Design for Health and Wellbeing (DHW) Lab

Case Study


Seeing how design had infiltrated many different contexts, Prof Steve Reay considered why design didn’t have a stronger presence in healthcare. After several serendipitous meetings, an opportunity to explore the role of design in a healthcare setting presented itself. In 2013, moving a design studio into Auckland Hospital, the DHW Lab was created. “If you want something to exist, start by putting a sign on the door.” The studio attempted to focus on a human-centred approach through consultancy, teaching and research. The DHW Lab project ran for five years. This research project was a story of the role of prototyping (learning and failing fast). The outcome of this iterative approach applied to an organisation’s operational efforts led to insights that informed not only Good Health Design (Auckland University of Technology), but were taken away by other design research organisations looking to explore similar approaches in their contexts. The results were a new organisation that could better recognise and define its values, provide trust and defend its beliefs that design had a place in healthcare, but that it needed to be design-led and evidenced through research.

The extent to which the research enquiry introduced a new way of thinking about something or its distinctivness.

When the research began, there was a recognition of the vast breadth of healthcare challenges and an opportunity to look for ways to approach some of these challenges differently. There was an emerging emphasis on the importance of users (patients and Whānau*) experiences and the need to involve them in improvement processes more effectively. This was happening in a contextual landscape where pressures on healthcare systems were increasing (with a growing ageing population). While technology offered solutions, this also brought complexity, especially when systems and processes did not support rapid transformation. Furthermore, financial pressures were increasing. Politically, healthcare is a complex and emotive topic. At the time, it was felt that there may be an opportunity to use design more effectively in supporting change. ‘Healthcare’ was trying to do something different, but risked using the same ways of thinking to keep doing the same thing.

* “Whānau is often translated as ‘family’, but its meaning is more complex. It includes physical, emotional and spiritual dimensions and is based on whakapapa. Whānau can be multi-layered, flexible and dynamic. Whānau is based on a Māori and a tribal world view. It is through the whānau that values, histories and traditions from the ancestors are adapted for the contemporary world.” (

It was recognised that design had been effective in other contexts (e.g., business), but less was known about how it could be used to help improve the experiences of patients and whanau – what was the opportunity for design to be brought into a hospital environment and help people in this environment to help it do something different… if this was possible, how should it be done? This was important - it was clear that things needed to be better, especially for patients and whānau, but also for staff supporting them in their healthcare journeys. It was thought that design could support a person-centred approach and the methods and tools to help people think differently about what was possible. There was a risk that the improvement process stayed the same and the opportunity to make a change would be lost, ‘filled’ by a different approach, or a different focus would emerge (and the potential of design would not be explored). At the time, the potential novelty was in considering how to bring together two very different contexts — hospital and design. This meant a better understanding of the similarities and differences between these disciplines and what worked well and what didn’t (and why) when bringing them together in this way.

What made the opportunity possible was the serendipitous informal existing relationships between the different contexts (friends and acquaintances) and a willingness to try to do something different, something reciprocal and beneficial. Design had proven its value in other areas the initial thinking was “how could it not work”.

The research was approached through the lenses of human-centred design, co-design, participatory health approaches, and performance and improvement. These were held together by a shared motivation to improve patient and whānau experiences and outcomes, reflecting the researchers’ personal philosophy, values, motivations and interests. The conditions that enabled the research to come together were the existing relationships, perceived opportunities and benefits and a willingness to be open to something new.

The thoughTful and systematic way the question was addressed through the research enquiry.

At a high level, the question asked was: How can design contribute to improved health and wellbeing?

Prototyping was used as a methodological approach. It was also used as a way to engage in dialogue about things that could be different, but in a ‘non-permanent’ way. As ideas and solutions were pitched as prototypes and therefore not permanent, they were less threatening in a context more resistant to change. Attempts to ‘think and do things differently’ using more traditional healthcare approaches were constrained by the traditional processes and systems that rejected them (when evaluating them using traditional ways of thinking). Prototypes helped people explore different ideas while minimising the ‘risk-taking’ that could affect individuals or organisations.  

Framing processes and activities as prototypes meant learning was fast, and methods could be ‘tweaked’ in response to the needs of busy people and changing environments and situations. Prototyping was a visual, creative and transparent way of engaging. It helped make thinking visible and accessible to all those involved in processes, lowering hierarchies and shifting the balance of power. It helped make ‘design’ to be more inclusive, increased participation (projects were a series of short engagements or experiments) and was cost-effective.  

“Test quickly, learn quickly. Rough sketches weren’t taken seriously, yet too much development was seen as too final. Needed to be a journey together, rather than transactional.”

What was discovered that was expected?
It was found that prototyping worked well as a method to understand new contexts and ways to help think differently. What was learnt was able to be easily applied in many other situations and contexts. Design focussed events, such as symposia were critical to engage non-designers and increase buy in and advocacy of others groups, as well as an outlet for the communication of learning and new ideas. However the implication of new solutions was difficult and ran up against the more traditional processes.

