Hospitals are under pressure to improve overall quality and operate more economically. Against that background, this design research project aims at optimizing discharge management outcomes by means of improved patient pathways. Referring to organizational science research that reveals a relevance gap for practice that could be met by prescriptive design research applied as a mode of organizational research, the project investigates how an understanding of patient journeys yield evidence by means of actionable knowledge, and how it be represented and integrated with that of the involved hospital ethnographic research, resulting in various issues along the patient journey, including associated current and potential solutions and new solution ideas. A co-design workshop with hospital staff and patients revealed additional design propositions towards an optimized version of a patient process with regard to satisfaction and quality. The issues point to areas for optimization in the larger systemic context defined by the patient journey. The findings from the co-design workshop indicate that local staff can indeed be enabled to contribute to crossdisciplinary ideation activities. The research contributes to an understanding of design-research-based evidence generation in the hospital context.