click to view image
Medical error in hospitals is high on the political agenda and rarely out of the news. Human errors and systemic failures lead to preventable harm and unnecessary suffering for patients. It is reported that as many as one in ten patients in hospital may suffer the effects of error in their care, resulting in costs of £2 billion annually. It is estimated that over half of these cases may have been avoidable.
A key aspect of the problem is that healthcare processes continue to evolve whereas the design of much ward-based equipment remains largely unchanged. Daily patient care involves a complicated interaction of many tasks and processes, supported by products that co-exist within the patient's bed space with little thought for safe integration and context of use. In short, current treatments are not effectively supported by available equipment.
Research associate Grace Davey is working closely with senior associate Jonathan West as part of a multidisciplinary team of designers, clinicians, clinical psychologists and business experts. This team is looking at this problem from a number of perspectives, as part of a three-year study called DOME (Designing Out Medical Error).
"Healthcare processes continue to evolve but much equipment on the hospital ward remains unchanged..."
The DOME research has led to a focus on the space around the patient's hospital bed. Through rigorous analysis, observations and user interviews, five healthcare processes have been identified as posing the most risk to the patient: handwashing, staff handover, isolation of infection, medication delivery and measurement of the patient's vital signs such as blood pressure and temperature.
By working alongside hospital staff at St Mary's Hospital in London, and by analysing where errors can occur for each of the processes, the research team has identified underlying causes and begun to develop a number of design interventions that will be piloted in order to better support clinical processes on hospital wards.
One of the first pieces of equipment that the team has developed is the Carestation, a central hub for treatment in the bed space. Observational research identified that medical staff were not complying with hand hygiene and infection control protocols because the necessary reminders and equipment were not always easily accessible. Positioning all the equipment in one convenient place would encourage staff to abide by these rules.
The Carestation concept could also support medication delivery, monitoring of vital signs and staff handover by providing a central place to keep notes and provide a surface to work on. The creation of this idea was a direct result of DOME's interdisciplinary approach and an understanding that all five high-risk processes are interconnected and impact on each other.
Further new products are being designed through iterative consultation with user and expert reference groups - and a parallel strand of research is drawing on solutions for reducing error in analogous industries such as rail, marine and chemicals. The DOME project completes its work in September 2011.
