What is good design? We’ve heard that good design is useful, usable, and desirable to the user engaged with a product or service. Dieter Rams, one of the most influential industrial designers in history, has given us 10 principles for what is good design. But what exactly is good design in healthcare? And how do we apply these principles to improve healthcare strategy, tactics, messaging, products, services, experiences, outcomes, and environments?

“Good design, like good painting, cooking, architecture, or whatever you like, is a manifestation of the capacity of the human spirit to transcend its limitations…it is a statement not a gadget.”George Nelson

If we look close enough, we can find elements of design hidden in healthcare and buried beneath acronyms—think lean six sigma, quality improvement efforts, and improving patient experience. What is noticeably missing among these efforts is design thinking.

Design thinking may sound complicated, but we have, and always will, experience design in our everyday life. Below are key ideas to keep in mind when embarking on your journey to becoming a design thinker.

Design : : Found everywhere and innate to everything.

We use it when we put our socks on in the morning. It’s an exchange between our selves and our environment. American philosopher John Dewey reflects, “Every experience is the result of interaction between a live creature and some aspect of the world in which he lives.” Where there is interaction, there is design.

But how often do we pause for reflection on our experiences—we’re either extraordinarily delighted or unusually disgruntled. How often are we aware of our environment—the meaning of our interactions within it—let alone open to absorb its insight and inspiration? We use design when we strip away the unnecessary, the superfluous, what detracts us from creating what we need, delivering what’s required, or living the way we desire.

Notable professor of Design, Management, and Information Systems at the Weatherhead School of ManagementRichard Buchanan is quoted “Design has no subject matter…”—therefore; it is up to the designer to choose what areas to explore and what problems to solve. When we broaden our understanding of design beyond the realm of logos, artifacts, apps, and HCAHPS, we realize its unlimited potential to drive us towards the outcomes we desire. Design challenges us to have a reason behind every decision that we make.

Design : : A product AND a process.

Design takes us on a seemingly unconventional (yet natural) path—steeped in the ambiguities and uncertainties of life—where opportunities and possibilities exist. Design begins with purpose and evolves through iteration: exploring the world, discovering issues, transforming opportunities, generating ideas, constructing models…testing, dissecting, refining, reflecting, and repeating it again from start to finish, each time with a newly enlightened vantage point. Sounds complicated? In fact, we engage in this process every day. Making a decision and reflecting on its consequence—what did we learn? Did this draw us closer to our intended outcome, or have we diverged in a way that offered a new view on our situation? Most importantly, what can we learn from this and apply to other experiences moving forward? If you look for design, you will find it—embedded in every aspect of our world and our interactions with it.

On paper, the process of design thinking can be boiled down to four key words: discover, define, design, and deliver. From start to finish, however, the element that makes the process of design tick is individual experience and creativity.


In healthcare in particular, employing empathy to think outside of one’s individual experience opens up a world of opportunity for improvement. Healthcare designers must discover and seek to understand what primary stakeholders value in a service exchange. What makes patients tick, what contributes to the stress of hospital staff, what concerns could potentially go un-aired? Interviews and focus groups underpin the discover phase. Firsthand accounts of the problems individuals experience help set the stage for meaningful improvement.


Often, and frustratingly enough, felt concerns are not easy to articulate. For a designer, however, poorly articulated problems represent opportunities. Based on the insights gained during the discover phase, designers must next define a problem. Before a solution to a complex problem can be developed, it is important to have a clear understanding of what is wrong. The definition stage urges designers to take often amorphous problems and seek out structure. Diving deep to understand the many layers of interaction at play sets the stage for practical, truly meaningful solutions. Defining a problem focuses creative energy on the development of effective and practical solutions.


The design phase represents the nuts and bolts development of potential solutions. This process is rarely, if ever, a one-and-done situation, and typically many solutions are designed before any version is implemented. This iterative process of designing, analyzing, and refining uncovers additional layers of meaning and brings elements such as financial feasibility and other important elements into the spotlight.


Once a potential solution has been developed, it must be tested. Exposing innovative ideas to the wild often opens new areas for improvement, as those who live the affected process engage with the new process or product. If a design fails in a certain respect, it may be revisited, tweaked and tested again. While not every solution may be perfect, those that are successful deliver meaningful results for key stakeholders.

In the context of a healthcare setting, the key steps of a design process can focus both internally and externally. Processes for patient and family interactions can be designed just as successfully as those centered on clinical service delivery.

Design : : A challenge and a dream.

Using design thinking heightens our awareness. We do not simply go through the motions, but rather we strive to continuously see the world in a different way. We are playful in our approach and allow ourselves to be open to a path that may challenge what is expected. Using design is about living and working with intention and being aware of what can be gained from every experience. We take an objective look around us to vet what is valuable and what isn’t in our lives and our work. So often we battle our better selves against what is comfortable, most accessible, what our budgets allow—but at what compromise?

With design, we see the big picture, yet have the ability to focus on the details. We understand the relationships between many moving parts and recognize opportunities to improve the function and agility of those parts. We recognize parts in relation to the whole. In healthcare, we see and understand individuals; we talk to and motivate individuals—while at the same time addressing the collective.

Design is about hierarchy and balance, similarity and contrast, dominance and emphasis, scale and proportion, texture and space, form and function—design thinking in healthcare is about applying these principles to the interaction of people and business. With design, we craft our messages with the listener in mind; we design our experiences from the vantage point of the consumer. With design, healthcare has the potential to make sense!

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