Reducing violence and aggression in A&E

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How can we reduce violence and aggression towards A&E staff and make A&E a calmer environment for patients? This was the question posed by the Design Council as part of their Design Challenges initiatives. These challenges address society’s most complicated problems and through open competition, aim to support ideas that will have real social impact.

In partnership with with the Department of Health, the challenge was to try and understand why patients might become aggressive and what types of patients might be more prone to aggressive behaviour.

The outcomes have been the product of months of extensive ethnographic research across 3 NHS Trusts in England and analysis showed that people became frustrated because of a lack of clear, effective information and guidance combined with their anxiety and pain as a result of reduced tolerance levels.

From here, a multi-disciplinary design team, led by PearsonLloyd, took the findings and developed 3 solutions to improve the situation for both patients and staff:

1. The guidance solution

A comprehensive package of information about the department, waiting times and treatment processes via on-site environmental signage, patient leaflets, and digital platforms.

2. The people solution

A programme of reflective practice designed to better support NHS frontline staff to manage and learn from incidents of violence and aggression. See PearsonLloyd’s site A Better A&E for further details.

3. The A&E Toolkit

  • Improving patient experience in A&E
  • Perpetrator characteristics
  • Triggers of violent and aggressive behaviour in A&E
  • 10 lessons for reducing violence and aggression in A&E

The impact evaluation report on two pilot studies showed that 75% of patients found that the signage reduced their frustration during waiting times and that a staggering 50% reduction in threatening body language and aggressive behaviour occurred with implementation of the design solutions.

For more information, see the Design Council’s full article and watch the animation ‘Design a better A&E’.

SERVICE: Health Design Advice

Our Health Design Advice service, delivered with Health Facilities Scotland, helps those who commission new, or substantially redeveloped, facilities.

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