How design can improve the user experience
As part of our ongoing conversation around ‘user-focused public services’, the Design Council’s Chris Finnegan showcases an example of how design can improve the user experience. John Mathers, Chief Executive of the Design Council, delivered a keynote address on this theme at our ‘Consumer Insight conference’ earlier this Spring.
Reducing violence and aggression in A&E: How design can improve the patient experience
There is a growing evidence base for the impact of design in improving frontline services, such as in healthcare service improvement. Design Council’s collaboration with the Department of Health to reduce violence and aggression towards frontline healthcare staff offers a practical example of a design-led response to a policy imperative.
The Reducing violence and aggression in A&E: Through a better experience programme offers a practical example of how design and behavioural science can help governments become more open, ambitious and collaborative in how they make and test policies.
The programme was undertaken by a triumvirate of Design Council, PearsonLloyd and the NHS, and sought to address non-physical aggression and hostility towards staff by improving the A&E experience.
Drawing on insights and methods from psychology, economics and neuroscience, behavioural science challenges the view that people always behave in rational self-interest, arguing that people often make decisions with little conscious awareness.
In the context of A&E, there is a natural assumption that people who behave aggressively towards staff have made an active decision to do so. We assume they are unwilling or incapable of changing, which leads to standard approaches of more security or threats of punishment.
However, if we know that people’s intentions do not always translate into action, 75% of patients said the improved signage reduced their frustration during waiting timesand that emotion plays an unconscious role in decision-making, we need to provide practical help for people to overcome these barriers or go with the grain of making better decisions. This means designing solutions that are grounded in what people really want and need.
Crucially, the design solutions were co-designed, installed and Threatening body language and aggressive behaviour fell by 50% post-implementationevaluated within working A&E departments. In this, the programme has directly bridged the gap between policy-thinking about how to manage staff safety on the frontline, and delivery against that policy objective through the application of design and behavioural science to create effective solutions.
PearsonLloyd worked with each Health Trust to customise the solutions to the For every £1 spent on the design solutions, £3 was generated in benefitsrequirements of each department, reflecting the different processes and cultures that exist, and are also offering a template package to allow Trusts to install the guidance signage at a lower cost. A multi-disciplinary design team, led by PearsonLloyd, produced three design solutions:
- The ‘Guidance solution’ – an information package that greets patients on arrival to inform, guide and answer questions creating a positive A&E experience.
- The ‘People solution’ – working with frontline staff through reflective practices to support their interactions with frustrated, aggressive and sometimes violent patients.
- A ‘design toolkit’ – free high-level design recommendations and guidelines to help ensure the built environment is optimised for patient comfort.
The ‘Guidance’ and ‘People’ solutions were installed and piloted at two A&E departments: Southampton General Hospital and St George’s Hospital, London. A comprehensive evaluation was carried out by Frontier Economics and ESRO to test their impact. It found:
- 75% of patients said the improved signage reduced their frustration during waiting times
- Threatening body language and aggressive behaviour fell by 50% post-implementation
- For every £1 spent on the design solutions, £3 was generated in benefits
The findings further strengthen the evidence that cost-effective design solutions, informed by a deep understanding of human behaviour, can play an important role in improving patient experience.
The ‘Guidance Solution for a Better A&E’ has been installed in seven A&E departments to date, with a further four installations planned and plenty more Trusts interested. PearsonLloyd are undertaking a pilot of their new template package for the ‘Guidance Solution’ with three Trusts. The template package allows Trusts to install the Guidance Panels for a lower upfront cost, which we hope will increase uptake across the NHS.
For further information on the programme, visit Design Council’s website: