Before they even enter A&E, patients can be hit with a series of negative and time consuming experiences. Where do they park their car? How long will they have to buy a parking ticket for? Where will they meet their family if they’ve been brought in by ambulance? Experiences like these can leave people frustrated and more likely to behave aggressively.
By working with designers, hospitals can deliver a service that extends beyond the A&E department’s doors, that is convenient and easy to use and understand. By designing clear parking systems, developing a service that helps people with mobility problems get into A&E or signposting the route to A&E clearly, the space outside the hospital can make the entire hospital experience less frustrating, and therefore less likely to provoke violence or aggression.
Visitors arriving at the hospital for the first time may not know where to find the A&E department and since they are likely to be in a heightened state of stress and anxiety they may not be able to focus on signs directing them. Getting lost or having to ask for directions to the department increases a visitor’s frustration and impatience.
At Great Ormond Street Hospital, Landor Associates designed simple new systems as well as more structural changes to enhance access to different parts of the hospital. At Birmingham Heartlands Hospital, the main entrance to A&E is visible as soon as the building can be seen and attention is drawn to it with clear, bold signage.
“A pedestrian crossing, controlled where appropriate, should be used where a walkway crosses a road within the site. Clear signs are essential, advising drivers to give priority to those crossing.”[Reference: Department of Health, Improving the patient experience: welcoming entrances and reception areas, 2004]
Visitors may arrive at A&E by ambulance, or using their own transport such as car or bike. If they cannot find a secure place to leave their vehicles they can get frustrated. The cost of parking near A&E can also be a frustration and while Trusts can consider providing discounted fees or alternative compensation for A&E visitors that need to use the car park they may also work with designers to develop new services that increase the value of the parking system.
Just as airports allow a separate check-in or fast track system for first class customers, A&E systems could be designed for patients arriving by ambulance to be checked-in a different way.
Designers could help you redevelop space outside the A&E department to enable drop-off areas near the department entrance or they might suggest making porter chairs or wheelchairs, that are fitted with magnetic brakes or RFID tags to stop them being removed from hospital grounds, available at the car park or drop off areas.
“Whatever provision is made for smokers, there should be proper arrangements for dealing with smokers’ litter. Special containers should be obvious but discreet in appearance, and, if possible, smoking areas should be deodorised. Containers should be cleared frequently, cleaned and maintained in good order. Cigarette ends, matches and other litter should be removed.” [Reference: Department of Health, Improving the patient experience: welcoming entrances and reception areas, 2004]
Designers will help you develop spaces and services that meet real customer needs. For instance, a proportion of visitors to A&E are expected to be smokers and the increased stress of visiting A&E is likely to increase their desire to smoke. Sheltered smoking areas, that are clearly signposted, should be made available to enable waiting people to relieve some stress.
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Use the links below to find out more about the triggers of violence and aggression at other stages of the patient's journey through A&E and how procuring design can help make A&E safer for staff and patients