This article has a correction
Please see: Safer by design
- Alison Tonks, associate editor
- 1BMJ, London WC1H 9JR
- atonks{at}bmj.com
While a badly designed chair might be a little uncomfortable, and a badly designed oven might test your ability to turn out evenly browned cakes, a badly designed piece of hospital equipment can kill you. In 2001, Wayne Jowett, a leukaemia patient in a UK hospital, died from an intrathecal injection of the intravenous drug vincristine. Intravenous and intraspinal connections were, and still are, interchangeable—a fundamental design flaw according to the chairman of the subsequent external inquiry.1 A similar design flaw contributed to the death in 2004 of a new mother who was given a bolus of bupivacaine intravenously instead of into her epidural catheter.2
In 2003, 16 year old Natalie Dibden died of a head injury soon after falling out of a badly designed ambulance.3 4 These tragedies and many others would never have happened in a world where hospitals, equipment, drug packaging and information, computer systems, and patient transport were specifically designed to prevent them—to protect patients from every conceivable harm, and particularly from human error. Cars, nuclear power stations, and aeroplanes are designed to be safe. They have to be. Rather belatedly, healthcare authorities all over the world are starting to learn from these industries and to think seriously about how good design can save lives.
Starting from scratch
It could be a long hard slog, according to a 2003 joint report by the Department of Health and the Design Council.[5 ] The report concluded that the NHS was complex, chaotic, and clueless about design.
“The NHS is seriously out of step with modern thinking and practice with regard to design. A consequence of this has been a significant incidence …
Sign in
Article access
Article access for 1 day
Purchase this article for £20 $30 €32*
The PDF version can be downloaded as your personal record







CiteULike
Connotea
Del.icio.us
Digg
Facebook
Mendeley
Reddit
Technorati
Twitter
Stumbleupon
Rapid responses
Latest Responses
Re: Ventilator associated pneumonia
Published 30 May 2012
Re: Restless legs syndrome
Published 30 May 2012
Author's reply
Published 30 May 2012
Re: Full access to trial data holds many benefits and a few pitfalls, conference hears
Published 30 May 2012
Restless Legs Syndrome: Fact or Fiction
Published 30 May 2012
Most responses
Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10 (12 responses)
Published 10 May 2012 - 23:32
The psychiatric oligarchs who medicalise normality (9 responses)
Published 2 May 2012 - 15:42
Are doctors justified in taking industrial action in defence of their pensions? No (8 responses)
Published 8 May 2012 - 12:21
Are doctors justified in taking industrial action in defence of their pensions? Yes (8 responses)
Published 8 May 2012 - 12:21
The hardest thing: admitting error (7 responses)
Published 2 May 2012 - 12:27