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Bad Design is a Health Risk
Poorly conceived medical equipment and hospitals can directly
contribute to the harm of patients.
Monday September 25, 2006
Designer and design groupies of all kinds will be pausing for
breath today as the fourth annual London Design Festival, a
fortnight of events and exhibitions spread across 150 venues,
enters its second week. The festival offers a great opportunity
for London, and Britain, to make a noise about something we are
truly good at. It trains a welcome spotlight on a discipline too
often ignored. Broadly speaking, everything man-made has
been designed, whether it is the wheel or the space shuttle, the
room in which you are sitting or the hospital in which you were
born. It is an unfortunate truth that most really good design is
by and large invisible to the user: it predicts their needs and
solves their problems without being noticed. Bad design, on the
other hand, is really hard to miss, mainly because you keep
banging your shin on it.
We don't give thanks to Jock Kinneir and Margaret Calvert when
we easily read a sign on the M1 at 70mph, nor is the name Harry
Beck routinely invoked by people who successfully navigate the
London tube thanks to the great design of its map. It is only
when we become enraged by a particularly awful bit of
supermarket food packaging or the flashing clock on a VCR that
we want someone's name - somewhere, someone must be to blame.
The cost of bad design in the private sector is disappointed
customers, missed sales targets and bankrupt manufacturers; the
cost of poor design in parts of the public sector, however, is
far greater. In many cases, inappropriately designed hospitals,
medical devices and healthcare systems can directly contribute
to the accidental harm of patients, harm that may affect as many
as 10% of all acute admissions. While most of these incidents do
not result in significant injury to the patient, many
unfortunately do prove serious.
To my mind there is no doubt that confusing and poorly conceived
medication packaging contributes to pharmacy selection errors
and problems with patient compliance; that unnecessarily
complicated medical devices contribute to user error; and that
healthcare buildings that do not provide good working conditions
for staff or supportive, healing environments for patients
contribute to healthcare-associated infections and a myriad of
other patient-safety incidents.
It seems odd that a country with one of the most sophisticated
design industries in the world should not be making best use of
those skills in the health sector, where good design is so
critical. Design has the power to transform the way we relate to
objects and environments. Design can make products and services
easy to use and difficult to misuse purely by involving the
intended users in the process of creation. Only when all the
elements that affect the quality and safety of care are
considered together and as part of a single system will
appropriate solutions be developed and a significant improvement
be achieved. Design is as important an element in that system as
anything else.
I am not so naive as to believe that design alone can save the
NHS. Getting to the root cause of complex safety incidents is
difficult; saying bad design kills patients is misleading. But
next time you are lying in a hospital bed ask yourself this:
could any of the elements you have just come into contact with
be better designed to make them simpler and more usable,
designed specifically to reduce the likelihood and consequences
of misuse or to improve the patient's experience and chances of
recovery? If the answer is no, you obviously haven't yet come
around from the anaesthetic.
· Colum Menzies Lowe, head of design and human factors at the
NHS National Patient Safety Agency, is speaking at the London
Design Festival on Thursday
comment@guardian.co.uk
Guardian Unlimited © Guardian Newspapers Limited 2006
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