities. Here it is about going out and meeting parents and children through qualitative methods such as field work (home visits and participant observation), interviews, group interviews, etc. And gain a deep insight into their world and their needs. With that insight, the likelihood of designing welfare so that it is actually experienced as value-creating increases. And by involving users and citizens, ownership is strengthened when solutions and strategies later need to be realized.

The simple is difficult

Perhaps you are one of the many who are already working. If you are, you have probably experienced that it is both easy, as the methods themselves are quite simple. But you, like many others, have also found it difficult to go out into the real world and talk to users, citizens or customers — and then know what you can conclude. It's more safe to sit behind the desk with a lot of quantitative data. To collect qualitative data, you need to meet people where they are. You need to ask open-ended questions. You have to listen. And you need to have their needs mapped on their premises — and be able to see patterns across the qualitative ones. It's harder than it immediately sounds. Especially if you're used to being the one telling citizens what's up and down.
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If you are not at it yet, then I can only encourage you and your colleagues to find the areas where there is the most burning need for innovation and innovation, and then get started collecting qualitative data and strengthening the foundations of your welfare development.

Good advice to get started

• Choose a topic or civic group that you and your colleagues lack insight into — either in general (e.g. youth life) or in a particular situation (young people dropping out of secondary education). Start by exploring your own knowledge and assumptions about the topic or 'group'. What do you know and what do you assume? Define for yourself what it is you need to gain more insight into — for example, how they experience the municipality's offerings. Write a question guide for yourself, with the most important questions or topics. Good qualitative questions are open-ended and add up to descriptive answers (e.g. describe how you...)
• Seek out, possibly through a professional in the municipality, a place where you can both observe and meet citizens (e.g. a job center). Please agree in advance that you can talk to some citizens in a quiet place. Always present what your purpose is and what your conversation will be used for. Tell them that you are interested in learning more about the interviewee's own experiences.
• Listen to what you're told — don't try to explain anything or come up with solutions. Ask questions and elaborate on your interviewee's experiences, needs and behaviors.
• Once you've talked to a few different people, try to see if there are patterns in what you've been told. You can condense the patterns into insights — something general you can say about the needs of this group or an understanding and behavior in a particular situation.
• Share what you've learned with your colleagues and use the insights to see if you have the right attention, optimal organization, and the right offers.
• And if it's too difficult, train a group of employees in qualitative methods and approaches.
• What challenges can your organization not solve on its own?
• Who can help explore the challenge and find and co-create solutions?
• How can others be motivated to participate in problem solving?
• How can a platform/arena be established that brings together all relevant parties and enables co-creation?
• Are there other initiatives and/or groupings that it would be interesting to associate with, ally with or be challenged by?
• Do you want to join the co-creation movement — and solve society's major challenges?

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