This study addresses the challenges faced by remote care centers in the Netherlands, which struggle to meet increasing demands due to inefficiencies in managing unplanned care. Centralists, tasked with addressing unexpected incidents, face an imbalance of limited control and excessive, unutilized autonomy, compounded by systemic ambiguities and a lack of comprehensive data. Through a focus on occupational affective well-being, the research identifies four interconnected emotional challenges: hollow autonomy, insufficient communication, tensions between empathy and urgency, and a lack of recognition.

To resolve these issues, this strategic design paper proposes leveraging data-driven intelligent platforms, exemplified by Intelligent Syntilio, to transform care centers into proactive hubs for patient care. Key strategies include step-by-step workflow guidance and tools for identifying and managing care patterns, empowering Centralists to enhance care quality. By addressing systemic inefficiencies and fostering proactive care, the study provides a roadmap for integrating intelligent platforms into homecare systems, contributing to sustainable, client-centered healthcare and a more effective partnership between Syntilio and care centers.

This paper offers practical solutions for improving operational efficiency and supporting the evolving demands of modern healthcare systems.

The main goal of this thesis is to create remote patient management (RPM) strategy to effectively involve patients’ families into e-health services, and promote the adoption and long-term adherence to lifestyle
modifications of entire families. By exploring the potential of family-centered care ideology for healthcare delivery, this thesis paves a way to include family members of myocardial infarction(MI) patients as co-recipients of formal care. To accomplish the objective, various activities were undertaken, such as researching factors that influence healthcare paradigms, exploring effective strategies to promote healthy behavior, and investigating the role of family members in shaping a patient’s health trajectory.

Through desk research and interviews with key-informants of cardiovascular and home based care, valuable insights were uncovered revealing the diverse roles family members can assume throughout a patient’s health journey. These roles were found to be dynamic and dependent on various factors including personal preferences and the stage in the health trajectory, highlighting the need for personalized healthcare approaches that cater to the unique preferences and dynamics of each family.

Uncovering a research gap of the representation of these roles, a new perspective recognizing the perpetual influential capacity of family members was adopted to further explore individuals preferences of in their ability to be involved in the patients healthcare and to influence the health behaviour of the patient. By adopting this approach, family members are encouraged to prioritize their own health while simultaneously providing support to patients in maintaining positive lifestyle behaviors essential for sustaining cardiovascular health.

Based on the insights gained from a qualitative study highlighting the differences in family contexts and subsequent preferences in health-oriented involvement, a service vision was formulated to demonstrate a family-centered healthcare delivery through a modular approach. The vision emphasized the importance of data-driven insights to inform tailored interventions for sustainable lifestyle adherence. By harnessing data, healthcare providers can gain valuable information about patients and family members, enabling them to tailor interventions and support structures to meet their specific needs.

To move closer to this service vision, it is proposed to follow a data-enabled design process that enables human, technological and organizational considerations and thereby empowering designers to iterate and expand the service ecosystem.

To conclude, this thesis creates an opportunity for engaging stakeholders and ensuring that the envisioned care approach aligns with the interconnected healthcare landscape, driving the system towards a more inclusive and comprehensive care future.

You will be reading a comprehensive study that examines the shortage of instruments for performing surgery in sub-Saharan Africa and the wastage of quality surgical instruments in the Netherlands. The report explores the potential solution of repositioning the excess instruments to sub-Saharan Africa, focusing on three product categories identified by Unifix Care as having the potential to make an impact. The thesis investigates the important elements that determine the value of these second-life products in Kenya. The conclusion reached is that none of the three product categories will have a significant impact in Kenya, leading to the recommendation for Unifix Care to discontinue this proposition.

In the next part of the thesis, the report takes a higher-level perspective and examines the decision-making process of Unifix Care when approaching and investigating expansion opportunities. It highlights the limitations of the current approach, which is deemed non-strategic and unsustainable in the long term. The section discusses the significance of making structured decisions and proposes a suggestion to proactively predict market potential to avoid investing time and resources into unprofitable opportunities. A recommendation is proposed to prevent this by implementing a quickscan that forecasts market conditions in advance. This approach aims to stay focused on the most important activities. Moreover, this thesis promotes the application of an effectual approach in conjunction with proactive prediction methodologies and theories that align with the causation paradigm.

This project delivers:
A study on the adoption of excessive Western second-life surgical instruments in Kenya, analyzing the potential impact by means of a triple constraint analysis.
A recommendation for Unifix Care to enhance decision-making effectiveness and adopt a more strategic approach for future opportunities.
A decision support model that facilitates strategic decision-making for Unifix Care.
A strategic opportunity framework that aids Unifix Care in prioritizing its actions based on opportunity landscapes.

Children with a Congenital Heart Defect (CHD) need to visit the outpatient clinic regularly their whole lives, often starting from birth. These hospital visits are frequently accompanied by feelings of anxiety and fear, which can have a detrimental impact on a child’s life. In collaboration with the Hospital Hero Foundation and the Willem-Alexander Children’s Hospital, the aim of this project was to design an intervention that reduces children’s feelings (aged four to ten) of fear and anxiety during outpatient visits to the paediatric cardiology department.

