Design Labs—The Power of With

Implications for Practice and Research

Current health-care team engagement, experiences, and retention are a worry for everyone involved in health care, from the highest levels of leadership to the bedside, including patients and families who read about nursing shortages and health-care burnout and wonder who will care for them or about them if and when they need care? According to Press Ganey (2024), one-third of the health-care workforce is not engaged, and disengaged employees are twice as likely to leave as their more engaged peers. As many as one in five health-care team members left their organizations between January 2022 and December 2023 (Press Ganey, 2024). There were many reasons why health-care workers left their organizations during and after the pandemic. Feelings of hopelessness, cynicism, disconnection from patients and from their calling, and sadness about what was experienced during the pandemic, as well as distrust in their leaders and environments, all played a part.

However, every time I log into a virtual design lab or walk into an in-person design lab, I feel the excitement, the joy, and infinite possibilities! Engagement abounds! A design lab can be as simple as a gathering of people who use the framework of design thinking to iterate solutions and innovations to problems in their environment. Design labs are the perfect venue to ignite teams to partner in creating solutions for health-care issues, feel heard, and own solutions for complex problems that plague most health-care environments today. I have watched with wonder as the demeanors of those participating in design labs have transformed from sadness or disinterest to inspiration and activation as the power of design thinking overtakes them. Design labs promote partnership, often fostering lasting power with relationships, building trust, respect, and caring as the team moves through the design thinking phases, which are described below.

Design labs as described in my book System Innovation: A Holistic Approach to Disrupting with Love and Human Caring (Kennedy Oehlert & Sitzman, 2025) are one of the most exciting multidimensional communication and disruption strategies available to health-care teams today. A design lab supports teams in exploring solutions for current health-care challenges, in a safe, creative space. They are a place where nurses can explore their own practice and challenge organizational policies and processes. They are revenue neutral, promote partnership and belonging, and are fueled by diverse ideas.

The design labs I facilitate use design thinking as their guiding framework. Design thinking by its very nature is power with; it is an iterative, nonlinear process for solving problems, informed by empathy for the end user(s). Design thinking places end users at the center of the innovation process, giving everyone, regardless of role or education, the power to design.

In health care we often have many end users (those that use or experience a process or product), including our teams, the patients, their families, and even the communities we care for. The voices of patients, families, and communities can be invited into design labs in a variety of ways. Comments received on patient experience surveys can be reviewed in the lab, along with the patient experience results. Those engaged in the lab can round on patients and ask them questions related to the issues being addressed in the lab. All health-care organizations document patient complaints and grievances and these can be reviewed in the lab as well. Bringing patient voices into the lab can be as simple as asking patients and families to participate in the design lab and patient and family advisors are a great addition to the design process. All end-user needs, hassles, and ideas are iterated together identifying innovations that truly resonate with all groups, instead of creating us versus them solutions. Design thinking aids in improving relationships as well as improving processes.

Phases of Design Thinking

Design thinking has five simple, often overlapping phases that provide guiderails for innovation. The first phase is to empathize: listen, observe, and learn from end users, stakeholders, and each other. The next phase is to define: state the lexicon and measures used, to establish common agreement and/or define a problem based on discoveries made in the empathize phase. Another phase is to ideate: brainstorm ideas, innovations, and solutions. The next two phases are build it and test it: develop a prototype or process that shows how the innovation or solution could work, then test the idea, innovation, or solution and gather feedback from end users. With what was learned from the test it phase, the next steps could include empathize, ideate, build it, and test it again (Kennedy Oehlert & Sitzman, 2025).

Design thinking is the great equalizer between generations, as all voices and ideas are considered valuable in the design lab space. Design thinking encourages divergent thinking, challenges generational and normative assumptions, and inspires exploration of unique solutions. Design lab is a place where I have witnessed our youngest and our most senior health-care team members’ partner with trust and respect.

Design labs are not structured, allowing time for curiosity, creativity, and exploration. They can be in-person or virtual and scheduled to fit the needs of the team. Design lab sessions can be as short as 30 min, or as long as 1 to 2 h. Teams may engage in design labs weekly for a set period of weeks to design, measure, and implement their innovations, or may choose to have longer design sessions.

At ECU Health we offer virtual design labs in 6 to 8 weekly sessions with 30 min allotted for each session. This allows busy health-care team members to participate during their workday more easily than if sessions were longer. A team brings a problem to the design lab, and we teach the design thinking process in real time as we work through the phases. Design labs need a facilitator who is familiar with design thinking. If there is not a design thinker to facilitate at your organization, the team can read about design thinking in the literature to familiarize themselves with the phases. Design thinking does not require expertise as much as it requires empathy for end users, diverse thinking, idea generation, and innovation.

All are welcome in design lab, and health-care teams are able to bring their ideas, their curiosity, and their whole hearts into the labs, designing solutions to health-care issues or to improve the health-care environment. In partnership, teams working together in design lab are a powerhouse for challenging outdated health-care processes, fostering innovation and producing unconventional and often brilliant solutions to wicked problems. Health care is replete with wicked problems!

It is exciting to harness the hearts and minds of our own teams to innovate for a better health-care future. Design thinking is our power with engagement and experience strategy for partnering to heal health-care ills. Design labs bring to life all that we can achieve working together. They embody the power of with, the power of you, of me, of us, innovating a more empathetic and loving health-care future together.