The Problem

One in ten hospital patients in the UK suffers unintended harm as a result of medical error - a key contributing factor is that clinical processes continue to evolve but the design of much ward-based equipment remains largely unchanged.


The Designing Out Medical Error (DOME) project aimed to better understand and map healthcare processes on surgical wards, establishing an evidence base to design equipment and products which better supports these processes and therefore reduce instances of medical error.

The Process

This three-year multidisciplinary project was set up with the aim to reduce medical error by creating a better fit between healthcare processes on surgical wards and the equipment and products that support them. The research team mapped surgical processes with NHS staff and patients; investigated how safety is managed in analogous industries; and used novel research techniques to identify and prioritise the five most error-prone processes on surgical wards - hand washing, information handover, vital signs monitoring, isolation of infection and medication delivery.

The Results

Interventions were designed for each process and tested in a simulated ward environment. These include the Carecentre, an all-in-one unit for the equipment needed for patient care in the bed space, a communication campaign for hand hygiene, and a new trolley to monitor vital signs that is easier to clean and use. Some of the design interventions are undergoing clinical trials and have been taken forward by manufacturers to production.


Royal College of Art Helen Hamlyn Centre for Design

The RCA has a long-standing interest in healthcare design dating back to the 1960s and the development of the standard or Kings Fund hospital bed. This work is now based in the Helen Hamlyn Centre where the focus is on Design for Patient Safety, with current and recent projects impacting on the design of packaging for oral and injectable medications, surgical instruments, ambulance design, infusion pumps and the preparation of drugs for anaesthesia.


Imperial College London

Imperial College London is a science-based institution with a reputation for excellence in teaching and research. The Faculty of Medicine recently celebrated its first decade, having been established in 1997, bringing together all the major West London medical schools into one world-class institution. The Faculty is one of Europe's largest medical institutions - in terms of its staff and student population and its research income.


Imperial College Business School

Imperial College Business School is one of Europe’s most dynamic centres for innovation and entrepreneurship. It is a constituent faculty of Imperial College London.


Engineering and Physical Sciences Research Council (EPSRC)

The EPSRC are the main UK government agency for funding research and training in engineering and the physical sciences, investing more than £800 million a year in a broad range of subjects – from mathematics to materials science, and from information technology to structural engineering.