Employed Methods
Throughout the project, the following methodologies were employed:
1. Literature research exploring the background of paediatric hospital-related anxiety and fear, and existing anxiety-and-fear-reducing strategies.
2. Interviews with children (with and without CHD), parents, and paediatric healthcare workers to map the current situation.
3. In-depth observations of the current context of an outpatient visit to the cardiology department.
4. The facilitation of creative sessions to generate ideas and concepts, ultimately resulting in the final design.

Home-Based Preparation
Home-based preparation was chosen as the leading fear-and-anxiety-reducing strategy. This strategy focuses on providing paediatric patients with information prior to their hospital visit. Due to the developmental and cognitive levels of the defined age group, the responsibility of home-based preparation lies with the caregivers/guardians of the patients. The following main research question was defined: How can design support children (between the ages of four and seven) and their parents in the home-based preparation process of an outpatient visit to the paediatric cardiology department?

Research Outcomes
Exploring the current preparation touchpoints, practised preparation methods, and the hospital experience from the child’s perspective resulted in the following summarised research outcomes:
• Every paediatric patient and their situation is unique. As a result, every child experiences an outpatient visit differently. Therefore, customised preparation is required.
• Parents encounter barriers during the home-based preparation of their children. Existing preparation touchpoints, including the Hospital Hero application, do not accommodate these barriers.
• Preparation of children should contain context-specific details and focus on sensory stimuli.

Intervention
Based on the research outcomes, a home-based preparation approach was defined. Context-specific triggers of fear and comforting elements were mapped and selected as preparation content. This resulted in the design of an online module that can empower children with CHD and their parents with home-based preparation. The online module was evaluated with parents and healthcare workers and shows promising results. Recommendations regarding improvements and implementation are provided.

If nothing changes, one in four employees must work in the healthcare sector in 2040, according to the Scientific Council for Government Policy (WRR, 2021). Therefore, acute care must undergo a fundamental system transformation to effectively address the needs of a growing and ageing population, while on the other hand there is a growing scarcity of personnel. Currently, the acute care chain consists of cooperating care providers such as hospitals, ambulances, general practitioners, and nursing homes in each region. A Regionaal Overleg Acute Zorgketen (ROAZ)-agency organizes the collaboration and has been given the responsibility to formulate transformation plans for the acute care chain. While a ROAZ-agency excels in optimising current collaborations between chain partners, it faces at least three knowledge gaps when it comes to designing a fundamental transformation. Overall, 1) the actors of the acute care lack a holistic view on the problem situation, 2) are predominantly inward-looking, and 3) lack a desirable vision of how the acute care could change as a whole. Therefore, this graduation project used a systemic design approach to facilitate the transformation towards a more resilient system. Resilience theory was consulted in this project, because of the prevalent framing of the growing older population, as a pressure on acute services (Adema, 2019). To produce transformation plans, the design process consisted of three phases. The first was mapping the current state of the system, the second was proposing a resilient state, and the third was exploring strategic responses aimed at achieving that state. Central to a transformation from one system state to another is a shift in paradigm (Meadows, 2008). A paradigm shift radically changes the way we see the world and with that it changes the way we give purpose to our systems. Four paradigm shifts are derived from interviews with experts and stakeholders from the acute care domain:

From viewing care as a business for professionals to approaching care as a social undertaking. From a belief in the makeable human, to live with a view of the end. From perceiving care as a commodity to seeing care as a common good. From the wish to live independently at home to the desire to live old together.

These paradigm shifts are at the foundation to how we can transform our acute care system. However, they still have to be made tangible. The shifts are shaped in four responses addressed at decision-making processes, information flows, spatial concepts, and social network.

We need a management structure which enlarges trust, flexibility, and professional freedom of action. A military mission command structure can be adapted to the context of acute care. Mission-command embraces operationally ambiguity and sees this as advantage, while commanders aim to be as clear as possible in their strategies and their underlying intentions (Braw, 2022).
There is a need for a central information structure to improve decision-making processes in and before acute situations. Information entailing acute care policies based on a patient’s values, wishes, and needs must be made available prior to an acute situation.
There is a need for new (architectural) typologies and processes to address different (sub-)acute care situations. These options lie for instance in communal senior housing, neighbourhood clinics, and geriatric emergency squares in hospitals. Acute process needs to facilitate space for geriatric, and palliative skills of professionals, especially at ambulance organizations and ED’s.
At last, we must create a longing for intergenerational social networks instead of enforcing obligatory social service. We need to foster intergenerational social networks, based on value exchanges between generations. Stronger social networks, when directed at reassurance, are likely to indirectly lower the pressure on the acute care chain.
This thesis concludes with a discussion of each response, highlighting opportunities for further development, and a set of final recommendations for the ROAZ-agency to embrace systemic design practices.

