Phase 4: Design

bloomington cove

Bloomington Cove, gathering feedback on aspiration statements for their Design plan.

What is Design?

Design is the fourth phase of the Partnerships in Dementia (PiDC) Alliance Appreciative Inquiry process. During design, members work together to build strategies and actions that describe how the dream will be realized.

For a brief overview of the Design phase please refer to our 
    Design fact sheet

What is the purpose of the Design phase?

The purpose of Design is to:

  • take the values, ideas and the vision that are outlined in your group’s or organization’s aspiration statements and turn them into a concrete plan of action
  • build a bridge between the best of what is currently in place in your organization and the preferred future (i.e., where your organization would like to be)
  • reflect on current practices
  • continue to build partnerships/relationships
  • determine what should stop, start and continue, and how this will happen
  • identify resources and supports needed to carry out changes

Your group or organization will then be able to develop multiple strategies and tangible actions for aligning practices with the aspiration statements.

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What will you have at the end of the Design phase?

The main product of the Design phase is a Design Plan that includes the following:

  • preferred options (those you are most excited about) for how to make your aspiration statements a reality
  • a goal for each preferred option
  • action steps to achieving each goal
  • who needs to be involved
  • how long it will take
  • what supports / resources are needed

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Developing a Design Plan

A Design Plan is essentially an action plan for making each aspiration statement that was developed in the Dream phase a reality.

There is no one-size fits all approach to Design. The steps outlined below can be worked through in a number of different ways:

  • You may choose to have the culture change coalition complete certain steps and then invite broader participation from others. Or you may invite broader participation for all the steps.
  • You may get input from people outside the culture change coalition using surveys, interviews, focus groups, workshops, conversation cafes, contests, discussion boards, other creative methods, or some combination of these methods. Choose what is most relevant to your setting(s).
  • You may tackle each step one at a time or you may work on several during a single workshop or event.


We have developed some Design plan worksheets that should help you capture your work each step of the way. Pick the worksheet(s) that you feel will work best with your organisation.

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Step 1: Getting feedback on the aspiration statements

Not everyone in your organization or community may have been involved in the development of the aspiration statements. Giving those who weren’t involved a chance to provide feedback at this point will provide an important opportunity for them to become part of the process.

During this step, you’re particularly interested in hearing what others in the community/organization think needs to happen to make the aspiration statements come true.

People who were involved in creating the statements will have a chance to provide input, too.

Here is a series of questions that we suggest asking for each aspiration statement:

  1. From your point of view, how would you know that [name of group or organization] has achieved this Aspiration Statement? What would it look like to you if it were already in place?
  2. What specific suggestions do you have to make this aspiration statement a reality here
  3. What needs to continue in order to make this Aspiration Statement a reality?
  4. What new things need to be done (or what needs to be started to make this Aspiration Statement a reality?)
  5. What needs to change to make this Aspiration Statement a reality?

Everyone who is asked to provide feedback is reminded that the aspiration statements are visions of the future, not necessarily reflections of what is happening now. Feedback might include what language, actions, practices, policies, and/or ways of relating and organizing need to be started, stopped, or changed to make the aspiration statements a reality.

There are many creative ways of encouraging people to give feedback. Prize draws and conversation cafés are just two examples. This is a good opportunity to have fun and get others excited about the culture change work. The important thing is to get feedback from diverse groups – older adults, family care partners, staff, management, and volunteers – so that the aspiration statements become a reality for all of them. Involving people in this way can build broad-based support for the direction your group or organization is taking.

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Step 2: Reviewing suggestions received through feedback

Review all the suggestions that you received about how to make the aspiration statements a reality. In a group, decide which suggestions you’re most excited about. Use the Priority Setting template to assist you in identifying those ideas that you are most excited by.

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Step 3: Setting goals for the suggestions you’re most excited about

Once you’ve identified the suggestions you’re most excited about (your preferred options for moving forward), it’s time to ask two questions:

  • HOW can we make them happen? What language, actions, practices, policies, and/or ways of relating and organizing need to be started, stopped, or changed to make them a reality?
  • WHEN will they happen – immediately (within the next three months), in the short-term (within the next year), or in the long-term (within the next five years)?

Once the ‘How’ and ‘When’ questions are answered for each preferred option, you’ll be in a better position to create design goals. There should be at least one design goal tied to each preferred option. The Creating Smart Goals out of Priorities template may assist you in identifying the information that will be important to include in your goals.

What makes an effective design goal?

  • It is something people can get excited about, something they want to achieve.
  • It reflects a NEW initiative or BUILDS on existing initiatives.
  • It supports the RELATIONAL MODEL of care (that is, it enhances the care experience for residents, family members and staff).
  • It is SMART (specific, measurable, attainable, relevant and time-based).

You may want to look at our Examples of Bad and Good Smart Goals before you begin developing your own goals.

Think carefully about the timeframe for each goal. We suggest inserting a timeframe into each goal like this:

“By [insert timeframe], we will have [insert what is to be accomplished]”


“By November 1, 2016, we will have a clear plan for how portable recreation carts will be regularly used in the home.

“By January 5, 2017, we will have portable recreation carts on all units.”

Drawing on information from the Creating Smart Goals out of Priorities template, use the Goal Setting template to draft your preliminary goals.

When you’ve drafted your goals, reflect on the following:

  • Is each of the goals clear and specific in terms of what needs to be accomplished?
  • Is it clear how you will know that you have achieved your goal?
  • Is the goal attainable?
  • Can the goal be realistically achieved within the timeframe given?
  • Can you get behind this goal? Does it excite you?

You can use the Goal Setting Checklist to assess your goal and determine if anything is missing. If necessary, revise your goal statements until you’re satisfied they address these questions.

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Step 4: Outlining action steps for each goal

Looking at the goals for each of your preferred options, think about what steps or actions need to be taken to achieve the goal. Consider the following:

  • Who needs to be involved?
  • How long will it take? 
  • What supports / resources are needed?

Consider all the steps that will need to be taken to complete each goal. Be as specific as possible. No detail is too small.

The Design plan should be reviewed on a regular basis and compared to the aspiration statements. Involve as many people as possible in the review by regularly inviting feedback.

Use the Outlining Design Steps template to develop a concrete action plan for each of your priorities.

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Dupuis, S.L., McAiney, C.A., Fortune, D. B., Ploeg, J., & de Witt, L. (2014). Theoretical foundations guiding culture change: The work of the Partnerships in Dementia Care Alliance. Dementia Online First, January 13, 2014. Available from Sage Journals Online

Hammond, S. A. (1998). The thin book of appreciative inquiry. 2nd ed. Thin Book Publishing Company: Bend, OR.

Tools and resources for Design

Is your organization experiencing challenges with the Design phase?

For assistance with overcoming culture change barriers see our guide to overcoming barriers to culture change.