Innovation in healthcare requires changing the institutional arrangements or what are often referred to as “the rules of the game.” Such a change demands that actors do institutional work—intentionally creating, disrupting, and maintaining the entrenched ways of operating within the system. This chapter explores how service design practices contribute to changing the rules of the game in healthcare by integrating research on service design and institutional work. Based on a literature review, five characteristics of service design practices—multidisciplinary, experiential, participatory, experimental, and reflective—are highlighted and linked to the antecedents of institutional work. Illustrative examples of service design projects from Experio Lab, an embedded service design group in the Swedish healthcare system, are used to contextualize the findings. In doing so, this chapter provides a clear rationale for how service design practices enable innovation in healthcare and offer insights for healthcare practitioners interested in working toward institutional change through service design.