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PROCEEDINGS i COPYRIGHT © 2013 Royal College of Art All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Every effort has been made to ensure that the advice and information in this book is true and accurate at the time of going to press. However, neither the publisher nor the authors can accept any legal responsibility or liability for any errors or omissions that may be made. In the case of drug administration, any medical procedure or the use of technical equipment mentioned within this book, you are strongly advised to consult the manufacturer’s guidelines. ISBN: 978-1-907342-70-7 Conference supporters: Megaman Charity Trust Fund, Design Science Conference partners: Helen Hamlyn Centre for Design, Hong Kong Design Centre, The Hong Kong Polytechnic University ii CONTENTS Page Session 1A – Transport and Travel 1 Better Healthcare Delivery - Ambulances that don’t (always) Transport Patients 2 Ed Matthews, Gianpaolo Fusari Approaches to Developing Creative Future Mobiltiy Solutions By Applying Inclusive 11 Design Strategies Ben Meyer, Brigid O’Kane Wayfinding for Visually Impaired Pedestrians 20 Theresa Beco De Lobo An Inclusive Wayfinding Assessment Tool in the context of Singapore’s Public 30 Transport System Shereen Sze-Wan Pong Shopping fresh food in the future: Are transportation choices available to future seniors? 39 Satoshi Kose Session 1B – Digital Interactions 47 People-Centred Desktop Design and Manufacture: a review of web enabled open source 48 tools for localised community focused inclusive design Scott Mayson Where do you go to...? Designing ‘connectedness’ in digital public space 58 Claire McAndrew, Ben Dalton, Bridget Hardy GIS-Participation: An Inclusive Design Approach 68 Graeme Evans, Steve Cinderby Can a crowd sourcing app for those with chronic conditions lead to innovative 77 design solutions? Lisa Austin, Christopher Eccelston Towards an Empowering Tangible Interaction Design for Diversity 87 Birgitta Cappelen, Anders-Petter Andersson Session 1C – Global-Local 98 Shifting Perspectives - Design for ASHA health workers in rural India 99 Arnab Chakravarty, Samiksha Kothari Challenging the Standard: designing schools for women in Afghanistan 103 Elizabeth Golden Framing the Temporal Territory of Inclusivity: Cultural Reflections on Finnish Design Heritage 113 Fahrettin Ersin Alaca Mapping the Common Ground: Inclusive Playscapes for Children in Jerusalem 123 - From Global to Local Tali Cohen Anderson Understanding user experience in persuasive systems as a way of informing the design of 133 inclusive health systems - an example of on-line diabetes self-management systems for Chinese older adults Shuk-Kwan Wong 1 Session 1A Transport and Travel 2 PAPERS Better Healthcare Delivery – Ambulances that don’t (always) Transport Patients Ed Matthews and Gianpaolo Fusari, the Helen Hamlyn Centre for Design, Royal College of Art, UK This paper outlines a design case study of an emergency healthcare vehicle carried out at The Helen Hamlyn Centre for Design at the Royal College of Art in London. Ambulances are key in transporting patients and delivering healthcare, but an interesting aspect of this project is delivering a breakthrough for the social innovations are becoming necessary to deliver safe, cost-effective healthcare. There are huge challenges in the demographics of ageing, society’s ability to fund the healthcare that we shall increasingly need, and the healthcare that is potentially available if sufficient wealth can be allocated to take advantage of it. The surprising realisation from the project work is that by improving ambulances and equipment to deliver better Urgent Care to the patient where he or she is, resources can be used far more effectively and we can avoid transporting patients unnecessarily, especially if they do not need Emergency Care. This in turn helps to promote social innovation through a more efficient, less monolithic hospital system, where patients can receive the right treatment in the right place at the right time – an intelligent approach, but one that is not necessarily easy to achieve. 