Floods, long periods of drought, wildfires, and natural disasters are becoming more frequent, in more extreme proportions. Our current food system is a major contributor to this. In particular, the livestock industry. This is due to the amount of land and water that the livestock sector uses, and the emission of greenhouse gasses. In order to work towards a livable planet for future generations, this project addresses how we can reduce the impact of our food system. One of the most promising ways to reduce the impact of our food system is to switch to a more vegetarian or plant-based diet.

This project focuses on the professional athletes who train at the Olympic training center Papendal and eat in the restaurant at Papendal. This is a unique situation where Papendal controls what the athletes eat. Although the plant-based market is growing enormously and more people are interested in reducing their meat consumption, hardly any vegetarian meals are sold in the restaurant. The manager of the sports restaurant at Papendal has no insight into what keeps athletes from choosing the vegetarian evening meal and what can be done to run a vegetarian menu in the future successfully.

A survey with athletes at Papendal was conducted to identify the barriers and attitudes of athletes towards vegetarian food. This research showed that most athletes are open to reducing their meat consumption. However, the main reasons that prevented them from doing so were that they had not thought about it, did not know what they should eat to get all their protein, and did not like the taste.

In this project, a strategy was designed to help Papendal work towards the vision of a successful vegetarian menu in the sports restaurant, where the goal is that half of all meals sold will be vegetarian in six years.

Several models were used to design this strategy, including behavioral change models and a model for achieving organizational change. The motivation technique called nudging was addressed to motivate athletes to change their behaviour. This motivation technique gradually steers consumers in a particular direction, at all times used for good purposes such as public health or sustainability.

Two roadmaps and two nudges were developed in detail as a final design. The organizational change roadmap helps Papendal work towards an optimal workplace for designing and implementing nudges. Furthermore, the other roadmap shows what type of nudges Papendal can implement over the years. Containing three horizons, each with a different focus of the behaviour change model.

Two nudges are designed in detail. To inspire Papendal what these nudges in the first horizon can look like. The first is a deck of playing cards containing information and visuals about the topic of vegetarian and plant-based food, which allows athletes to get in touch with this topic in an accessible and fun way. Next, a playful cube is designed with similar information on the sides. The cube can be placed on the dinner tables, attracting athletes' attention to increase awareness around this topic.

The healthcare sector uses a lot of on single use medical products, causing large amounts of CO₂ emissions and excessive amounts of waste. This project contributes to a circular Intensive Care Unit (ICU) by investigating the barriers and possible solutions for a transition from single use video laryngoscopes (VL) to (partly) reusable ones, in order to develop guidelines and best practice for the transition of other single use medical products to reusables.

To produce single-use products, raw materials are extracted, products are manufactured, used, and disposed of after using the product just one time. This is known as the linear economy or the ‘take-make-waste’ system, having a devastating effect on the environment. However, reusing medical products comes with organisational challenges. Concerns with patient safety, liability, the costs, and complexity of developing and maintaining in-house reprocessing infrastructure and logistics have left hospitals with a complex organisational challenge.

The research question for this project is: How can the ICU become more sustainable through overcoming organisational challenges hindering the implementation of reusable video laryngoscopes? With the sub-questions: 1. What are the barriers and enablers for implementing the reuse of video laryngoscopes in the ICU? 2. How can the reuse of video laryngoscopes be implemented at the Erasmus MC? 3. What could be the next step in transitioning similar products (to the video laryngoscope) from single use to reusable?
This design project was structured through three phases: Exploration, Analysis and Conceptualisation phase. Three product journeys were analysed: a single use VL, semi-reusable VL and a completely reusable VL. This project concludes, contrary to the original hypothesis, that barriers to for the implementation of reusable VL’s are minimal. The semi-reusable VL seems to require the least change from the organisation, but the fully reusable VL contributes better to the end goal of a fully circular ICU in 2030, notwithstanding its higher up-front cost.
For the implementation of the reusable VL it is essential to spark the actual implementation of the reusable VL and communicate with and facilitate stakeholders. The implementation processes need to be kickstarted through the set-up of a tender, followed by a pilot, pilot evaluation and expansion of the pilot in order to ensure proper implementation. After implementing the VL three other medical devices were identified to follow in the footsteps of the reusable VL: Laryngoscope blades, bronchoscopes, and scissors. Laryngoscope blades and bronchoscopes can be collected in the same place since the use-case of them is very similar to the VL. Scissors will require further research but follow a similar journey to and from the CSD.

This report brings value to the ICU of the Erasmus MC through identifying that the Erasmus MC has the resources and capabilities to implement the reusable VL’s, as well as presenting recommendations for the implementation process.

