Designers have to be aware of the inertia of systems and their resistance to change, and be agile and prepared to overcome that resistance. Designing collaboratively is an act of partnership. This relation- ship implies synchronicity—having a common purpose and a common responsibility—as in a symphonic orchestra. It is during this process of communicating and working in partnership where people form bonds, and reach consensus. They do this interacting, conversing, listening, observing, learning and collaborating in an atmosphere of empathy and care for others. All of these interac- tions encourage people to become highly motivated, and able to give their best response to design problems. In design as collective intelligence, designers seek advice to understand the issues and identify what is needed. They are active listeners, not only keeping quiet when listening, but rather identi- fying key issues, common interests, values, purposes, barriers and opportunities in the speech of the other. For design as collective intelligence to materialize, what is required? DESIGN AS COLLECTIVE INTELLIGENCE: THE NEED FOR GOOD LEADERSHIP Leaders in design projects do not have to be appointed bosses; rather, all members of a working team can be leaders, using their capacities to help everybody else get the best out of themselves. Good leadership is distributed leadership; it is not top-down, it decentralizes decision-making processes, motivating instead of demanding, and empowering people without controlling them. Design as collective intelligence requires flexibility to adapt to different problems, users, disciplines, situations and resources without diminishing the group’s capacity to deliver a top-level response. To look at design problems in different ways and to respond to constantly changing situations requires not only flexi- bility, but also mental and social agility in order to go beyond the ability to adapt to change, and instead generate change. In addition to the dynamics of designing with others, designers also have to be aware of the inertia of systems and their resistance to change, and be agile and prepared to overcome that resistance. Designers must know the systems within which their projects operate. Designers must be keen observers. Designers must also have good communication skills. Good communication skills foster the creation of a feedback rich environment. In design as collective intelligence, people are resourceful, reacting properly in difficult or ambiguous situations; coherent and honest, so that they are understandable to others, and thus generate trust in their ethics, knowledge and judgment skills; courageous, to make difficult decisions when decisions are needed and doubt paralyses others; and self-aware, to know where the limits of their knowledge and abilities are, and when to seek advice. Collective intelligence flourishes when people apply their dis- ciplinary knowledge while interacting with others, offering fresh views on the topics at hand and engaging in mutual understanding processes. It must here be mentioned that interdisciplinary work requires disciplinary competence. Very often, we can find ourselves working with controlling leaders or controlling clients; these people promote passivity, fear, and collective stupidity. To create the best possible design work, designers need good clients and good team members. But where did we learn that? Was it at school? Are we teaching this to our students? Let us now move to our experience as designers, and explore the kinds of situations in which we have worked. HOW DO WE WORK? At Frascara-Noél we practice a design that is user-centered, evi- dence-based and results-oriented. To do this, we use several tools and strategies including prototypes, iterative designing, empathic approaches, diagrams, problem-based learning, and interdisci- plinary teams. To begin with, we include the users in our design process sooner or later, and preferably sooner. The users are the experts; our best allies when trying to understand our design prob- lems are the people who suffer them, and for whom we have to create better situations. We use these tools to connect people, produce high functioning teams, collaborate on multiple scales, and encourage effective peer production. EXAMPLE 1: THE BLOOD TRANSFUSION FORM In 2009, we redesigned a hospital form used to request blood com- ponents for transfusions in an Italian Hospital (Figure 1). Our users were directors of hospital facilities that normally need blood, such as Surgery, Gynecology and Hematology. A form isa tool, an administrative tool, and it should help peo- ple perform their task easily and efficiently. Through observations and dialogue with users, we first identified how the form was used, what the obstacles to its use were, and what it was supposed to do. We then developed what we call performance specifications. We observed that in an emergency situation, for instance, when a gynecologist needed blood urgently, he did not fill out the form himself, but asked a nurse to do it. This practice, obviously, created an overload on the nurses’ part, and was detrimental to both the nurses and the overall efficiency of the hospital. These issues suggested that the tool presented design diffi- culties that needed to be addressed. When the gynecologist was available to talk with us, he explained the barriers posed by the form. The main barrier was the time and cognitive effort filling it required, taking the doctor’s attention away from his main task of caring for the patient. Through the design of prototypes, we started an iterative pro- cess of design and interviews. Eight prototypes were necessary to arrive at a solution that we could consider successful (Figure 2). Prototypes create common grounds that help us communicate with others, focus the conversation, and reduce possible misinter- pretations. The prototypes we developed resulted in 52 modifica- tions to the existing form. We got a good level of cooperation from the client and the users, particularly when a meeting was called OPPOSITE, FIGURES 1-4 1 The original blood transfusion request form. 2 The final design for the blood transfusion request form. 3+4 Examples of the forms used for think-aloud interviews.