How could a Designer‑in‑Residence model using systemic, participatory design help us understand a hospice system today and co‑imagine better futures for hospice care?
CONTEXT
Palliative and end‑of‑life care in the UK is under increasing pressure from ageing populations, widening service remits, rising technological complexity and fragmented systems. Hospices are expected to provide holistic, relationship‑centred support while navigating workforce challenges, funding constraints and changing expectations about where and how people receive care. In this context, small, local innovations can easily be overwhelmed by structural pressures if we do not understand how different parts of the hospice system interact.
A systemic design approach is used to treat hospice care not as a single service or building, but as a complex, interdependent system of people, practices, technologies, environments and policies. Systemic mapping makes visible how elements such as staffing, funding, patient experience, reputation and technology uptake reinforce or undermine one another over time, and helps identify leverage points where relatively small interventions might have meaningful impact. This provides collaborators and decision‑makers with a shared view of “how things work” that goes beyond individual anecdotes or siloed metrics.
A participatory design stance brings staff, patients, families and volunteers into the mapping process, recognising them as co‑interpreters of the system rather than passive subjects. Participatory system mapping and co‑design methods are adapted to respect time constraints and emotional demands, enabling stakeholders to articulate what matters to them, contest or refine the emerging system picture, and surface situated knowledge that external observers would miss. This involvement supports better‑grounded insights and builds local ownership over any future changes.
Speculative and co‑imagined futures are introduced because systemic maps alone do not tell us what kinds of hospice futures are desirable, ethical or acceptable in practice. Speculative design methods provide structured ways for stakeholders to explore “what if?” scenarios, to explore the implications of new technologies, and to articulate values and principles for relationship‑centred, technology‑supported hospice care. By moving between current systemic understanding and collaboratively imagined futures, the project generates outcomes that are both analytically rigorous and practically generative. Maps that guide where to intervene, participatory methods that make system change more democratic, and speculative concepts that offer concrete starting points for innovation, commissioning and policy conversations.
AIMS & OBJECTIVES
Advance design in hospice care by developing and testing a Designer‑in‑Residence model that combines systemic and participatory design to understand a situated hospice system and co‑imagine desirable, technology‑supported futures.
Construct in‑depth systemic maps of hospice care, using interviews and observations to surface key elements, relationships and leverage points in the current hospice system.
Adapt and apply participatory system mapping methods that enable time‑pressured hospice stakeholders to co‑create their own view of the system and its dynamics.
Co‑imagine future, relationship‑centred hospice services and technologies through speculative and co‑design workshops with staff, patients, families and volunteers.
Critically examine the Designer‑in‑Residence model as an approach to design‑driven innovation in sensitive healthcare settings, generating guidance for other hospices, design teams and health organisations.
OUTCOME
The project generates a set of outcomes that collaborators and media can draw on to understand both the current hospice system and possible futures:
Designer‑in‑Residence model and guidance
A documented model for embedding designers in complex healthcare environments, including ethical considerations, practical lessons and recommendations for organisations interested in design‑driven innovation in palliative and end‑of‑life care.
Current hospice system maps
Visual maps that articulates how a hospice system currently operates as a system, highlighting strengths, tensions, bottlenecks and leverage points for change. This was achived through Interviews and Particpatory design workshops creating scope for comparison of methods and validating cross-over elements.
Participatory workshop approach
Development into how to conduct participatory design workshops in a working healthcare context. Demonstrating engagement and recruiting tactics with a workshop stucture that is asychronous, multi-model, and hybrid.
Co‑imagined concepts for future hospice care
A set of relationship‑centred, technology‑supported ideas (new service models, digital tools and spatial concepts) that translate abstract systemic insights into tangible directions for service development, innovation projects and policy discussions.
This PhD research is in collaboration with Marie Curie Hospice Liverpool, and is funded by Doctoral Network in AI for Future Digital Health at The University of Liverpool.
The Inclusionaries Lab 