Product design
“We have been very fortunate in that we have a good name for design and, more often than not, are working with people we have worked with before,” says Philip Ross. “They see how we have responded to their needs and feedback in the past, and are happy to work with us again.” At the outset, it is this customer research that
informs the rest of the development and testing stages. This enables our designers to get a good handle on all conflicting needs, and to design a product that will have the greatest possible impact. “There is no getting away from the design challenges in mental health,” says Philip Ross. “More often than not you have conflicting safety, maintenance, and clinical needs. Simply put, from a safety and maintenance perspective you would prefer everyone to live in an empty box room because there are no ligature risks and nothing to damage, but it’s not going to help people get better – the fundamental purpose of mental health environments.”
HYGIENE REQUIREMENTS
Gus Thomas, another design engineer who worked on the en-suite development, says: “There are the hygiene requirements and all of these need to be taken into consideration from the very start of the design process, so that you end up with a solution that satisfies everyone as much as possible.” This ‘listen to everyone’ approach – known to us at Safehinge Primera as ‘Voice of Customer’, or VoC, – means the team knows exactly where the weaknesses lie with existing solutions, and, equally, which elements of the design brief are critical for success and which ones are simply ‘nice to have’. For example, with en-suite doors in general,
care providers have traditionally chosen between cut-down doors, full doors with door- top alarms, or foam doors, or have decided to do away with the doors completely. However, as Gus Thomas, myself, and the team, went through the first stage of its process, we discovered flaws with every one of these options. Most notable were the ligature risks on door frames, hinges, and gaps, fears that the doors and fittings could be used as a weapon, and the possibility of staff complacency. Philip Ross adds: “Success is down to the depth and breadth of the people you speak to. We spoke to more than 120 people, and had 20-plus organisations involved at different stages of the process.”
CONCEPT DEVELOPMENT
After this stakeholder input, the team moves into the concept development phase. Gus Thomas explains: “Normally products tick a few of the boxes, but they don’t factor in the wide
There is no getting away from the design challenges in mental health – more often than not you have conflicting safety, maintenance, and clinical needs
spectrum of requirements. We want to tick all the boxes and only compromise where it does not have a major impact on the fundamental aims of the product. Key to the en-suite door was when we took an earlier stage sliding door concept to the Design in Mental Health exhibition in 2016. We quickly realised there were some flaws with the design, but it created a talking point and allowed us to tease out what issues were, or were not, important. We had 20-25 people come over and fill out research questionnaires prioritising design issues. The perfect product doesn’t exist, so you have to make compromises along the way. We use the customer feedback to decide where best to flex.”
Having understood the limitations of existing solutions, and received feedback on the first concept, we took an engineering-led approach and identified four key design insights from various stages of prototype development.
They were: l Design insight 1: Two hard surfaces meeting creates a ligature point, and even creating a gap between hard surfaces doesn’t eliminate the danger. A simple example of this is having a 50 mm gap
between the door and the frame. However, simply wedging a shoe, a towel, or a knotted bedsheet, quickly overcomes this ‘safety’ feature.
l Design insight 2: The next concept the team developed used flexible rubber doors to eliminate the two hard surfaces. However, we learned from early prototypes that soft materials can be picked at or manipulated using everyday tools to create ligature points in the time between observations. One particular example of stabbing the rubber door leaf with a biro created a makeshift ligature point in a matter of seconds.
l Design insight 3: While load release then became essential, day-to-day practicality was required to avoid frustration for the staff or the service-user, so the door needed to open and close in normal use without accidental detachment.
l Design insight 4: Clients told us that loose items could be weaponised. For example, foam doors could be used as an effective battering ram when folded – so we decided that lightweight, flexible materials were safer. Gus Thomas, who led the development of the door leaf, says of the process: “The final leaf design was one of the more challenging aspects of this product. It took a long time and a lot of prototypes. We probably made and tested over 50 different leaf shapes and manufacturing techniques to try to ensure that the door cannot be weaponised. Most of these were unsuccessful, but we kept
Safehinge Primera says that ‘rather than taking existing solutions and merely trying to make incremental improvements’, it ‘tries to solve with a blank canvas, and decide the best approach based on the design brief’.
‘In-house’ tests include kicking and jumping on the frame mounts to ensure they do not come loose or break, and a DH-recommended mallet test. JANUARY 2018
24 THE NETWORK
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