"Projects were successful when teams were strong, open to new ways of thinking and doing, and travelled through a project together."

What was discovered that wasn't expected?
What was unexpected was that despite the interest in the creative space in the hospital, it was often difficult to draw in clinicians and the public. Staff, patients and whānau were perceived to be 'too busy' to visit or engage, the space and projects were not visible, or design wasn’t considered a priority. At the time, the potential of the opportunity wasn't fully understood locally but was respected globally.

"You don't know what you've got until it's gone."

How was this different to what was previously known?
What was learnt was how pioneering the opportunity was- to put a creative codesign space into a city hospital broke new ground for design. A key insight, was how important good relationships and alignment of purpose, values and culture, and expectations were, and also what these ‘looked like’ and how they were understood from the many different perspectives. This meant that for the project to be sustainable longer term, these needed to be closely watched and responded to and were as important as other factors (e.g., funding) that impacted the success of the project.

The extent to which the work changes thinking or practIce.

So what...

The research helped to:

  • make visible the challenges and opportunities of using design as a mechanism for change in healthcare contexts
  • bring insight into what is needed for successful collaborations between design and health
  • contribute to establishing 'Design for Health' as an emerging discipline
  • showed the potential for the use of design in healthcare
  • validate creative methods and approaches, and provide new ways of thinking
  • inform practice (for both design and health), and organisational and operational decision-making processes.

Was the research question adequately answered?
The research question was a starting point for ongoing research and discovery. Many projects grew from the initial starting point, and new knowledge, thinking and practice developed throughout (and beyond) the project's duration. Design contributed through context, process methodology, implementation, commercialisation and knowledge transfer.

The findings of the research were shared via journal articles, conference presentations, informal tours, symposia, news and TV outlets, awards, digital and physical artefacts and social media with a range of different groups, including health, industry, design, academia, research, students, NGOs and research participants.

The project and the work that was generated led to the development of:

  • New local and international relationships
  • The Design for Health and Wellbeing Lab
  • Good Health Design
  • New models and frameworks to support universities and other organisations to serve communities better.
  • New frameworks to help support students engaging in real-world projects

The research and the DHW Lab project that resulted from it informed how others approached and established design for health initiatives in New Zealand and internationally. This research, and the experiences of those involved, helped save others from having to start from scratch. It was a testament to the courage of the design team to embrace and share the results and their experiences honestly and take accountability for their role in the project's outcome. While it was expected that different groups and organisations would use the research to see potential in their own unique and specific way, the development of tools like 'initiate.collaborate' may help to make future projects more successful. The research helped legitimise design for healthcare workers, and design became attainable because it was made tangible.

“If you want something to exist, start by putting a name on the door.”

– Steve Reay, Director Good Health Design

Resources and Links

DHW Lab –

Best Design Awards (Purple Pin in Public Good) –

Best Design Awards (Silver Pin in Spatial) –

DINZ Case Study –

Research Papers

Stephen Reay, Guy Collier, Justin Kennedy-Good, Andrew Old, Reid Douglas & Amanda Bill (2016): Designing the future of healthcare together: prototyping a hospital co- design space, CoDesign, DOI: 10.1080/15710882.2016.1160127

Helen Cunningham & Stephen Reay (2019): Co-creating design for health in a city hospital: perceptions of value, opportunity and limitations from ‘Designing Together’ symposium, Design for Health, DOI: 10.1080/24735132.2019.1575658

Ivana Nakarada-Kordic, Nicola Kayes, Stephen Reay, Jill Wrapson & Guy Collier (2020) Co-creating health: navigating a design for health collaboration, Design for Health, 4:2, 213-230, DOI: 10.1080/24735132.2020.1800982

Reid Douglas, Stephen Reay, Josh Munn & Nick Hayes (2018): Prototyping an emotionally responsive hospital environment, Design for Health, DOI: 10.1080/24735132.2017.1412689

Stephen D. Reay, Guy Collier, Reid Douglas, Nick Hayes, Ivana Nakarada- Kordic, Anil Nair & Justin Kennedy-Good (2017): Prototyping collaborative relationships between design and healthcare experts: mapping the patient journey, Design for Health, DOI: 10.1080/24735132.2017.1294845

Joanna K Fadyl, Helen Cunningham, Ivana Nakarada-Kordic, Stephen Reay, Tineke Waters, Kate Waterworth & Barbara E Gibson (2020): Settled and unsettling: design and flows of affect in a hospital waiting area, Design for Health, DOI: 10.1080/24735132.2020.1733345

Steve Reay, Claire Craig & Nicola Kayes (2019) Unpacking two design for health living lab approaches for more effective interdisciplinary collaboration, The Design Journal, 22:sup1, 387-400, DOI: 10.1080/14606925.2019.1595427