Hypertensive disorders of pregnancy that include gestational hypertension are seen to complicate pregnancies worldwide. Even if hypertension resolves postpartum, these women are at an increased risk of developing cardiovascular issues in the future. So, they are recommended lifelong lifestyle changes that include making adjustments to their diet.
Although the hypertensive pregnancy offers an opportunity for positive change due to high motivation, various challenges get in the way of implementing change. Additionally, an individualistic and personalised approach is required to facilitate the adoption of healthy eating. However, the current setup to support women in the change-making process does not cater to this. A data-driven eHealth service has the potential to provide personalised support and therefore can prove to be useful for guiding women with gestational hypertension in making the required diet modifications.
This graduation thesis was set up with the aim to design the concept of a service that provides personalised support to women with gestational hypertension and helps them realise the prescribed diet changes. The design process was guided by the formative research on the challenges and enablers to diet change relating to pregnancy as reported in the literature followed by translating them into providing continuous care by applying behaviour change theories.
As a solution direction to providing personalised support, it is envisioned that women with gestational hypertension will be supported using a chatbot-driven service that assists them in effectively managing their diet by providing continuous training based on their lived experiences and with the help of relevant triggers. The chatbot was developed with the aim to (1) help the women cope with emotions, (2) provide knowledge and (3) effectively manage their diet.
The chatbot serves as a tool to gather data from the women, uncover it and deliver continuous support. In the process, it improves the current care pathway by providing (1) immediate response without increasing the load on the medical team, (2) ease of interaction through uninterrupted contact and increased reach and (3) personalisation of care utilizing tailored support. Thus, it has the potential to act as an effective means for guiding women when making diet changes while catering to specific needs within a diverse population. Further analysis through user testing is required to understand its acceptability and desirability in everyday use.

The Box contains monitoring devices patients can use to perform monitoring activities in the comfort of their home. The success of the service relies on active patient participation. With The Box, the treating medical team now has insights in the patient’s health condition from a distance. It doesn’t require the patient to be physically present in the hospital, and there’s now even more reliable data available to adjust the treatment to. It makes the carepath insightful and approachable by both parties, resulting in accessible digital consultations. Since The Box has proven to be a success in patient care, several departments started adopting this service as well. However not much attention has been given to how the healthcare staff at LUMC is experiencing the implementation of The Box. As the idea of patient home monitoring looks very promising, the reality however is quite discrepant. Not having the physical presence of patients in the hospital, would appear to reduce the burden on healthcare staff, as instead these “empty” hospital bed will simply be taken up by other, even more severe cases, causing a larger amount of patients to both monitor digitally and take care for physically. It leaves us with the question of “Who will do it?”. Who will take on the so to speak additional workload? The healthcare staff at LUMC is experiencing more workload with the implementation of The Box as its intended use is mostly focussed on remote and safe patient monitoring, while missing out on an opportunity for assisting the care-team. It occasionally happens that additional staff is hired to cope with the excessive workload, or that LUMC is also investing in an intelligent system that prioritizes patient data. But momentarily, healthcare staff’s solution is simply to not check up on every patient that sends in data. The Box may appear as an implemented innovation in the care practice of LUMC, but in reality it is still a prototype. Therefore it requires scaling to towards an improved standard healthcare practice. The goal is to turn The Box into a mature proposition that can be implemented hospital-wide, but also that has the ability to change the current healthcare system. The burden on the care-team must be suppressed or else the future will include an immense scarcity of healthcare professionals of which the majority will be burnt out. A roadmap is created to show opportunities for continuous prototyping and what value it brings, scaling strategies, patient monitoring and what level of staff involvement it demands, required developments and finally stakeholder collaboration. What it actually proposes are the changes to be made to create an integrated healthcare solution that is focussed on “unburdening” the staff. LUMC is not capable of changing this alone: they are specialized in research, education and healthcare, yet they lack expertise on data management, financial resources, digital developments, etc. It therefore needs support of multiple organisations. The deliverable aims to show a designer’s perspective on scaling The Box from a prototype level towards a mature healthcare proposition.

This project envisions the future of telemonitoring for peri-operative care. Through an extensive literature research and further expert and context exploration, a design strategy is created, as a starting point for the development of new services and technologies in healthcare around surgical environments. The design process with a strong focus on analysis guided the development of the project. This allowed the creation of a future vision that considers the findings from the literature, user and trend research and gives a direction to the current state. Within the creation of a future vision, different scenarios are detailed, to give a more detailed idea of how peri-operative care would be. In addition, some recommendations and future steps are presented, to facilitate the achievement of these future scenarios by providing the stakeholders involved with some tools to assess the viability of implementation and inclusion in planning. Finally, the project includes a call to action to develop technologies and services that enables the extension of care to the home context and the empowerment of patients to have a conscious and active role in maintaining and seeking their wellbeing.

