Design Bugs Out

Patients go into hospitals to be cured of what ails them, but the ugly truth is that some get sick from being there. In 2007, around 9,000 people in the United Kingdom died from hospital-borne infections. Though the National Health Service has implemented procedural changes that have halved the number of antibiotic-resistant staph infections, or MRSAs, in the last three years, the agency is not content to stop there. “We cannot be complacent and must keep up the fight against such infections,” says Paul Cryer, who manages the two-year-old Healthcare Associated Infections Technology Innovation Program for the Department of Health, which sets policy for the NHS and is now targeting the hard-to-clean furniture and equipment that patients come into contact with.

The bible of U.K. hospital procurement officers is Supply Chain, which features 620,000 NHS-sanctioned products, from endobronchial tubes to wall-mounted examination lamps. “Furniture in the past has been designed for ease of manufacture and a price that vendors think will attract the NHS,” Cryer says. Though affordable, the Supply Chain offerings are vehicles for pathogens like MRSA and Clostridium difficile. In July 2008, the DH turned to the Design Council for solutions. The resulting program, called Design Bugs Out, began with a team conducting interviews for a month with patients and caregivers in NHS hospitals in Huddersfield, Manchester, and Southampton. From that research, health-care experts determined 11 categories of products in which redesigns could drastically reduce infection-related fatality rates.

The Design Council assigned rethinking everyday health-care equipment to the Royal College of Art’s Helen Hamlyn Centre. Furniture and other environmental objects were the subject of a national competition open to teams of designers and manufacturers. The RCA took on hand sanitizers, pulse oximeters, mattress covers, blood-pressure cuffs, and sanitary curtain handles. Its cannula time-tracker, which charts the number of days that an intravenous line has been in place, is already on the market, and the NHS will soon select manufacturers for the other RCA prototypes.

For the design competition, each of the 32 teams that entered identified the object it wanted to concentrate on. “The commode certainly attracted the most interest,” says Chris Howroyd, a Design Council project manager. But everything from storage to seating was ripe for reinvention. “The National Health Service is the world’s second biggest employer, behind Wal-Mart,” says Richard Seymour, a cofounder of the London-based industrial design consultancy SeymourPowell, who headed the jury. “To plug clever designers and ambitious manufacturers into this system, with little litter in the middle, needed to happen.” Four teams were selected to produce prototypes: Kinneir Dufort and Bristol Maid, a bedside cabinet; Hollington and Herman Miller, a patient’s bedside system; Minima and Vernacare, a porter’s chair; and PearsonLloyd and Kirton Healthcare, which won with two separate entries, the commode and a patient’s chair. “They have been designed to be cleaned more easily, and that’s what we set out to achieve,” Cryer says. “They also look better and function in a more useful way for patients.”

Last April, the Design Council took the prototypes on the road, displaying them in 25 hospitals across the U.K. and soliciting more than a thousand written responses. The in-depth development process (and the accompanying publicity) persuaded most of the manufacturers to bring the projects to fruition. Tooling was finalized this past winter, and most production runs are starting now. “This project goes beyond redesigning commodes and cuffs,” Howroyd says. “It’s a demonstration of how design teams can really play a part in health-care efficiency and how innovation can engage people on the front lines, like nurses, janitors, and porters.” He forecasts that the products could usurp their Supply Chain competition within six months. Here the designers navigate the germ-busting features of four reconsidered objects.