1 3 PAPERS Designing better things for people is the focus of the Helen Hamlyn Centre for Design, which was founded in 1991 to consider design that includes older people. Foreseeing the ageing demographic that we are now so conscious of, the initial DesignAge project looked at design for our ageing population and alerted industry and the design profession to the far-reaching implications worldwide. For Saab – we designed an accessible car for older drivers, and for Safeways – a jar, that’s easy to open and easier to grasp on the shelf. Since then we have developed design thinking to address a range of social problems in the areas of three research labs. Age & Ability: design for a more inclusive society irrespective of age and ability, Workplace & City: research into changing patterns of work and urban life, and the lab where this project is based, the Healthcare & Patient Safety lab: creating better and safer healthcare services and products. The essence of the methods is to work with as many ‘users’ and to research and design together with them. We look for the involvement of industry – as we cannot make a difference, or ‘Bridge the Gap’, if the design work does not result in a product or system change that gets to market and is adopted. The lead author, Matthews, had 30 years in design consultancy before joining the Centre. His experience was that unless the client was very visionary, the designer was usually given a brief, (something such as “We want it in time green for next year”) and the client waited to see what came out, either monitoring and collaborating to some degree, or just waiting until the work was presented. On the ‘Double Diamond’ model of the design process described by the UK Design Council in 2005, the definition of the brief lies halfway along the timeline, and consultancy projects will usually deliver concepts in 4, 6, maybe 12 weeks at the most. In contrast, our projects are set up on longer timescales, and with briefs that are more a research question than a prescription. Our Research Associates programme teams recent graduates from the RCA with an industry partner for a year. The first six months are spent doing research with users, analysing it - with users - to create an evidence-based design brief. We then co-design with users, make mock-ups and prototypes, and then get our users to evaluate them. Then we use their feedback and iterate the process – getting something right usually takes three iterations. In 2003 we undertook a study for the UK Department of Health: a system-wide, design- led approach to tackling Patient Safety in the UK National Health Service (NHS). Human beings naturally make mistakes, and in healthcare the root cause of the majority of mistakes is the flawed system. The resulting report (a booklet snappily packaged to look like a blood bag) was endorsed by the Chief Medical Officer, and the Centre was honoured by the Ergonomics Society in 2005, receiving the President’s Medal for the work. Based on widespread stakeholder engagement, with designers visualising to help to map-out healthcare and supporting systems, the conclusion was that we need to involve design thinking at the start of the 2 4 PAPERS innovation process. It led to recognition of problems in the approach to design within healthcare and paved the way for our subsequent healthcare projects. Following that work, UK National Patient Safety Agency (NPSA) grew in scope, recruited a design manager, and started to use design as way of understanding and addressing patient safety issues. They had noticed a rise in adverse incident reports from ambulance services. The pivotal point was an accident where a young woman with a medical problem and psychiatric complications decided to get out of the ambulance when it was rushing her to hospital on blue lights at 70mph, and she was run over and killed by her mother who was following the ambulance in her own car. Whilst the NPSA knew anecdotally that design shortcomings might be a contributory factor, they needed some help to understand the true nature of the problem and wanted ideas as to how design could remedy the situation. The work on this ambulance project began in 2005. Initial research showed that ambulances had just evolved incrementally from horse carts used in the Crimean, and the American Civil War, to carry away soldiers injured at the front line. There had been very little critical examination or considered thought as to what the treatment space should be in order to support current, scientific evidence-based clinical thinking, and meet the existing needs of patients and paramedics. The result is that what we have today is a badly laid out, un-ergonomic environment that is full of storage spaces and furniture that create dirt traps and hazards both to patient and clinician. Ten ‘Design Challenges’ were identified, outlining areas where design intervention could improve safety. The work fed into an ambulance standardisation programme as until 2006 there were 29 separate UK services, each buying inconsistent designs according to personal preferences. Almost all of them exhibited design issues. As a result of the programme, there are 11 trusts today, of which five or six procure to the same specification. Another positive outcome was the securement of research funding to take on a broader, system-scale challenge. The UK government had taken an initiative to train advanced paramedics, or Emergency Care Practitioners, beyond usual ambulance crew skill levels, but there was no thought given to better the equipment that they were using.