Enabling Change from Within: A Service Design Approach to Building Change Capabilities in Healthcare
Authors
Brophy, Emily ; Strazio, Erika ; Limstrand, Lea Texmo
Term
4. term
Education
Publication year
2026
Submitted on
2026-05-26
Pages
140
Abstract
This thesis examines how a service design approach can help make change stick in complex hospital settings. Here, service design means a practical, collaborative way of improving services by involving the people who deliver them. Many healthcare initiatives look promising on paper but are hard to embed in daily work. To address this, the study worked with nurses in two cancer departments at Rigshospitalet. Using a real case as the setting, the project focused on everyday issues such as collaboration, roles and responsibilities, and the steps patients go through (the patient pathway). A practice-based, iterative process—workshops, observations, and ongoing involvement—was used to see how change unfolds in the organisation. Early on, it became clear that previous efforts had largely stayed at the level of intentions. The project therefore shifted to building internal capability by enabling nurses to take ownership. Rather than treating design as an external fix, responsibility was shared and nurses were supported to develop, test, and implement their own solutions. This led to a concrete output—a patient-focused one-pager—and a toolkit to support continued change, including simple methods for facilitation, coordination, and implementation. The findings indicate that service design can enable change by fostering ownership, strengthening collaboration across organisational boundaries, and building internal skills. At the same time, it takes significant time, motivation, and a willingness to work through uncertainty. Overall, the thesis positions service design not only as a way to solve problems, but as an approach that helps organisations drive and sustain change from within.
Denne afhandling undersøger, hvordan en service design-tilgang kan få forandringer til at hænge ved i komplekse hospitalsmiljøer. Her forstås service design som en praktisk, samskabende måde at forbedre ydelser på, hvor dem, der leverer dem, aktivt inddrages. Mange forbedringstiltag i sundhedsvæsenet ser lovende ud på papiret, men er svære at forankre i hverdagen. For at imødekomme dette arbejdede studiet sammen med sygeplejersker fra to kræftafdelinger på Rigshospitalet. Med et konkret caseforløb som ramme blev der fokuseret på daglige forhold som samarbejde, roller og ansvar samt patientens forløb gennem systemet. En praksisnær og iterativ proces—workshops, observationer og løbende deltagelse—blev brugt til at følge, hvordan forandringer udfolder sig i organisationen. Tidligt stod det klart, at tidligere indsatser ofte var blevet ved intentionerne. Projektet skiftede derfor fokus til at opbygge interne kompetencer ved at styrke sygeplejerskernes ejerskab. I stedet for at se design som en ekstern løsning blev ansvaret delt, og sygeplejerskerne blev støttet i selv at udvikle, afprøve og implementere deres løsninger. Dette førte til et konkret resultat—en patientrettet one-pager (én-sides oversigt)—samt en værktøjskasse, der understøtter det fortsatte forandringsarbejde med metoder til facilitering, koordinering og implementering. Fundene peger på, at service design kan muliggøre forandringer ved at skabe ejerskab, styrke samarbejde på tværs af organisatoriske grænser og opbygge interne kompetencer. Samtidig kræver det betydelig tid, motivation og villighed til at håndtere usikkerhed. Afhandlingen viser dermed, at service design ikke kun er en problemløsende metode, men også en tilgang, der hjælper organisationer med at drive og fastholde forandringer indefra.
[This apstract has been rewritten with the help of AI based on the project's original abstract]
Keywords