In this graduation thesis I investigate how to design for patient empowerment in the context of head and neck cancer (HNC) patients in their follow-up phase (the first 5 years after treatment). This project is set up with the Erasmus MC and was initiated to elaborate on their current service called the Healthcare Monitor (HM). The HM is a structure of electronic patient-reported outcome measures filled in by patients before every follow-up consultation. The answers are shown in a dashboard to the treating physician and used during patient consultations (Dronkers et al., 2020). What the current HM lacks however, is insight for the patients themselves into their health and addressing their concerns in between the consultations. Therefore this project aims to develop an additional service to the HM that empowers patients in between consults whilst also providing the doctor with a more frequent and realistic insight into their wellbeing. Patient empowerment can ultimately lead to a better quality of life. In this project it is viewed as a process that can be influenced through design. Therefore an inspirational model is created in this thesis that designers can use when designing for patient empowerment. HNC patients in their follow-up need to deal with a lot of different physical and psychosocial side effects (Aguilar et al., 2017). I investigate their concerns using the double loop method of Jung (2021). I analyze the community context through a computational analysis of online cancer community platforms. The patient context is investigated through a focus group with 6 care professionals and interviews with 9 ex-patients. 4 main concerns are found. Patients want to: •Be prepared for what they can expect and do •Have the overview of how they are doing •Be supported when they have a doubt •Have a relevant service for them The model for patient empowerment and patient concerns are combined to create a design vision. The vision is to provide patients with an overview that enables them to gain more control in dealing with issues that concern them. This overview was designed in a prototype application through 3 main elements; a logbook with previous experiences, a possibility to track current experiences and an overview of expected experiences based on peer experiences. This prototype was tested by 6 ex-patients who found value in the low threshold way to contact others, find trustworthy information and track their wellbeing. They valued peer experience exchange and better insight into themselves as this can ultimately lead to more reassurance in between consults. Based on this test further improvements, suggestions for the next steps and possibilities to scale the concept are presented. When developing an app for patient empowerment the Erasmus MC should; •Include peer patient experiences •Provide the patient with insight into their wellbeing over time •Integrate tools and databases in one complete overview For designing in the field of value based healthcare, this project stresses the importance of incorporating experiences of the community and using a multidisciplinary approach.

Problem In the current care pathway for patients suffering from a Myocardial Infarction (MI), a paradox has been identified in long-term chronic care: modification of cardiovascular risk factors reduce mortality and prevent recurrent cardiac events. However, MI survivors rarely change their lifestyle and relapse often in old habits. The identified cause within the system is a gap created by a lack of professional and social adherence support in relation to cardiovascular risk management. Research has shown how social support from a partner can improve lifestyle change adherence. To fill the gap, this study looks at how the patient's partner can be supported and empowered by the healthcare system to positively fulfill this role. Therefore, this strategic design thesis aims to develop a tangible strategy for the Hart Long Centrum of the LUMC by answering the following research question: "How can partners of chronically ill patients, that suffered from a MI, provide effective and positive support for the patient to maintain long-term preventive lifestyle changes by means of an eHealth innovation linked to The Box?” Dyadic Opportunity The partner of the patient is able to influence the patient’s health behaviour and motivation through the dyadic nature of their relationship. Therefore, a new perspective has been identified for 'The Box' to stimulate long-term preventive lifestyle change; using positive dyadic communication and support to influence the illness perception of patients and partners. This offers the opportunity to create a parallel track to bridge the chronic care gap. The track will be next to the current care pathway, in the form of an eHealth intervention that complements the existing 'The Box' innovation. Dyadic Experience Each individual in a couple, who have experienced a MI, goes through their own grieving process after a life changing event such as transition from a ‘normal life’ to a chronic illness. Within this process it has been shown that the needs of the partner and patient change over time. This dyadic adaptation process has been examined and the dynamic key needs of the partner have been identified: •How can the partner support the right way at the right time? •How can the partner themselves be supported? •How to strive for a relationship where the right balance between ‘patient’ and ‘loved one’ is achieved during the adaptation process? Solution Direction A future solution is envisioned in which the patient's partner is actively given a central role in participating in long-term lifestyle change: Partners will be empowered and guided by the healthcare system, by means of an eHealth intervention driven by hybrid intelligence and P4 mechanisms (prevention, prediction, personalization, participation), to positively support the patient in the right way at the right moment in changing their lifestyle in the long term. WeCAIR - Partner Perspective of the Hybrid Intelligence Portal (HIP) To make the strategy of influencing patient adherence by empowering and guiding the partner tangible, WeCAIR is designed. WeCAIR is part of a Hybrid Intelligence Portal (HIP) which monitors and guards the balance of human dynamic interactions and needs between partner, patient and care professional. WeCAIR is a user-friendly interface developed from the perspective of the patient's partner. As discussed in the chapter before, the interface has three different main features: (1) Personalized Dyadic Route, (2) Behavioural Support and (3) Lifestyle Education. These characteristics are aimed at empowering and guiding the partner to take on a balanced role in relation to their life partner (the patient) in the adjustment process to chronic illness, in order to positively support the patient in the right way at the right moment in changing their lifestyle in the long term. Conclusion The proposed strategic Product Service System (PSS) improves the current care pathway by involving, supporting and empowering the partner in the care process, resulting in long-term adherence to lifestyle changes. Ultimately, this leads to secondary prevention for the patient and primary prevention for the patient's partner. For the LUMC Hart Long Centrum, this means that by implementing the PSS they will be one step closer to their goal of providing the best clinical and innovative care to patients.

