This graduation project, focussed on the environmental impact of the ECG-lead sets used at Erasmus Medical Centre (EMC). It explores how circular design techniques can help create a more sustainable healthcare system. Although ECG-lead sets are crucial for cardiac monitoring and diagnostics, they are frequently single-patient use (SPU), this greatly increases CO2 emissions and medical waste. Although there are multi-patient-use (MPU) alternatives, hygienic concerns, cleaning workload, and regulatory limitations limit their wider adoption. The project set out to redesign ECG-lead sets using an evidence-based and context-specific methodology, in order to evaluate theoretical sustainability strategies and their actual implications.

The research phase consisted of an in-depth exploration of the current ECG-lead set used across multiple EMC departments. Through interviews, direct observations, user journey mapping, and stakeholder analysis. The environmental impact of both SPU and MPU sets was measured using a Life Cycle Assessment (LCA), which revealed that MPU options become more sustainable after just four use cycles. Cable tangling, unclear ownership resulting from multiple department transfers, and inconsistent cleaning procedures were among the main obstacles found. The need for system-level thinking was highlighted by the frequent conflicting stakeholder interests, which ranged from procurement logistics to patient safety.
With a focus on co-creation, the design phase adhered to the triple diamond process: explore, ideate, implement. The concept for a modular, reusable ECG system with enhanced usability, durability, and lifecycle transparency was influenced by three co-creation sessions and multiple expert interviews.

Digital traceability to track usage cycles and maintenance, visible cleanliness indicators, and easy-to-use cable management were among the possible design interventions. In order to address user experience and operational viability, core concepts were validated through prototyping and testing with nurses and technical staff.

A reusable ECG-lead set that minimizes environmental impact and fits in the EMC context is the end result. Implementing dry electrode technology in the design, it reduces valuable material waste from conventional electrodes and keeps these in the loop of the circular economy. Embedding RFID tags to allow traceability, and lifecycle monitoring. The design enables individual part replacement and greatly reduces material waste by supporting circular strategies like reuse, repair, and refurbishment. This design shows how circular principles can be effectively translated into workable, scalable medical device solutions through co-created and context-specific design.

According to the project's findings, systemic knowledge and stakeholder involvement are both necessary for future healthcare transformation. In addition to producing better design, the project is an example that offers a scalable framework for implementing circular design in other medical product industries, making it a validated case study.