Designing for Upstream Work: Learnings from Co-Design for Preventative Solutions with Urban Fire Departments

Scholars and practitioners in public health and social welfare increasingly recognize the need for preventative interventions that address root causes rather than respond to emergent crisis. However, they face significant challenges in designing tools and demonstrating success for these initiatives. We characterize these crucial, but difficult to develop and scale solutions, using Dan Heath’s term “upstream work”. We then explore design solutions to support upstream work through a multi-phase co-design process to assist fire departments developing alternate EMS response programs to reduce 911 call volume. We contribute to literature on designing to support data practices in community organizations and further delineate the key challenge of these programs as upstream initiatives: demonstrating success to stakeholders. We then present our co-designed prototype, a data dashboard to make the promising work of preventative programs visible for different stakeholder audiences. Finally we reflect on good practices for designing to support community based upstream initiatives.