The Ocean Cleanup is an NGO founded in 2013, with the aim to rid the world’s oceans of plastic by 2040. Collecting this plastic however begs the question: ‘What to do with this waste after it has left the ocean?’To answer this question, first, it is important to look at the material. In my research, I defined the following tiers of ocean plastic:Tier 1: Mechanically recyclable plastics and recolourableTier 2: Mechanically recyclable plastics, but black and non recolourableTier 3: Non-mechanically recyclable plasticsBased on an analysis The Ocean Cleanup and its context I defined three main goals that it should attempt to achieve with the plastic: Value: To gain as much income as possible from the plastic in order to be less dependent on donations.Awareness: To use the plastics to generate as much awareness as possible for the ocean plastic issue.Volume: To find a purpose for the entire volume of the extracted ocean plastic.No single product made from ocean plastic can satisfy all the goals and tiers at once. By developing a combination of complementary ideas with an underlying strategy, The Ocean Cleanup can maximise the impact on all three goals while ensuring that the different ideas fit with the material tiers.Through a combination of literature research and interviews (both with consumers and experts) I designed and developed the following strategies:1: Limited Ocean Plastic EditionsPartner with specific companies to make limited ocean plastic editions of existing products. This creates a win-win-win situation in which the consumers get a special version of a product, the partner company benefits from the positive brand association and The Ocean Cleanup accomplishes all three goals.2: Interior&Exterior ArchitectureCollaborate with processing companies to create building materials from the ocean plastic. In this context the fact that the material cannot be coloured is of lesser importance and the demand for sustainable materials is high.3: Arts & ExperimentsThis context allows for the extraction of as much value and awareness out of the non-recyclable plastic as possible by using it in for example: art projects and design competitions.These three distinct strategies fit together in an overarching brand concept I call: Ocean Product. This brand establishes a single point of recognition for consumers, while at the same time differentiating The Ocean Cleanup’s plastic from that of competitors.Finally, I integrated all findings into a partnership selection tool, which can help The Ocean Cleanup decide which partnerships are worth pursuing and which are not.I believe that this strategy, with its three tiers and partnership selection tool presents a complete vision of how The Ocean Cleanup can turn 80.000.000 kg of waste into ‘Ocean Product’.

This Master’s thesis looks at the development of a Service Design solution for a Supportive Health System in the field of nutrition. The project is scoped within Clear, a young organisation using Continuous Glucose Monitoring technology (CGM) to support better nutritional habits. This thesis applies a mixed-methods approach, integrating quantitative and qualitative data collection and analysis to answer the following questions: (1) How shall responsible parties generate a Preventive Health behaviour in the in- dividual? (2) How shall design parties integrate data in the design of Supportive Health Systems? And (3) How shall organisations deliver services that integrate Supportive Health Systems to facilitate Preventive Health Behaviour? The end goal of the final service solution presented in this thesis is to offer a proof of concept for a viable proposition in the emerging field of Personalised Nutrition. It is meant to be a guide for implementation to the collaborating organisation, and an actionable way to provide inspiration for key stakeholders of the field.

This master thesis explores how Philips wearable the biosensor can bring value in the cardiovascular disease care pathway. This project proposes a concept of product-service system to improve patient care in transcatheter aortic valve stenosis implantation (TAVI) perioperative journey. Aortic valve stenosis (AS) is one of the most common and progressive valvular heart diseases in ageing society. According to the European Society of Cardiology (2020), the burden of AS symptoms affects the patient’s quality of life and survival. For intermediate or high-risk patients experiencing severe symptoms, they are often suggested TAVI treatment, is a minimally invasive clave replacement surgery. However, TAVI patients are also frailer and with comorbidities, which requires multidisciplinary teams to deliver perioperative patient care. The problem is defined as when patients step out of the hospital, there is a lack of communication in (1) knowing when and what actions to take if complications occur; (2) Knowing how active can and should the patient during home recovering. Hart, a smart digital care assistant, is a PSS for the adoption of Philips wearable biosensor data in TAVI perioperative patient care. Hart initiating communications on helping patients reflecton their own health situation, building shared knowledge by using patient-shared contextual information with long-term monitoring during physical activities or experience of symptoms.

