Background Hospice care is in a period of change, with shifts towards redefining access, diversified demand and advancements in technology transforming current models of care. Beyond a problem-solving activity resulting in product/service improvement and innovation, Design could help reimagine alternative scenarios and lead to system-level transitions, hence acting as a strategic agent of change in future hospice care.

Aim We aim to co-define and co-imagine current and future hospice care as an ecosystem of people, objects, environments, technologies, interactions and narratives of care. Objectives include; a) co-creating a systems map of the current hospice care; b) co-defining key values, requirements and challenges in the current system; and c) co-imagining new value propositions in future hospice care systems.

Methodology and methods We propose an advanced design approach to future hospice care informed by System-shifting design, Speculative design, Human centred design and Design framing principles. We adopt a Designer-in-Residence model as a new innovative method for interdisciplinary collaboration and investigation.

An innovative collaboration between a hospice and an academic design research centre allows for a team of design researchers to undertake a 12-month residency in a hospice to gain first-hand contextual understanding and to conduct 1) Semi-structured interviews with staff, visitors and patients (N=15); 2) Observations of patients and staff (N=10); 3) Co-define and co-design workshops with all stakeholders (N=2).

Finding First, a systems map of existing hospice care will help clarify and communicate how the system works, capture narratives, experiences and tensions and underline strategic areas for future system-level transitions. Second, a system-shifting design map will help identify new value propositions for future hospice care.

Conclusion This design-driven study incorporates advanced design principles and for the first time, introduces the innovative Designer-in-Residence model in the context of hospice care. We expect the outcomes to stimulate interdisciplinary discourse and collaboration and inform research and practice.