One in ten hospital patients in the UK suffers unintended harm as a result of medical error. A key contributing factor is that clinical processes continue to evolve but the design of much ward-based equipment remains largely unchanged.
The Designing Out Medical Error (DOME) project aimed to better understand and map healthcare processes on surgical wards, establishing an evidence base to design equipment and products which better supports these processes and therefore reduces instances of medical error.
This three-year multidisciplinary project was set up with the aim of reducing medical error by creating a better fit between healthcare processes on surgical wards and the equipment and products that support them. The research team consisted of designers from the Helen Hamlyn Centre for Design at the Royal College of Art, surgeons and psychologists from Imperial College London and Imperial College NHS Trust, operations management expertise from Imperial College Business School as well as human factors specialists.
The team mapped surgical processes with NHS staff and patients, investigated how safety is managed in analogous industries, and used novel research techniques to identify and prioritise the five most error-prone processes on surgical wards. These are hand hygiene, information handover, vital signs monitoring, isolation of infection and medication delivery.
Interventions were designed for each process and tested in a simulated ward environment. These include the CareStation(TM), an all-in-one unit for the equipment needed for patient care in the bed space (pictured), a communication campaign for hand hygiene, and a new trolley to monitor vital signs that is easier to clean and use. Some of the design interventions are undergoing clinical trials and have been taken forward by manufacturers to production.
The project has won a number of awards and has also been exhibited internationally including at the Hunterian Museum at the Royal College of Surgeons.