SMART PODS TO RECONFIGURE URGENT HEALTHCARE DELIVERY

Lead Research Organisation: Royal College of Art
Department Name: School of Design

Abstract

Since 2001 government policy has created a new set of professionals, Emergency Care Practitioners (ECPs), and a new style of urgent healthcare provision to support the vision of a healthcare service designed around the patient. ECPs are paramedics and nurses with additional training to treat patients at home, in minor injuries units or to stabilise patients for transport to specialist clinical units. Although professional training has been developed for ECPs there has been no research to look at the technologies needed to support this new role. This project is looking at emergency and urgent care work in detail. We propose that supporting technologies can be delivered as Smart Pods with three components: a vehicle/docking system, a treatment (vehicle) unit and a treatment package system (equipment and consumables). The first stage of the project is to model the operational systems to determine the distribution of the vehicle/docking systems for the Smart Pods to deliver the right care at the right time in the right place. At the same time we will be working with clinical partners in the East Midlands and South West to look at 4-6 treatment types (including chest pain, minor head injuries, minor illnesses and falls). These treatment types will be analysed in detail in A&E departments, minor injuries units and ambulance services to look for similarities and differences in clinical practice to provide the framework for the treatment packages and initial data for the layout in the treatment (vehicle) unit. We will propose a standardised pathway for the treatment types and will use a simulation mannequin to test the clinical treatment unit layout in a laboratory with doctors, nurses and ECPs.We will start working on the design of the vehicle by reviewing the current systems and looking at distribution and delivery systems in other industries, e.g. military, car breakdown services, food delivery. We will look at how new emergency care vehicles are ordered, purchased and manufactured and compare this with other low-volume vehicle manufacturing (e.g. Lotus, Maclaren) to help us develop viable solutions. This information will be used to look at both manufacturing and purchasing issues to explore if the Smart Pods concept is viable.Vehicle engineering and associated systems options will be surveyed, in particular chassis/drive chain and intelligent vehicle technologies and we will consider sustainability issues in terms of full life-cycle energy usage. Computer models and animation scenarios covering the full range of proposed SmartPod applications will be developed. The final part of this first phase of the project will start to consider issues of implementation in more depth with patient groups representing people affected by a range of urgent and emergency care conditions. We will also consult members of the lay public, clinicians, and those involved in the planning for, managing, and evaluating urgent and emergency care to investigate views on change in the provision of urgent and emergency care and to identify any unanticipated challenges (e.g. political, organisational, cultural) in implementing change.

Publications

10 25 50
 
Description Harrow's research in mobility design includes complex, multi-stakeholder, evidence-based projects where the principal outcome is the artefact itself, reported in conference papers and invited presentations. This research built on Design for Patient Safety: Future Ambulance, a year-long study, initiated by NHS National Patient Safety Agency, to investigate how better design of vehicles and equipment could improve the safety of patients and ambulance staff. Harrow was Principal Investigator and supervised a funded PhD student. The Smart Pods project addressed the whole system of emergency and urgent pre-hospital care. It brought together research by clinicians, designers, social scientists, ergonomists and operations management analysts from four universities (Loughborough, West of England, Bath, Plymouth) and resulted in a range of innovative propositions to enable clinicians to take healthcare to the community and reduce patient journeys and hospital admissions. The project responded to changes in policy necessitating a reconfiguration of urgent care using a new group of healthcare professionals, Emergency Care Practitioners. These are trained with additional skills to take healthcare to the community, reducing hospital visits and achieving high levels of patient satisfaction. Until now, ECPs have been using out-dated and inappropriate equipment. The system comprises three levels: treatment space, treatment packages and vehicle systems to make the components fully mobile within the community. Research activities were developed in four work streams: operations management and procurement, ergonomic analysis of clinical activities, vehicle design and the socio-technical framework. The system was exhibited at 'EPSRC Pioneers 09', UK (2009). Related publications included Harrow et al., Improving Patient Safety (2008). Harrow and Thompson (RCA) presented the project at 'Healthcare Design.09', USA (2009). Smart Pods were featured in the London Evening Standard, Daily Mail, Autocar and Nursing Times.
Exploitation Route The work addressed the changes in staffing and in patient needs within the National Health Service, focusing on modular solutions to eliminate unnecessary journeys to Accident and Emergency and make more efficient and safe those journeys that are necessary. Its findings are relevant to anyone considering A&E provision and patient transport.

