Formative Interventions for Healthcare Sustainability: A Developmental Design Agenda

This chapter proposes a developmental design approach to build a long-term design research agenda to study and advise healthcare services towards meeting sustainability challenges. The study involved the application of systemic design tools in a participatory design workshop to create a formative understanding of the stakeholders, contexts and systemic interventions towards sustainability of healthcare systems. Healthcare services draw on vast logistics systems, generating waste streams and redundant uses, with a significant sustainability impact. Analysing the complex functions of any regional healthcare system reveals material flows and proscribed service interactions that reinforce continuing breaches of preferred sustainability levels. These flows are largely due to institutional arrangements defined far upstream of use and disposal. Yet, the actions and choices of healthcare consumers are becoming larger factors to consider in the overall environmental impact of healthcare systems. Patient-centred healthcare shifts a significant share of the responsibility of health outcomes on the consumer, including waste generated through home healthcare which is typically routed through municipal waste streams. Whether policies, healthcare services, or individual patient choices—nearly all actions in the healthcare system trigger actions with sustainability impacts. Healthcare’s complex systems are difficult to navigate individually, especially for non-experts. Although constant strides are being made towards making healthcare systems more sustainable, their complexity makes it difficult to verify the efficacy of interventions within the system and across the interconnected network of stakeholders and sub-systems.