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Design Bugs Out: The Role of Design

All the products went through expert review sessions

Why have designers been brought in to help tackle HCAIs?

Studies suggest that the greatest risk for patients is from surfaces located near them that come into direct contact with patients’ and carers’ hands*. Meanwhile research among healthcare staff suggests that redesigning furniture and equipment could enable better cleaning of these surfaces in two ways. First, cleaning would be more efficient because the items are made easier to clean, for example by eliminating crevices, joins and hard-to-reach contours.

Second, making previously hard-to-maintain items easier and quicker to clean means they will be cleaned more often and more regularly.

How do designers work?

Designers work in a unique way, using a combination of techniques and methods that can be applied to almost any problem. These range from research to rapid idea generation and prototyping. Above all, designers get to the heart of users’ needs, building a detailed picture of how they experience services and working with them to trigger new ideas for how the services can be reshaped.

• Research – understanding the user: the Design Bugs Out design teams talked to healthcare staff, patients, housekeeping staff and others in a variety of NHS hospitals to generate fresh insights. They used observational research methods such as experiencing procedures and environments firsthand as well as shadowing staff, conducting interviews on camera and recording demonstrations in situ. In this way the research team got an understanding of the clinical environment that led to ‘journey maps’ plotting movements of staff, equipment and furniture to understand the important cross-infection zones.

• Generating ideas and testing solutions: to find a good idea, designers use tools such as brainstorming to generate lots of ideas. Then they narrow them down, so the best ones can be brought to life and improved through a cycle of rapid prototyping and testing.

• User-testing: early prototypes are user-tested. For instance, the design team behind the Porter’s Chair used chalk on a user’s hand to discover the chair’s main touchpoints.

• Design briefs: the design teams review the results of the user research and use them to produce briefs. In Design Bugs Out the design briefs covered: the patient bedside environment (patient chair, bedside storage and over-bed table); patient transport (a porter’s chair); and a commode. The Design Council also appointed specialists in healthcare design at The Royal College of Art’s Helen Hamlyn Centre to design and prototype ‘quick win’ innovations in five further priority areas in hospital wards, identified through ‘grounded’ research in NHS hospitals. These included a blood pressure cuff, a pulse oximeter finger clip, a patient bed mattress, cubicle curtain handles and a cannula.

• Testing: the eleven Design Bugs Out prototypes will embark on a national tour of selected NHS hospitals and healthcare conferences, and further input from healthcare staff, patients and the general public will be gathered. The aim is to create demand for the new products from NHS Trusts so manufacturers can go into full production, with the new products starting to enter service in NHS hospitals from 2010.

How can designers help public services?

Design is a trigger for the innovation needed to create the high quality, personalised services people increasingly expect, but within existing budget constraints. Design offers unique insights into service users’ needs and a set of methods to meet them. It crystallises problems and generates practical, cost effective solutions, providing a structured way to innovate, test ideas and deal with key public service issues including value for money, risk management, personalisation and sustainability. In particular, design allows ideas to be generated, prototyped and tested before large-scale investment is committed.

Last year, the Design Council launched Public Services by Design, a support programme to help public service managers exploit these benefits. Over the next two years, Public Services by Design will be developed with help from a wide range of people working in public service delivery, policy and design.

The programme is a direct result of the Innovation Nation White Paper (2007), which challenged the Design Council to help the government create services that connect the public to policy making while being cost effective.

References: ‘Importance of the environment in meticillin- resistant Staphylococcus aureus acquisition: the case for hospital cleaning’ – Lancet Vol 8 Feb 2008 101-113)