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Designing an ambulance fit for the future

26 September 2011

Building on six years of research at the Royal College of Art, the design project, Redesigning the ambulance: improving mobile emergency healthcare, is set to improve the experience for patients and to create a better treatment space for staff. Today’s ambulance crews are highly skilled professionals. They no longer merely transport patients to hospital but diagnose and treat patients in often challenging conditions.

The Helen Hamlyn Centre for Design project began with designers joining ambulance crews on callouts during 12-hour shifts. Key insights were translated into sketch designs, and a full-scale test rig was mocked up in cardboard and foam. The design team then worked with front line paramedics, clinicians, patients, academic researchers and engineers in a co-design process to develop and evaluate proposals.

Salient features and benefits
 THE FIRST main feature is the centrally positioned stretcher, which allows the clinician all-round access to the patient to give safer, more efficient treatment.  In existing ambulances, only one side of the patient is easily accessible because the stretcher’s clamped to the wall.  The stretcher the new ambulance uses is a large one, to manage bigger patients and the UK demographic trend towards increasing obesity.

 Secondly, all of the equipment and supplies have been fixed to one side of the vehicle on a simple, carefully designed, ‘Working Wall’ to position everything ergonomically, following evidence from a great deal of user-research.  A simple but very effective addition is a small fold-out table for the attendant to use as a lay-down space for items in use, instead of laying them out on the patient.

 Thirdly, modular Treatment Packs are loaded into the vehicle before each shift by the ‘Make-Ready’ team, containing everything needed for particular jobs – for example, dressings, cannulas, airways and oxygen kit, burns, and a maternity pack.  This way the crew knows that the vehicle is fully stocked for the shift, and they don’t need to overload it ‘just in case’.

 Fourthly, and a big innovation, is simply to bring together existing digital technologies that we take for granted in our phones and cars every day, make them work together, and revolutionise the ambulance. The new ambulance’s Communications and Monitoring System provides much better road navigation, enables video links, discussion with hospital colleagues and specialists, and access to patient records.  It also sends vital signs and handover information directly to the hospital whilst en route.  This is much more efficient than transcribing notes scribbled onto a surgical glove, onto a paper form, to be later transcribed again into the NHS system.

 Fifth, the Easy-Clean Interior has been designed to avoid corners and crevices where dirt can collect. Evaluations have demonstrated significant improvements in infection control as a result; the interior is better-lit, has a better ambience and is less intimidating to the patient.

 Finally, the design team have added some ridiculously simple features, for example, giving ambulance clinicians some hand-cleaning facilities – it may seem incredible, but there’s nothing provided at the moment.  The same goes for storing personal belongings, and there’s even room for a cooler-box to reduce food poisoning amongst staff caused by their sandwiches going off during a 12-hour shift in hot weather.

The project team is currently working with commissioners, ambulance trusts and manufacturers to ensure that learning from the project can be implemented and will lead to quality and productivity improvements across the NHS.

For more information about the Royal College of Art, click here.

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