How does change occur in healthcare settings? In this paper, we take a design-based approach to healthcare research. From researcher-patient interactions to information sharing between practitioners, we examine how clinical research can mediate a change of routines and illuminate potential new system structures. Using a hospital-based cognitive care clinic as an example, we demonstrate how the inclusion of new actors, tools and resources was able to shed light on the prevalence of hearing loss among mild cognitive impairment (MCI) patients and lay the framework for new care pathways.

How can we design and engineer research that leads to the development and effective implementation of complex healthcare interventions? We advocate for a systems design-based approach when initiating clinical research to anticipate the proposition of complex interventions. Using cognitive care as an example, we investigate how hybrid design-inspired methodologies can promote organisational effectiveness and how strong clinical evidence can support successful conceptualisation and uptake of novel interventions into routine clinical practice.