Improving signage to properly explain the ‘process’ that patients will go through on arriving in A&E, and make waiting times less frustrating, and working with frontline NHS personnel to support their interactions with patients dealing with a difficult situation, can significantly improve patient experience, and reduce non-physical aggression and hostility towards staff in such environments, a report has confirmed.
In April 2011 the Design Council and the Department of Health launched a national search for design teams to ‘re-think the design of hospital A&E departments in a bid to reduce violence and aggression towards NHS staff’ (HEJ – April 2011 and March 2012). A design team led by PearsonLloyd was then commissioned to look at how design could ‘create a better A&E by reducing anxiety and frustration which often leads to violence’. On 28 November last year, the Design Council, and microeconomics consultancy, Frontier Economics, published an impact evaluation findings report, Reducing violence and aggressions in A&E (downloadable in full at: www.designcouncil.org.uk/ aeevaluation) based around a ‘new, proven design solution’ devised by PearsonLloyd. The report showed ‘clear evidence’ that A&E departments could ‘improve patient experience, increase staff wellbeing, and save money’ via the two-pronged approach set out – a ‘Guidance Solution’ – signage to guide and reassure patients, and a ‘People Solution’ – a programme to support staff in their interactions with ‘frustrated, aggressive and sometimes violent patients’ through communications training and reflective practices. The findings were based on the ‘solutions’ being implemented, and the results evaluated, at two pilot Trusts – St George’s Healthcare NHS Trust in London, and University Hospital Southampton NHS Foundation Trust (UHS), over a 12-month period. Key findings showed:
• 88% of patients said the new signage ‘clarified’ the A&E process.
• 75% said that it made the wait ‘less frustrating’.
• Threatening body language and aggressive behaviour were halved.
• Offensive language and swearing fell by 23%.
• For every £1 spent on the design solutions, £3 was generated in benefits.
Based on the ‘positive outcomes’, the Design Council recommended that other Trusts adopt the designs, and the ‘solutions’ have now been implemented at five around England. PearsonLloyd has also established a standalone programme structure, including a dedicated website (www.ABetterAandE.com) to help implement the programme nationally.
