Engineering Systems Interventions in Practice: Cases from Healthcare and Transport

This chapter presents four cases of practical interventions in engineering systems: transforming national healthcare by construction of super hospitals; developing deep emergency response using AI; decarbonising global shipping in a global system transformation; and prototyping future urban transport systems. The cases come from two sectors, healthcare and transport, and demonstrate interventions of various complexities and lifecycles. To ensure comparability, each case is developed based on a common analytical framework and in-depth interviews with leading practitioners working on transforming engineering systems. Findings across the cases document five learning points. Engineering systems design does: firstly, apply a systems perspective to understand the entanglement of different system elements, their connections, boundaries, and causal effects; secondly, evaluate the value of these systems in the light of current performance, state of play, (future) technological possibilities, and user needs to identify complication and societal business cases for interventions; thirdly, organise a lineage of projects and programmes across time and space for systematised experimentation to explore the solutions space and implementation at different levels in the engineering system; fourthly, embed standardisation and flexibility in the system for maintaining value delivery while embracing future needs and opportunities; and finally, carefully navigate the complex and dynamic stakeholder landscapes, manage, and develop the discourse within and around the systems through user and public engagement to ensure benefit realisation of the intervention.