Methods:

• Initiating open dialogues and sensemaking together – facilitated by an action researcher – to transform disempowering (pathogenic) mindsets and patterns, using boundary objects.
• Integrating user voices and feedback (focus-groups, annual surveys, website, Ombudsman).
• Pedagogical tutoring of professionals and user relatives (TSM).
• Developing professional approach to service ethics (introductory training for newly employed personnel, reflective joined dialogues, study circles)
• Altering some service routines for more user influence and co-creation.
• Combining “hard”/instrumental and “soft”/trusting, supportive, health promoting leadership towards service personnel.

Living lab as a tool and method

• In CoSIE, Living Labs were aimed at facilitating co-creation of a shared vision of the piloting service and a model of the stakeholder and user roles and relationships in service design or improvement.
• In Jönköping pilot, stakeholder dialogues focused on first-line manager and personnel approaches and roles in delivering authorized services to users with disabilities
• The dialogues were organized as a series of joined reflections and sensemaking dialogues in a first-line manager group that were facilitated by a driven mid-manager and action researcher.
• User voices, structured reflective questions, thought evoking pictures, new theoretical references, self-organized study circles and task solving groups were methods used to promote joint re-articulation of a more co-creation friendly service vision.
• These sensemaking dialogues involved many of living lab elements to help co-create and visualise a model for changing local service culture: 1) Analysing decision making officials’, first-line manager and their personnel experienced roles and responsibilities; 2) identifying and satisfying information and knowledge needs among first-line managers and their broader needs for leading and governing service improvements; 3) designing improved service processes and pathways and considering under what conditions they may be tested and implemented; 4) analyzing especially manager and personnel capacities, planning and deploying some improvements;
• Also LLs sessions with other pilots based on comparing and contrasting their service understandings and roles as well as change visions have increased Jönköping pilot awareness of commonalities (importance of service ethics) but also its specific strengths (political, top-managerial support) and remaining challenges (timing, coherence in systemic change).

Open data, Social media and Digital technologies

• Open data – especially annual service user surveys with cross-municipal comparisons of social and disability services have been used by first-line managers to inform each other and their personnel about service status and improvement potential, but in combination to locally generated user voices. Jönköping as pioneering municipality has undertaken additional measures towards more fair surveys by sending neutral personnel to assist service users in replying to surveys.
• Social media – has been less used as a channel due to access issues and inequalities it creates among people with varying disabilities. Yet, it has been successfully used to reach out to service users with information and call to focus group interviews or community reporting sessions. Users communicate their complains or praise about services via municipal website and this user data is analysed and used.
• Digitalised user voices – service user experiences and improvement suggestions expressed in focus-group interviews and user voice films by community reporters have been circulated around and used as a source of user knowledge and inspiration for co-created improvements in services.
• Smart/digital technologies – Covid-19 has increased the use of smart/digital technologies for communicating important (hygiene and security) information to disability service users. Digital tools has been used to assist the user and collaborate in support implementation: to do lists, calendar, shopping list, GPS-to find right address, safety alarm, set reminders, time timer (concretize time) Tover tafel – interaction based simulator to train motoric skills, exercise, stimulate the senses.