Design is a process that creates ideas and delivers new products and services. It helps businesses and the public sector shape their ideas so that they deliver practical, attractive and useful propositions that people want to buy and use.
At its heart, design is the process of translating ideas into reality. Whether it's being used to develop a new service, a piece of graphic marketing material or an innovative product, a number of key attributes underpin every design-led project. The Design Council illustrates these attributes using a model called the Double Diamond.
The Double Diamond model illustrates how designers work through four key stages. First, they open up space for lots of different ideas to be discovered and shared. Then by focusing on user-needs they help identify and define priority areas to address. Next, a designer will develop multiple prototype solutions based on the opportunity areas identified and finally, they will focus on distinct objectives and manufacturing or other constraints to deliver a final solution.
You can use the design process to ...
Discover and explore issues
Good designers spend time with the end-users of the products and services they create and involve them in the process of designing and making. They do this to understand what it is that people actually need and want, rather than make assumptions. Through this process, designers often uncover latent as well as known needs. This ensures what they create is useful, useable and desirable.
To understand how frontline staff and patients experience violence and aggression in A&E, and what leads to such behaviour, ethnographic researchers spent time interviewing and observing people using A&E for the Reducing violence and aggression in A&E project. By working with experts including managers and staff at three NHS Trusts, emergency care specialists and organisational consultants, researchers developed a clear picture of issues faced by frontline staff. The research conducted in the discovery phase of the design project helped them establish that improving people’s experience of the service – individually and collectively – will help to improve their behaviour.
A design-led innovation process can help managers, planners and clinicians create a modern NHS, centred around high quality patient care, staff safety and cost savings through increased productivity. Design can help you develop integrated QIPP plans and improve performance against A&E clinical quality indicators.
Define a problem and establish the project agenda
The next stage of the design process acts as a filter where the review, selection and discarding of ideas takes place and where findings from the Discover stage are analysed, defined and refined as problems.
Design focuses on creating the best possible responses to real human needs so it is intrinsically a very collaborative process. Designers will collaborate with a range of people – from users and frontline staff to investors and experts – and bring together a multidisciplinary team to identify and tackle all of the issues involved.
Evidence on violence and aggression in A&E, collected during the initial research phase of the Reducing violence and aggression in A&E programme, was analysed alongside insights generated from ethnographic research. A set of priority objectives, intended results and a picture of how designers could help deliver solutions was established. When defining the opportunity areas for design solutions they recognized that:
- The current system tries to contain the high level aggression and violence, rather than tackling the root causes and low level frustrations.
- Violence and aggression doesn’t only come from patients, but also concerned friends or relatives. At present, very little is done to address their needs.
A set of design briefs were created which asked multidisciplinary teams to respond to the opportunity by explaining how new systems, services, products, communications, buildings or experiences could be designed to improve the patient experience of A&E and lead to lower levels of violence and agression.
Develop ideas
During the Develop stage, the design team together with key partners (such as engineers, developers, programmers, and marketing teams) and internal teams will refine one or more concepts that will address the problems or issues identified during the Discover and Define stages.
Design development methods used here include creative techniques and methods such as brainstorming, visualisation, prototyping and testing. Through visualisation, designers synthesise often complex ideas which helps communication and understanding with users and other stakeholders.
Designers begin building and testing prototype solutions early in the development process. This iterative approach means solutions are refined and improved many times before they are rolled out – a process known as prototyping. Prototyping helps iron out any errors and issues before money is committed to fully implementing a solution. This mitigates risk, since the solution is less likely to fail having been tried and improved many times.
For the Reducing violence and aggression in A&E programme, a team of designers working with researchers, specialists in organisational dynamics and clinicians generated ideas for new communication systems, staff services and secure spaces.
The design team created computer models, mockups and initial prototypes to test their ideas in real A&E departments and get feedback from staff and patients. Feedback on initial prototypes helped the design team develop their concepts further and begin to establish criteria for evaluating the success of their final solutions.
When developing concepts they worked on the understanding that solutions needed to:
- Acknowledge that people attending A&E are in physical and emotional pain
- Manage people’s expectations of the service
- Make sure that people understand the system they have entered into.
Deliver solutions
The Deliver stage of the double diamond design process is where the final concept is taken through final testing, signed-off, produced and launched.
It will result in a product or service that successfully addresses the problem identified during the Discover stage. It will also include processes for feeding back lessons from the full design process to inform future projects, including methods, ways of working and relevant information.
This Reducing violence and aggression in A&E toolkit has been developed to allow NHS managers across the country to iterate and refine the new solutions to meet the needs of their specific situations.
An evaluation framework has been established to monitor how staff, patients and visitors to A&E interact with new design solutions, how they affect their experience of A&E and how levels of violence and aggression are affected. It has been developed alongside the design concepts to support their adoption. When delivering design solutions as part of the Reducing violence and aggression in A&E programme, the designers recognised that any solutions need to be retrofittable in every A&E across the country, regardless of department size, design or layout.