This report presents the design of a new, dignified experience for the water method for stillborn babies between 28 and 42 weeks that supports parents in their grieving process and fits within clinical practice. After a stillbirth, parents are given the opportunity to spend time with their baby and create memories. One method that can support this is the water method. The water method is a preservation technique where the baby is placed in cold water and laid in a water basin, which helps slow down deterioration and has a positive effect on the baby's skin. However, babies between 28 to 42 weeks are too large to fit inside the water basins. Nurses express the need for a solution that offers care and respect. The goal of this thesis is to design the technical requirements for the water basin and to design the interaction between primary stakeholders, nurses and parents.

This project follows a user-centered approach, involving nurses from the obstetrics department and bereavement specialists to include the parental perspective. Interviews, co-creation sessions and evaluations were carried out to understand stakeholders needs.

The final design, Memora, is a transparent water basin that is partially recessed into a base that provides space for personalisation and memory-making. Designed to fit into hospital environments, Memora has a tilting mechanism so that the basin can be easily emptied. The mobile stand ensures that the water basin can be positioned close to the parents, even when the mother is less mobile.

This project serves as a foundation for further development of Memora. The current design offers a warm, dignified and personal experience that supports parents in creating memories with their baby and fits within clinical practice. However, future work is still recommended to improve visual stability, optimize water outflow, integrate storage and to further develop the frame structure.

Healthcare is undergoing a paradigm shift from a paternalistic model, where healthcare professionals (HCPs) made decisions on behalf of patients, to a patient-centered approach that recognizes patients as active partners in care.

Shared Decision-Making (SDM) has emerged as a cornerstone of this transition, aiming to align treatment decisions with patients’ values, preferences, and lived experiences. For patients with esophagogastric cancer, SDM is particularly beneficial: treatment and care options are limited, invasive, and burdensome, yet differ substantially in side effects and impact on quality of life. Decisions in oncology care are preference-sensitive, emotionally charged, and made under conditions of uncertainty and stress. These factors make it essential to include the patient’s perspective in decision-making to ensure decisions are aligned with what the patient values most.

However, individuals with Limited Health Literacy (LHL) face significant barriers to meaningful participation in SDM. These barriers stem from challenges in processing medical information, expressing personal values, and navigating increasingly digitalized healthcare systems. Without tailored support, these patients risk exclusion from the decision-making  process, which increases the chances of decisional regret and reinforces health disparities.

 

This thesis explores how esophagogastric cancer patients with LHL can be better supported in healthcare decision-making. Conducted in collaboration with Amsterdam UMC, the project employed systemic, service, and human-centered design methodologies. A multi-layered research process combined literature review, patient journey mapping, a case study of an outpatient clinic, an extensive co-creation study involving individuals with LHL, and expert consultations. These steps revealed systemic barriers to SDM, including fragmented communication practices. Co-creation identified several needs of the target group, including a desire for more balanced communication in which HCPs allow time for pauses and actively encourage patients to ask questions.

Building on these insights, iterative idea development, prototyping, and co-creation with individuals with LHL was employed, alongside evaluation with HCPs and experts. This led to the development of a modular communication tool aligned with the project’s design goal:

“To support patients with LHL  in articulating their values and information needs, while enabling healthcare professionals to actively elicit these insights and tailor their way of informing and supporting accordingly”

 

Perspective Mapping, the developed tool, facilitates relational, stepwise consultations. It helps HCPs elicit and incorporate patient values, clarify treatment trade-offs, and co-construct summaries that feed into multidisciplinary meetings. Its modular structure allows flexibility, supports reflection, and enables patients to build communication skills transferable across their care trajectory.

 

Evaluations highlighted the concept's potential to reduce uncertainty for patients, strengthen trust, and align treatment decisions more closely the patient’s perspective. However, for sustainable adoption of the tool, and for any implementation of a communication intervention in that matter, the importance of  seamless integration into clinical workflows is underscored.

 

This thesis offers both a practical design intervention and a conceptual reframing of the challenges limiting communication between HCPs and esophagogastric cancer patients with LHL. It emphasizes SDM as an integrated, continuous process rather than an isolated event. By addressing the communication needs of patients alongside the workflow requirements of HCPs, the project advances the development of more equitable and patient-centered oncology care decisions.

The Dutch health system faces significant challenges, yet health policymakers encounter complex dynamics that can hinder the development of effective policies. This research explores the integration of Human-Centered Design into health policymaking to help policymakers navigate these dynamics and develop more effective, responsive policies. Using a mixed-methods approach—including a literature review, semi-structured interviews, and a co-creation study—this study highlights the potential of Human-Centered Design to support policymakers in overcoming barriers in policymaking. By integrating its principles, health policies can be better aligned with real word needs, reducing the likelihood of costly revisions.
To support the integration of Human-Centered Design in policymaking, this study identifies ten challenges policymakers face when integrating it, based on interviews with policymakers, and proposes five solution areas derived from a co-creation session with policymakers and citizens. To further advance the integration of Human-Centered Design in health policymaking, this study recommends exploring practical tools that can assist policymakers in applying its principles, as well as exploring the role of designers in guiding this integration.