The work was taken forward by Harrow and colleagues in a follow-on project.
Sectors Communities and Social Services/Policy,Healthcare,Transport

URL http://researchonline.rca.ac.uk/1602/
 
Description The research undertaken in the EPSRC Smart Pods project fed directly into the design research project Redesigning the Emergency Ambulance funded by NHS Innovation Fund. This has produced a tested prototype - now the subject of further funded development - and stimulus to rethink patient transport for more efficient use of resources and better patient care. Significant non-academic publicity was attracted including broadsheet newspapers and BBC television as well as specialist periodicals.
First Year Of Impact 2011
Sector Healthcare,Transport
Impact Types Societal,Policy & public services

 
Description Horizon 2020 - Research and Innovation Framework Programme
Amount € 69,375 (EUR)
Funding ID 644329 
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 01/2015 
End 08/2015
 
Description NHS Innovations London
Amount £150,000 (GBP)
Funding ID NHS London Regional Innovation Fund 2009-10 Final Submission 
Organisation NHS Innovations London (NHSIL) 
Sector Public
Country United Kingdom
Start  
 
Title Prototype Emergency Ambulance 
Description A prototype Emergency Ambulance was built, supported by follow-on funding after the EPSRC Smart Pods project ended. A full-size testing rig was constructed alongside an appearance model. The clinical team defined protocols for consistent, measurable clinical evaluation. Three separate evaluation sessions measured specific outcomes throughout the study: 1. A potential to achieve fewer healthcare-acquired infections (HAIs), measured by a reduction in contamination incidents during scenario-based testing. 2. Fewer adverse incidents and equipment failures, measured by a reduction in treatment time and mitigated clinical incidents during scenario-based testing. 3. Improved patient experience - measured by increased patient ratings. The evaluations have demonstrated a reduction in time taken to complete certain treatment stages by 37%-50%. Cross-contamination infection instances within the treatment space were reduced by 69%. A 10% improvement in staff Technical Skills scores through better ergonomics was recorded. Modest additional funding has been gained from the EC Horizon 2020 Research and Innovation Framework Programme (H2020-ICT-2014-1 call). This is intended to lay the groundwork for a further larger funded project. 
Type Support Tool - For Medical Intervention
Current Stage Of Development Initial development
Year Development Stage Completed 2013
Development Status Actively seeking support
Impact Engagement with NHS commissioning bodies through workshops and conferences. 
URL http://www.rca.ac.uk/research-innovation/research/current-research/redesigning-the-emergency-ambulan...
 
Description EPSRC Pioneers 09 Showcase Event (exhibition, London Olympia) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact PIONEERS 09 was an EPSRC exhibition in March 2009 at the Olympia Conference Centre.

From the EPSRC website (Accessed 25 October 2014):
"ABOUT THE EVENT
Pioneers09, EPSRC's showcase event, aimed to connect leading university researchers with UK business and industry. Featuring the latest research from over 20 UK universities, the event also provided networking opportunities and information on EPSRC funding.

PROGRAMME
A programme of keynote speakers, seminars and debates examined the impact of science and engineering on our economy and society, and how building relationships between universities and businesses can bring huge benefits to all.

HANDS-ON EXHIBITION
The Pioneers09 exhibition showcased an impressive range of research tackling major challenges such as climate change and improving quality of life for our ageing population. Interactive stands meant that delegates could see, hear, feel and take part in the exhibits."



Visitor numbers for this activity are not known. It is assumed that a significant number visited the exhibition, which was widely noticed in the media.
Year(s) Of Engagement Activity 2009
URL http://www.epsrc.ac.uk/newsevents/pubs/pioneers-09-connecting-business-with-pioneering-research/
 
Description Healthcare on the Move 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The exhibition at the Royal College of Art, Healthcare on the Move, addressed the discrepancy between the needs of patient transport and current solutions by showcasing new directions. These will enable emergency care practitioners and other healthcare professionals to assess and treat more people in the community, instead of taking them by ambulance to hospital.

This achieved publicity in blogs and other media. It was part of a broader strategy to engage a wide community with potential innovations in patient care and transport.
Year(s) Of Engagement Activity 2009
URL http://smartpods.jimdo.com/exhibitions-1/healthcare-on-the-move/
 
Description NHS Innovation Exposition 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact From the Innovation Expo site
The Innovation EXPO will be a unique event that brings together the private, public, voluntary, academic, and scientific healthcare communities in an innovative environment. The EXPO will have high profile speakers, thinkers and practitioners, such as Edward de Bono and Martha Lane-Fox. It's going to be a large and interactive event and will cover over 5000sqm at ExCel Centre in London Docklands, with over 80 major exhibitors, 20 keynote presentations and more than 60 seminars spread over 2 the days. The event will offer thousands of frontline staff, local influencers and decision makers across the NHS and social care the opportunity to learn, discuss, experience and share innovation.

Publicity was achieved, stimulation of discussion, and requests for further information / involvement.
Year(s) Of Engagement Activity 2009
URL http://www.institute.nhs.uk/index.php?option=com_sm2emailmarketing&task=showarchivemessage&id=164&It...