Social innovation, socially responsive design and social enterprise
There have been many healthcare design projects at the Royal College of Art Helen Hamlyn Centre, spanning over ten years of experience in socially responsive design. Three recent projects are outlined below:
Design Bugs Out
Making Britain’s hospitals cleaner and safer has become a top Government priority in recent times. Well-publicised problems with HCAIs, especially MRSA and C.difficile, led to the Design Bugs Out programme, launched last year by the Design Council in partnership with the Department of Health and the NHS Purchasing and Supply Agency.
The aim was to bring designers together with clinical specialists, patients and frontline staff to help combat infections by making hospital furniture and equipment easier and quicker to clean.
The design challenges were identified following extensive research in hospitals across the UK involving nurses, patients, cleaners, porters and other healthcare staff. They were selected as items that, if redesigned, could have the most potential to reduce patient exposure to HCAIs through contact with their immediate surroundings.
Figure 3 – current blood pressure cuff design
One of the items which one chosen for re-design was the blood pressure cuff (fig.3). Current cleaning practices require the cuff to be wiped clean using a wet cloth in-between patients, yet this is ineffective on the Velcro fastening and leaves the fabric cold and damp. The re-designed cuff (fig.4) fastens using magnetic catches, thereby replacing the need for Velcro. The cover is made from easy-to-sanitise PVC and printed with simple to follow instructions and cheerful graphics.
Figure 4 – Revised blood pressure cuff design
Other designs included an ‘intelligent’ mattress, a cannula with a self-timing indicator, a wipe-clean handle for a curtain, a smoother pulse oximeter (for measuring oxygen content in the patient’s bloodstream) and a patient wipe dispenser which encourages patients to maintain their own cleanliness.
They have received excellent feedback and two of the designs have also won awards for their use of materials (Materials And Design Exchange awards, May 2009).
The graphic design of injectable medicines
According to the National Patient Safety Agency, nearly ten per cent of all adverse medical incidents reported in 2004/5 involved medication. Of these, a quarter involved injectable medicines; a hugely disproportionate number given that only a small minority of medication is given via injection. The term ‘injectable medicines’ refers to drugs that come in ampoules, vials, pre-filled syringes and infusion bags. Many of these incidents arise from confusion over packaging and labelling.
The research looked at problems with existing designs, which are caused primarily by an emphasis on promoting the company brand so that all drugs are packaged in the same corporate livery. Work was conducted closely with a user group of healthcare staff at all levels to discover how medicines are stored, prescribed, dispensed and administered. The aim was to establish what information was vital for staff to be able to give the medication safely.
Findings from the user study were distilled into separate design points (fig. 5), each of which formed an illustrated double page spread in a booklet. It is intended to be a best practice guide aimed at packaging designers and pharmaceutical firms, as well as being a reference guide for those involved in NHS procurement.
Figure 5 – sample graphic design recommendation for injectable medicines
Redesigning surgical tools
As the cost of surgical procedures rise, manufacturers and health service providers alike are looking afresh at the design of surgical instruments, many of which have not been redesigned for decades. Such tools do not reflect advances in new materials, new technologies, ergonomic practice or surgical technique. In some cases, instruments cannot perform the functions they were originally designed for, forcing the surgeon to improvise in the operating theatre.
DePuy, a subsidiary of Johnson & Johnson, is a manufacturer of orthopaedic components such as knee and hip implants and associated surgical instruments.
This project in partnership with DePuy set out to generate new design ideas against the background of rising cost pressures and changes in surgical practice and legislation. The market for orthopaedic surgery is growing by 12 per cent a year but the cost of instrumentation pushes up the cost of any surgical procedure.
The study focused on user need and application as a route to innovation. Both surgeon and patient were considered as primary users since the design of the surgical tools affects the surgeon’s skill, stress level and precision as well as patient comfort and recovery time. The team of supporting staff and scrub nurses were also included since they transport, prepare, store, handle and remove the tools and have to be considered as important secondary users.
Figure 6 – conventional knee replacement kits
Fig. 6 shows two instrument kits conventionally used for knee replacement surgery. They are complicated to assemble, clean and pack and expensive to produce.
Figure 7 – newly designed instruments
The two newly designed instruments are shown in fig. 7. These have the same functionality as the kits in the blue boxes. They require no assembly, they meet their cost target, they are intuitive to use, reduce the surgical step time and are currently being taken to clinical (in-vivo) trials.