Using the systems approach to design out medical error

Understanding systems contributions to adverse events is essential when designing for patient safety, particularly in complex, dynamic and distributed systems. The design of medical equipment, environments and processes is often fragmented, driven by organisational change and budgetary restrictions and constrained by professional silos. This paper describes a unique project that uses a multidisciplinary systems approach to designing healthcare environments. DOME (Designing Out Medical Error) is a three year project that brings together clinicians, designers, human factors experts, psychologists and business experts to apply a user-centred approach to the design of safer clinical systems. The project focused on five processes (medication, vital signs monitoring, infection control, hand hygiene and handover) on elective surgical wards.