Technological advancements in genomic analysis have enabled the use of polygenic risk scores (PRS) to determine an individual's genetic predisposition to various diseases. The Estonian Health Insurance Fund (EHIF) is planning to introduce a service where 40-year-old women in Estonia can receive an indicator of their polygenic risk for breast cancer (BC). If a high PRS is detected, the individual is enrolled in the breast cancer screening program to help identify potential cancer earlier.
Although PRS itself does not pose a direct health threat, its communication may cause worry and lead recipients to seek support from healthcare professionals, adding strain to the healthcare system. Therefore, EHIF aims to convey PRS results through a digital channel that helps recipients understand their results without causing undue worry or prompting unnecessary consultations.
This graduation project focuses on the digital communication of BC PRS, aiming to provide recipients with peace of mind regarding their genetic risk. A literature review was conducted to analyze genetic risk, existing PRS services, and the informational and social support needs of recipients. To further understand the needs of 40-year-old women in Estonia, the target group for this service, 15 user and expert interviews were conducted.
Based on the insights from the interview studies and the literature reviews, the following aspects from genetic counseling are highlighted to create peace of mind for recipients receiving a BC PRS result:

• Use of empathic statements,
• reflective interaction with the recipients and clarification of PRS information,
• use of analogies,

• providing a sense of control to the recipient,

• framing genetic risk as a small change, and
• highlighting the value of PRS communication as an early warning.

As part of the conceptualization phase, a service blueprint and two roadmaps were developed. The service blueprint proposes the My Genetic Mirror concept, aiming to create an identity- focused perception of the service, simplify the PRS result using a fire safety metaphor, spread out information delivery to prevent overwhelming communication and provide resources for follow-up questions.
To consider future development of the service concept, both a strategic and a tactical roadmap were formulated. The future vision of these roadmaps for 2030 focuses on creating emotionally reassuring yet cost-efficient genetic health management for a peace of mind. A preliminary evaluation of the service concept was conducted with four design students. The thesis concludes by highlighting contributions to new knowledge, identifying limitations, providing recommendations, and offering a personal reflection.

This report outlines a project that aimed to increase engagement with patient reported outcome measures (PROMs) for patients at an outpatient clinic. The target group was people living with HIV (PLHIV). This study was made possible thanks to the client, Amsterdam UMC, who are undertaking a larger research project that aims to improve the quality of life (QoL) of PLHIV.

The project included a comprehensive literature review and user research that involved shadowing of nurses in order to explore the clinic’s context. At this point PROMs started being introduced at the outpatient clinic. To identify design opportunities, attitudes towards PROMs, and initial impressions of PROMs, semi-structured interviews were done with patients and nurses. To further the discussion of PROMs three provotypes were made and presented to participants during the interviews. The main takeaways related to patients not knowing the value or purpose of PROMs or lacking the motivation to complete them. From these takeaways design criteria were identified by making the design goal and interaction vision, which led to the development of four concepts by research through design, brainstorming, and role-playing.

A Harris profile was done on the four concepts and one of them was selected to move forward to design and implementation. The concept was a card game, and it was further iterated on by using accessibility guidelines and persuasive game design. The objective was to make a game that, while being accessible, would help change patient behavior regarding PROMs. A lo-fi mock-up was created for the game to test the different game elements with people, leading to refinement of the concept and turning it into a high-fi prototype that was tested with the target group, PLHIV.

The results were positive, with patients showing enthusiasm for the game, but with some room for improvement. Patients found the game to be compassionate and useful in learning about PROMs. The game was also tested with a peer navigator who offered many insights from the perspective of patients who are not open about their diagnosis and on how the card game could be used in relation to their role at the outpatient clinic.
These findings highlight the potential of using gamification to create inclusive learning tools (i.e. the card game) in the health sector to increase engagement with other health tools (i.e. PROMs) and the importance of continued work to optimize these tools for patients with chronic illnesses such as HIV.

This graduation project arose from Erasmus MC’s mission to continuously improve the patient experience. The results of the patient monitoring by Erasmus MC showed that an intervention at their ophthalmology outpatient clinic (OOC) could contribute to this objective. The patient satisfaction scores on wait time experience were very low at this outpatient clinic. Previous research has already shown that wait time experience is an important impact factor on the overall patient experience.

The project started with a literature study. The literature study looked at the topics of patient satisfaction, communication of patient information and the waiting experience. For each of these topics, patient expectations and uncertainty appeared to be among the most important drivers. The result of the literature study was a set of possible interventions, each based on adjusting and managing patient expectations and reducing uncertainty for the patient.

Next in the project was mapping the context where these possible interventions happen. This user and context research concerns the environment and work flow of the clinic and patient needs and characteristics. For each sub-topic, the research method was chosen that provided the most valuable and reliable information with the least possible burden on the patients of the outpatient clinic. Methods used include walk-alongs, expert interviews, system analysis, user experience account analysis and empathy mapping.

Three main causes of dissatisfaction of patients were identified in the research. Firstly, the unrealistic expectations that patients have about the length of a visit. Secondly expectations about the provision of waiting time information, partly caused by the hospital itself, that are not being met. Lastly the lack of a clear overview of the different steps a patient goes through during a visit for both patient and employee. The complexity of the patient cases at the ophthalmic outpatient clinic in combination with the work flow at the outpatient clinic makes it difficult to predict the steps and waiting times during a patient visit based on the information present in the system. However, three data sources were found in the study that can serve as a reliable source of information to provide personal appointment information to patients. Another important finding of the user and context study is the way in which patients’ visual impairments affects their waiting experience.

The design phase consisted of designing ways to apply the proposed interventions within the described context while considering the limitations of the patient group. This resulted in the following three recommendations: adding information to the appointment letter, optimizing the provided digital and printed information for OOC patients, and providing OOC patients with personal, dynamic appointment information during their wait using a physical information booth in the waiting area of the clinic. These recommendations work in unison with each other to ensure the desired effects for all patients during the full patient journey. A prototype of the designed physical information booth was developed and used in user testing to evaluate certain aspects of the design concept.