From the margin to the middle

How to create structural space for social design in healthcare?

Type Update
Published on 23 October 2022
Part of Embassy of Health
From the margin to the middle
Part of Embassy of Health

Using design within healthcare can be a valuable, enriching and innovative way to develop fresh approaches to the challenges the healthcare domain is facing. At the same time, this exchange is not an instant path to success, as reality often shows. During the series Duurzame inzet ontwerpkracht in de zorg [Sustainable use of design in healthcare], participants and stakeholders from healthcare, design, science and education discussed bottlenecks and opportunities that might arise when different domains work together. Initiator Joost van Wijmen wrote a retrospect on the series.

The projects

The series Sustainable use of design in healthcare, revolved around the projects FysiekFabriek, Re-creatie and ENCOUNTER. FysiekFabriek brings people with physical disabilities into contact with designers to jointly develop new practical tools. The designers of Re-creatie create connections between people with disabilities and their surroundings. This is done with care for people, materials and the living environment. ENCOUNTER#9 consisted of a series of designed encounters between older people from residential care locations and young people, training to become social workers, with the aim of learning from each other. Based on experiences of the three projects, opportunities, bottlenecks and challenges were explored.

Encounter#9 - credits: Marcus Peters

Added value

The participating experts recognized the added value of social design in similar methods of working. Each design consisted of a repetitive process of “doing-thinking,” analyzing and enhancing. First the designers peeled off and examined the issue they were presented with. This triggered a process in which underlying bottlenecks, desires, goals and ambitions of the organization were retrieved or redefined. By the use of stories and narratives complex issues were made tangible. In addition, designers acted attentive of others, providing custom-made designs, placing relationships at the center and navigating along common protocols. In doing so, they provided a context for participants flourish. The careful application of this methodology proved to be the strength of each project and is characteristic of social design.

 An escape route

Attendees also noted that designers and healthcare professionals work differently. They each relate to different rules. The job of healthcare professionals is to provide quality care to people who need it, supported by rules, “protocols” and financial systems. Designers, on the other hand, are expected to work outside accepted conventions. They are allowed to work with ‘more freedom,’ bypassing the sometimes constricting ways of the healthcare system.

Holistic approach

The combination of the mentioned freedom and the specific working method of social design projects creates space for different accents in the approach of caregiving. The starting point is formed by relationships between people, with adjustments to one’s own practice or situation. This offers a more people-oriented or holistic approach and tilts the view on current problems, such as workload or staff turnover.

Encounter#9 - credits: Marcus Peters


While the attending experts saw opportunities, they also detected bottlenecks. If real changes need to take place, a pilot project must truly transform into an approach that becomes a permanent part of regular care. This requires space, time, energy and money on a structural level. Organizations, policy makers and political administrators will therefore have to deal unorthodoxly with financing, the deployment of (care) professionals and the definition of care. One possible approach is to position design as a tool of change, while still safeguarding the core values of design.

The designer also has a task. The designer enters a ‘foreign’ domain, where belonging is not evident. This requires an emancipating attitude in which the designing or artistic methodology is positioned as a unique expertise.


A solid positioning means also providing insight in the mechanism of social design. You could say: providing evidence of the impact to institutions, directors, partners and funders. This consists of scientific, artistic and determination on policy level, of the benefits of projects. Noticing that if the gaze remains strictly on measuring (the hard impact), there is no eye for the subjective qualities (the soft impact). This might result in one-sided care, as we see reflected in controlling (monitoring) or optimizing (more for less) care.


If social design is only used as a marginal, quick fix, without enabling true exchange between those involved, the adventure is doomed to fail. The strength lies in collaboration between all participants and stakeholders.

If social design wants to play a role in future challenges in healthcare, it is important to make it a significant part of existing structures. Because through exchange in practice, we experience each other’s expertise, bottlenecks, limitations, courage and solutions and a viable approach emerges. This takes guts as well as time and money, because in practice we sometimes see this approach fail. But only from a learning friction between design and care, a different approach will take root and grow.

Read the complete article (in Dutch).

The complete article can be found on the website of Social Design Showdown. Joost van Wijmen (initiator and social designer) distills in this article, what surfaced during three expert meetings on the sustainable use of design in healthcare. The series was set up by Joost van Wijmen and Jetske van Oosten on behalf of the Creative Industries Fund NL, within the context of the Embassy of Health.

The article describes the overarching qualities, recognizable challenges and more widely applicable opportunities of social design. For many designers, these insights are an everyday part of their practice. As such, the article fills the need for sharing knowledge on this topic.

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