Creative Arena – Case study: Design Bugs Out

A project for the Department of Health has created widespread public-sector interest by pioneering a practical model for design procurement strategies, and public/private sector working arrangements.

Infections such as MRSA and Clostridium difficile have been the cause of widespread illness and even death in UK hospitals. They cause fear and concern for patients and their families.

The Department of Health tasked the Design Council with providing solutions to the problem. The result was the Design Bugs Out project, which saw teams from the Design Council and the Royal College of Art spending time on hospital wards speaking to staff and patients who work at the sharp end of NHS care. Their objective was to find out which implements could benefit from better design.

Paul Cryer, programme manager for the project at the HCAI Technology Programme at the Department of Health, says the basic thesis for the project was simple and straightforward. ‘If things are designed to be easier to clean, and made from materials that are easier to clean, they will get cleaned better and stay cleaner for longer,’ he says.

The way the project was understood and embraced by staff, visitors and patients suggests that this simplicity was fundamental to the success of the exercise. Expert panels came up with lists of common hospital items that would benefit from a redesign and stage two of the project commenced. This split into two strands.

The Helen Hamlyn Centre at London’s Royal College of Art worked on six tools commonly used by doctors and nurses. Simple improvements have included a blood pressure cuff – the part of a blood pressure monitor that wraps around a patient’s arm – which fastens with magnets instead of Velcro. The change removes a rough surface that could harbour bacteria with a smooth one that is easier to clean.

Meanwhile, design consultancies were invited to team up with manufacturers to enter a competition to redesign essential items of hospital furniture. Shortlisted groups won a £25 000 prize to cover costs to prototyping and the chance to pick an item or items to work on. The brief requested that they keep end-prices of the new products as close as possible to the existing items to ensure they’d be widely used.

The involvement of manufacturers, with their production expertise and prototyping capabilities, meant the project progressed quickly and smoothly, says Cryer. The prototype designs have already toured hospitals nationally for feedback, and are also on display on the Design Council’s website. ‘The manufacturers are big players, they know what they are doing. The products should certainly be available next year,’ says Cryer. The project is thought to be the first of its type to use this procurement strategy.

‘Is it an innovative procurement method for design? Yes it is,’ says Cryer. ‘Is it a good way for the private and public sectors to work together? Yes it is, and there has been a lot of interest from other areas of the public sector.’

‘Design Bugs Out is a model of innovation,’ agrees the Design Council’s David Kester. ‘It has only taken ten months, and there are big upsides for the NHS. If the project can deliver better products that are no more expensive, yet reduce infection, that is a huge win.’

The project also provides a template for future work in other sectors, not least because designers and manufacturers retain copyright in their concepts in the spirit of making potentially life-saving designs universally available.

‘If you operate an open-invitation model, with the opportunity for private-sector companies to come together and own the intellectual property for these projects, there is a great incentive for them to participate in public-sector innovation,’ says Kester. It also seems that the simple and robust business model may travel well. ‘These are transferable lessons. You don’t need the Design Council there to do it. The whole point is that you can just get on with this stuff,’ says Kester.

Any designers who have not worked in the public sector, and who still perceive it as a stuffy world of civil servants, may need to rethink their prejudices.

‘People [in the public sector] have been highly responsive to innovation. The real mistake would be to think otherwise,’ says Kester. ‘Inevitably, there is an element of being cautious, but the private sector is the same in that regard.’

As Parliament has been learning to its cost, the UK population does expect some caution in the spending of public funds. If new ways of design procurement mean taxpayers’ money is better spent, their time may truly have come.

Design Bugs Out – Hospital furniture
Five common items of hospital furniture have been redesigned as part of the Design Bugs Out project. Each has been the result of a designer/manufacturer partnership. The brief called for end costs to be kept as near as possible to costs for existing versions of the items.

• Commode, by Pearson Lloyd and Kirton Healthcare
• Bedside cabinet, by Kinneir Dufort and Bristol Maid
• Patient bedside system, by Hollington and Herman Miller
• Patient chair, by Pearson Lloyd and Kirton Healthcare
• Porter’s chair, by Minima and Vernacare

Design Bugs Out – Medical tools
The Design Bugs Out project yielded redesigned versions of some of the devices most commonly used by doctors and nurses on UK hospital wards. Design is by the Helen Hamlyn Centre at the Royal College of Art, with initial input and later feedback gained during hospital visits.

Blood pressure cuff:
Uses magnets instead of Velcro to fix and adjust, allowing a wipe-clean surface to be used for the whole cuff

Cannula time tracker:
Inserted through the skin to allow drugs to be administered without repeated injections, a cannula should be changed on a regular basis. This model changes colour to show how long it has been in use

Curtain clip:
Hospital curtains are hard to keep clean. If everybody uses the wipe-clean handles, transmission of bacteria can be reduced

Intelligent mattress:
Punctured mattresses can harbour bacteria, but the punctures are hard to see. This version features a layer of hypochromic ink to make punctures stand out

Pulse oximeter:
A simplified version of a commonly used tool, this has fewer moving parts and is easier to clean

Wipe dispenser:
This clip-on dispenser can be attached wherever it is needed, allowing staff, patients and visitors access to antibacterial wipes quickly and easily