To satisfy the growing needs of customers for services many product-oriented companies in various industries have started switching their focus from products towards service offerings. To stay competitive, New Service Development became an important concern for many companies to achieve. Company Z, which is one of the largest product-oriented corporations around the globe, continuously improved its New Product Development processes to successfully launch technology-driven product innovations. Aware of the current importance of service offerings, Company Z has integrated New Service Development into their processes but still faces challenges while developing their service offerings. A key role in developing and launching services plays the recently established New Services Design team of the service development and delivery function.
The aim of this project was to identify the pitfalls of the current New Service Development process of the New Services Design team of company Z and identify opportunities for overcoming them to create an improved process framework that fits the flexibility required for services. The development and delivery stages of the New Service development process of company Z were reviewed and literature was researched about Services and New Service Development. It was found that New Service Development in order to be successful require, compared to NPD, a different mindset, high customer involvement and flexibility. However, product-oriented companies tend to keep their old New Product Development approaches for certainty reasons and the rather less researched field of modern New Service Development.
Comparably, internal company research revealed that Company Z develops and delivers its service offerings with a product-oriented stage-gate process that originates from the company‘s product mindset. Based on the literature and qualitative research it was identified that this product-logic causes a highly fragmented and overstretched process that causes excessive amounts of bureaucracy, a strong focus on documentation, low customer involvement, and uncollaborative teams. In order to address any of these issues in the long term, the product-logic, which is the start point of the Causal Chain, needs to be replaced by a service-logic. To find a solution, in this rather academically unexplored research area, a Delphi study with several experts was conducted. Based on the Delphi study and literature it was discovered that an incremental change towards a service-logic can be fostered by establishing a high level of customer-centricity within the current New Service Development process. A solution was created that enables customer involvement within the New Service Development process of Company Z via early service prototyping to foster a service-oriented way of working. Finally, a Roadmap describes the implementation of the service prototyping approach in three horizons.

Emerging diseases like the current pandemic, COVID-19, and the increasing number of chronic diseases around the world are putting considerable pressure on the healthcare system, demanding for more services, with higher quality and more efficient. Hence the healthcare system needs to transition towards sustainable healthcare. An approach to achieve a transition towards sustainable healthcare is the Quadruple Aim. It is a practical framework that focuses on improving the health of the population, improving the work-life of care providers, enhancing patients experience and reducing health cost. To implement these four aims, it is necessary the collaboration between multiple disciplines and the implementation of an innovative approach. Open innovation provides a space for transdisciplinary collaboration and innovation to occurs. Hence, this graduation project explores transdisciplinary collaborations in the healthcare sector, focusing on open innovation initiatives. The research question for this study is how to build effective transdisciplinary collaborations in healthcare? This graduation project took place in two countries, the Netherlands and Mexico. In the Netherlands, I realised interview research in eight open innovation initiatives. Later, in Mexico, I did a case study at the Research and Technological Development Unit inside the General Hospital of Mexico ‘Eduardo Liceaga’. Afterwards, I realised a comparative analysis between both studies, followed by a design phase to build effective transdisciplinary collaborations in healthcare. The results of the two studies present a future vision and a future-oriented strategy for the Research and Technological Development Unit to improve collaboration between actors. The future vision contributes to the alignment of the actors involved in the unit so that they can work in the same direction. The strategy is formed by three strategic lines: organisational and project development support, building a knowledge community, and promote and consolidate the unit. These strategic lines aim to guide the actors towards the future vision by suggesting a series of steps. The success of this initiative could contribute to boost innovation in healthcare. A suggestion for future research is on how design can facilitate the implementation of the strategy by considering the collaboration of all the actors present in the unit.

With the influence of COVID-19, people all over the world are facing significant challenges. Families with school-aged children face difficulties in helping the children transition from traditional school to online education while bearing various stress due to the epidemic quarantine measures. The situation leads to an intense parent-child relationship during the quarantine period because of the increased conflicts about the children’s learning status, especially for Chinese families, which attach great importance to studying. Through a literature review on parents’ involvement in children’s study, the cultural influence on parenting style, and how the epidemic context could impact the children, I have a basic understanding of the context. The design goal was defined by combining the insights obtained from the in-depth interviews with nine families and relevant design theories on designing for children and parent-child communication. The project aims to improve parent-child communication by creating a relaxed conversation atmosphere during the COVID-19 quarantine period for Chinese families with children aged from 9-12 who are about entering their puberty and could have more communication problems with their parents. With the inspirations of ideas from brainstorming sessions and the Doraemon character, the time travel concept was created and developed to create a relaxed communication atmosphere and provide more communication topics for parents and children at home. A prototype was developed and tested with four families to evaluate the extent to which it can improve parent-child communication at home. The test results showed that parents believe the design makes sense in helping create a positive communication atmosphere at home and, therefore, could facilitate a better parent-child relationship. From the children’s feedback, the long-term attraction to the children in using the product can be a direction for further development and improvement.

Philips believes that in order to keep creating real and sustainable value for its stakeholders, it is crucial to have a deep understanding of trends of economy paradigm. As the trends show, to transform towards transformation paradigm and sustain future growth and profitability, understanding challenges and identifying opportunities in the healthcare field are essential for Philips. The current healthcare field faces a lot of challenges and needs disruptive innovations. Integrated, patient-centric, and efficient care delivery models are urgently needed. Value-based care was proposed under the background. It emphasizes improving healthcare outcomes while reducing cost. Philips also believes value-based care is the ideal healthcare delivery system. To transform towards value-based care, Philips collaborates with local hospitals to initiate value-based care studios. Selecting suitable projects to run in studios is vital while there are no guidelines or toolkit to help project selection. My assignment is to design a project selection toolkit for Philips' value-based care studios. After exploratory research and design iterations, finally, an improved project selection journey and corresponding tools to help each phase of the improved project selection journey are designed. They aim to provide suitable information in suitable time to facilitate productive discussion and decision making in project selection process.

