Health systems are facing significant societal and organizational challenges that require enhancing their resilience and sustainability. The transition toward more sustainable health systems is both delicate and complex, and it needs radical changes of perspective as regards the holistic and multi-disciplinary approach to health care. Over the past years, interest in what is called Sustainable Healthcare has grown globally: there is no common definition, but all the approaches to this emerging domain focus on making health care environmentally, economically and socially viable. The present work aims at investigating the role of design towards Sustainable Healthcare, to propose, through case study experience, a systemic vision of the topic. The research methodology is deeply rooted in the framework of Systemic Design, aiming at defining how design strategies can improve the environmental sustainability of medical products, services, and systems, considering its close relationship with the social and economic aspects. Specifically, the research addressed the case study of chronic haemodialysis.

The thesis focuses on the definition and the analysis of the items which make up the dialysis system, by combining different approaches, borrowed from sustainable design and human-centred design. In order to establish a general frame, three different dialysis units and hospitals based in different European countries (Italy, Sweden, Denmark) were compared. This comprehensive analysis allowed to set specific guidelines for dialysis products, equipment, and treatment. The comparison of three international case studies highlighted how design should work on product and equipment to improve environmental sustainability on a global scale while addressing local systems to improve sustainability on a territorial level. The outcome of the research is a set of design strategies for the healthcare sector that take into account the technical, operational, social and environmental requirements of chronic treatments.