Investigating the “In-betweenness” of Service Design Practitioners in Healthcare

  • Jonathan Romm
  • Josina Vink


In recent years, there has been a growing investment in service design to transform healthcare. While existing literature describes several trade-offs related to catalysing change in complex settings, there has been little understanding to date of how practising service designers in healthcare respond to these choices. There is a need to learn more about how these practitioners navigate their positioning, achieve change and influence healthcare organisations. Bringing forward the situated and contextual knowledge of practitioners about their approach is critical for advancing the emerging practice of healthcare service design. This chapter explores and weaves together the narratives of seven practitioners who employ service design within the healthcare context. What is revealed from this exploration is an “in-betweenness”—where practitioners cope with and make use of contradictions through three compound approaches in healthcare service design. We have labelled these approaches as (1) enacting the insider-outsider, (2) creating radical-incremental change, and (3) catalysing top-up dynamics. The dialogue that emerges through this chapter deepens the understanding of how service designers approach their work within the existing dynamics of social and organisational hierarchies while co-creating change with and within healthcare organisations. Through reflection on the composite nature of healthcare service design approaches, this research offers a grounded perspective on service design practice in healthcare and sheds light on possibilities for future research.



We would like to thank the practitioners involved in this inquiry for their time and openness in sharing their experiences. We would also like to thank Simon Clatworthy, Andrew Morrison, Ted Matthews and William Kempton for their feedback and comments on the text. Funding for this research includes the Centre for Connected Care, the Research Council of Norway and the European Union’s Horizon 2020 Research and Innovation Programme under the Marie Skłodowska-Curie grant agreement No. 642116.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.The Oslo School of Architecture and DesignOsloNorway
  2. 2.Service Research Center (CTF)Karlstad UniversityKarlstadSweden
  3. 3.Experio LabCounty Council of VärmlandKarlstadSweden

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