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Tastefully redesigning the care pathway


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Friday, 25 March 2011

Tastefully redesigning the care pathway

Aggressive behaviour in A&E costs £69 million a year in lost productivity, staff absence and increased security. The solution proposed by the Design Council, under an initiative funded by the Department of Health, is to get designers to make A&E an altogether cheerier, comfier place.

The idea is that soothing colours, scatter cushions and nice throws will combat the effects of 10 pints of rough cider and turn the average slavering yobbo into a model citizen.

Leaving aside the question of whether aggression could be addressed more cost-effectively by hiring bouncers with large dogs, the central problem with this latest initiative is that it is in direct conflict with the government’s commissioning policy.

Redesigning A&E is merely encouraging people to present for treatment at hospital and increasing the likelihood of inappropriate referrals.

Faced with the embarrassment of seeing patients in dingy consulting rooms, and knowing that the local A&E department has been made over with tasteful uplighting, Nordic furniture and daring fabric combinations, style-conscious GPs will simply find a reason to refer.

And when patients, newly empowered by choice -- no feng shui about me without me -- get wind of the fact that they are getting substandard décor in primary care, all Mr Lansley’s good work will be undone.

NerissaS says:
Apr 18, 2011 05:55 PM
Come on; Be reasonable. Is the NHS about fashion conscious care? or 'the highest level of care to the highest number of people' What tax payers are really bothered about is that they get the most for their money, more so in the field of health care and even more so in tough financial crisis. Do we really want to encourage people to turn up drunk (for example) at A$E so the NHS can nurse them back to health in a soothing environment, only to repeat this the following weekend? Yes a soothing environment may calm patients down, but what it does not do is prevent the problem in the first place. If you really want to be cost-effective, it's about prevention not cure. I'd rather have my tax contributions put towards preventing binge drinking and other causes of aggression in the A&E and towards easing short staffing (which probably is a factor on a busy friday night at A%E), rather than the walls and sofas of a building that one would try and avoid anyways.
shodkin says:
Apr 18, 2011 05:55 PM
What good work has Mr Lansley done?
I fully agree with N Santmano's comments above.
swarmington says:
Apr 18, 2011 05:55 PM
My experience both as a patient and carer and as ex-NHS worker is that frustration and bad temper can be alleviated by patients being treated with kindness, consideration, professionalism and in a timely manner. I also aggree with N Santimano; it's about prevention and adequate staffing. Prevention is always tricky though if we consider that binge drinking and violence have origins outside of health care, i.e. in poverty, hopelessness and lack of education. If,as a society, we're not prepared to care for one another from an early age, then we will have to live with the unacceptable consequences.
NerissaS says:
Apr 18, 2011 05:55 PM
I agree with Sally Warmington; prevention is tricky when it falls outside the remit of 'clinical care' however, appropriate definitions of health encompass more than clinical/disease aspects and include a more holistic description. If the NHS ultimately deals with the consequences of the societal causes of violence and drinking, it is inevitably intricately involved with other streams of health such as Public Health. Then financial decisions need to be made taking this into account. The department of Health is responsible for both the NHS and Public health. The question is; Is this expenditure doing anything to reduce the problem or is it just sustaining it in the long run.
NVA says:
Apr 18, 2011 05:55 PM
What about a designer baseball bat? You aren't going to prevent drinking nor the agressive behaviour of the usual A&E customers on Friday and Saturday nights. All the politeness in the world won't protect staff neither will soft furnishings. Prompt service and security staff with powers of arrest just might help.
CH_design says:
Apr 18, 2011 05:55 PM
I am surprised and disappointed by the tone of this article. This challenge is about sparking and championing innovative thinking to solve a long-standing problem which continues to blight the NHS.

To imply that the Department of Health and the Design Council would respond to such a serious issue with an aesthetically driven, makeover show-esk approach is totally incorrect and borders on the insulting.

We already know designers can have a major impact on violence and aggression in A&E. A few years ago, Birmingham Heartlands Hospital had a significant issue with violence against staff, they engaged specialist designers, who observed and analysed how the department worked and how patients interacted with and responded to the systems in use. They proposed changes to the department’s layout, information systems, waiting areas and other elements. After the work was completed, violence fell by over 60%.

I’m delighted that we have had a huge response to our challenge from specialist designers and businesses in system design, product design, information design and architecture. These are the disciplines which will be used to find new ways to reduce violence in A&E. We have also had an overwhelmingly supportive response from front line staff, NHS trusts and experts in the field of A&E with whom designers will work to find solutions which are low-cost, easily implemented and most of all, effective in reducing violence and aggression. The Department of Health and Design Council hope that new design solutions can deliver a strong return on investment to the NHS, their staff and patients alike; by making A&E environments safer and more efficient.
jpatterson says:
Apr 18, 2011 05:55 PM
Without wishing to compound the offence, the piece was intended satirically and is not a serious critique of the DH or the Design Council, both of which are fine institutions.