I have mae three quilts for friends from my XS boards. Basically, they stitch the centers and I design the block around their piece. The first was a friend who stitched 25 pieces by Elizabeth's Designs for her daughter Elizabeth. Most were less than 8" square/hexagon. I designed a quilt block around the hexagon with tulips pieced in the corners. I picked a nice floral for the background and the tulips were in pink, lavender and yellow. I quilted the pieced part inthe ditch by hand and quilted around the hexagon about 1/4" in. That was four years ago and it is still in great shape. Of course they have no real wear on it (no dogs just one cat) and the one daughter who is now 10. She uses it on her bed and it is washed regularly. But of course, since her mom is a stitcher she knows how to wash it, etc.
It can be done. I am working on a Christmas quilt with the embroidered squares with patchwork in between. Try it on a small piece first and go for it.