The importance of value-based health care
Worldwide, health care systems are struggling to control costs while improving care outcomes. An ageing population, increase in chronic patients and shortage in care professionals result in high burdens on our health care systems. Current health care systems are organized around delivering quantity. When this is continued, health care costs will rise in an unsustainable pace and the quality of care will be affected. The concept of value-based health care proposes a paradigm shift where we move from organizing care based on volume to value. This concept suggests measuring value of health care based on outcomes achieved for the patient instead of volume delivered.

Assignment
Value-based health care (VBHC) is an evidence-based approach and can be used to improve individual and public clinical care. Longitudinal and systematic measuring and sharing of health data is essential to be able to track outcomes and improve clinical care accordingly.

Periodic patient health data can be used by care professionals to provide timely treatment interventions to patients. Additionally, patient health data can be used to build predictive models to support care professionals in providing more personalized treatment. For this, patient self-care supported by eHealth services is becoming increasingly important where the role of the patient shifts from being a ‘care user’ to a ‘care contributor’.

However, patients express concerns regarding the safety of eHealth services and are not thoroughly informed on how patient health data can improve both individual and public clinical care. Based on this, this thesis will answer the following research question:

How can care providers strategically obtain patient health data, in order to improve individual and public clinical care?

To answer this research question, a theoretical ecosystem which envisions a way of strategically obtaining patient health data to improve clinical care is developed and used during user research.

A theoretical ecosystem for the cardiovascular domain
Cardiovascular diseases (CVDs) are the main cause of death globally and the number of people living with chronic cardiovascular disease is increasing daily. Providing preventive care to those cardiovascular patients is key to manage the disease properly. Patient self-care, eHealth services and predictive models can have major implications on how cardiovascular care is managed and provided. Because the potential impact technology can have on improving clinical care for CVD, the theoretical ecosystem was designed for this domain.

The ecosystem is designed using insights from extensive preliminary research. It is a product service system which uses patient-generated health data from the telemonitoring service to better manage care and build predictive models to support cardiologists in providing tailored treatment. This ecosystem allows patients to receive personalized treatment and advice, have easier access to care and enables them to contribute to care easier.

Frisian Health Campus case
The theoretical ecosystem is used during a use case for Frisian Health Campus (FHC), a client of Deloitte. FHC is an initiative that aims to become a pivotal player in developing and supporting care innovations in the northern region of the Netherlands. In order to improve clinical care, they aim to connect various care providers in the region by developing a platform where patient health data is shared for research. Deloitte did extensive research to disclose what FHC is legally allowed to do with patient data on such a platform. However, they did not know what patients and care professionals think of such a platform and what is necessary to let patients share their health data with them. Therefore, the ecosystem that is designed was used to do research on the desirability of FHC’s envisioned data sharing platform.
User research and design challenge
In total 7 cardiovascular patients and 6 cardiologists were interviewed to gain a better understanding of how the theoretical ecosystem addresses drivers and needs of these users. It was found that patients are more than willing to share health data for research if privacy and security are guaranteed. This showed there is not a problem with the willingness to share health. Instead, barriers with keeping up the data flow were identified:

The desire to measure and share health data fades over time because patients find a balance in medication and lifestyle,
Measuring and sharing health data remind people they are a patient,
Patients are unaware of the value of their health data.

Results from user research resulted in the following design challenge:

To increase adherence of measuring and sharing health data, the design should let patients experience the value of health data and trigger personal drivers to periodically measure and share health data.

During user research, various alternative drivers to measure and share health data were found and are used to design behavioural interventions in the final concept. Three main triggers were identified. I would measure and share health data to:

Reassure my family and friends,
Contribute to care of other people,
Support my doctor in providing better care.

DataDonor
The final design, DataDonor, is a digital environment which consists of an informative website regarding the value of health data and a module that can be added to existing telemonitoring services to share health data for research. This way, patients and care professionals can use the initial telemonitoring service. Additionally, the module provides patients with information regarding the impact of their data donations on their care and that of others. To maintain measuring and sharing adherence, DataDonor adapts to personal drivers to measure and share health data over time.
By repositioning the role of a patient from being a ‘care user’ to a ‘care contributor’, patients are not reminded they are a patient when measuring and sharing health data but enable them to be a vital contributor to individual and public care.

Validation
DataDonor has been evaluated with patients, the client and health care experts to assess the concept on both a user and client level. These sessions resulted in relevant feedback and validation and are shared in chapter 7. However, to fully validate the effect of DataDonor, it should be tested over a longer period of time.

Conclusion
DataDonor is a digital environment supporting care providers to strategically obtain patient health data to improve clinical care. By guaranteeing secure and anonymous use of patient health data and by enabling patients to contribute to their own care and do good at the same time, patients can be triggered to share health data with their care providers. Additionally, by appealing to personal drivers to measure and share health data, DataDonor provides a solution that fit the needs of the patient, business and organization.