Enabling integration in early-stage innovation

Abstract

Healthcare innovation increasingly depends on the integration of fragmented knowledge distributed across diverse stakeholders and organisations. This challenge becomes particularly urgent in the context of adolescent and young adult (AYA) cancer survivorship, where care pathways extend over long periods and span multiple organisational boundaries. Despite growing investment in digital and service‑based innovations, many initiatives in such settings fail to progress beyond pilot stages due to limited coordination and the absence of shared understanding across stakeholder groups. We examine how generative co‑design (GCD) facilitates early‑stage knowledge integration in the development of integrated AYA survivorship care. Drawing on an in‑depth case study in a Dutch hospital, we analyse how diverse stakeholders—including care professionals, managers, patients, designers, and technology experts—use artefact‑mediated collaboration to surface, connect, and integrate fragmented knowledge. Our findings show that GCD supports the creation of a shared co‑evolution space in which stakeholders first untangle complexity, then co‑evolve problem and solution framings, and finally converge towards an integrated solution direction. The findings contribute by showing that GCD facilitates the creation of a triadic design space in which knowledge synchronisation and problem–solution co‑evolution can begin early on, adding a step before standard design processes. From a practical perspective, the facilitation of knowledge untangling enables more relevant and integrated solutions across organisational boundaries. At the policy level, the results highlight the importance of supporting participatory and design‑led approaches that strengthen hospitals’ innovative capability.