Taking ergonomics to the bedside – A multi-disciplinary approach to designing safer healthcare

•Work analysis of bedside healthcare processes carried out based on over 70h of observation and shadowing on 3 surgical wards.•Over 14 processes were identified and an HFMEA identified nearly 200 potential failure modes in the 5 highest risk processes.•A causal analysis identified number of common systems influences on safety – education, lack of reminders, feedback & design.•Designers and clinicians worked together to develop a suite of solutions, tackling failures across the range of processes.

A multi-disciplinary approach to designing safer healthcare was utilised to investigate risks in the bed-space in elective surgical wards. The Designing Out Medical Error (DOME) project brought together clinicians, designers, psychologists, human factors and business expertise to develop solutions for the highest risk healthcare processes. System mapping and risk assessment techniques identified nearly 200 potential failure modes in hand hygiene, isolation of infection, vital signs monitoring, medication delivery and handover of information. Solutions addressed issues such as the design of equipment, reminders, monitoring, feedback and standardisation. Some of the solutions, such as the CareCentre™, which brings many of the processes and equipment together into one easy to access workstation at the foot of the bed, have been taken forward to clinical trials and manufacture. The project showed the value of the multi-disciplinary and formal human factors approaches to healthcare design for patient safety. In particular, it demonstrates the application of human factors to a complete design cycle and provides a case study for the activities required to reach a safe, marketable product.