Key issues to be addressed
The hospital environment brings together large numbers of people who are too ill to remain in their homes or to continue with their lives as normal, so by its nature this structure concentrates illness, infection risks and vulnerability into a defined space.
There is considerable potential for things to go wrong and when they do they are highly publicised, so there is a strong drive to identify the causes and reduce the occurrence of avoidable harm to patients. Areas currently identified and under scrutiny include errors in administering medication, errors in infection control and errors in communication between staff, and between clinicians and patients. Similarly, falls and other in-hospital accidents are being studied in order to understand how they happen and how they can be avoided in future.
There are initiatives to take healthcare into the community, whereby minor illnesses or injuries will be treated at home or in the place where they occur, so that patients will be discharged without needing to be taken to hospital.
Such changes could potentially alter the nature, effectiveness and size of hospitals and, in turn, will have an impact on the specification of ambulances for emergency and urgent care and the working practices of ambulance crews and paramedics. These changes will all depend on design interventions at the level of systems, processes, communications and products.
Preventative healthcare aims to reduce or eliminate altogether the onset of illnesses and diseases. There is an increasing trend towards self-testing and home-monitoring solutions. For example, personal blood glucose meters, home pregnancy tests and remote monitoring of cholesterol all give the user increased control of their own health and relieves the healthcare system of procedures that can easily and accurately be done in privacy by the patient themselves. This enables people to self-manage and achieve quality of life at home, yet manages risk.
Attitudes are changing and patients are becoming increasingly proactive in managing their own health. For home monitoring and preventative solutions, design can have a significant influence and requires a different set of design sensibilities than when designing hospital-based equipment used by professionals. Design sensitivity, aesthetics and human factors understanding can all lead to improved devices.
One such device (fig. 2), developed by a graduate in Industrial Design Engineering at the Royal College of Art Maja Kecman, enables women to take a cervical smear test by themselves and in the privacy of their home.
Figure 2 – home use smear test kit Design has a vital role to play in addressing these issues both in and out of hospital. It is essential that these issues are met in order to transform the healthcare system into a more sustainable organisation.