Dr Sue Hignett Architects for Health Designing for Impairment

Loughborough Design School

Ergonomics /

Human Factors (HFE)

Disability and Inclusive Design

Dr. Sue Hignett

Reader in Healthcare Ergonomics & Patient Safety


International Ergonomics Association (IEA)

� Scientific discipline concerned with the

understanding of interactions among humans

and other elements of a system, and the

profession that applies theoretical principles,

data and methods to design in order to

optimise human well-being and overall

system performance (IEA, 2000)


Ergonomics v Human Factors

� ‘ergonomics’ sometimes used to refer to interactions

with the physical environment

� ‘human factors’ sometimes used in connection with

psychological / organisational issues

� can not sensibly consider one without the other so

terms now mostly used interchangeably

Key words: safety, performance, comfort and satisfaction


Change in public perception of disability

� How much has it changed practice?

� What is the latest thinking about rehabilitation?

� What does it mean for design?

2012 Paralympics


Models of Disability

Medical Model: Individual physical or mental limitations

• Solutions are found by focussing on the individual

• Service provider prescribes and acts for a passive client

Economic model: Policy making

• Perception of a person’s inability to participate in work

• Assess the degree to which impairment affects individual productivity

Social Model: Effects of environmental, social and attitudinal barriers

• Prevention of participation in society

• Failure of society to adjust to meet needs and aspirations

• If a wheelchair user cannot use a bus….. the bus must be redesignedhttp://www.guardian.co.uk/news/datablog/gallery/2012/aug/31/paralympics-press-association-sport-graphics#/?picture=395465841&index=5


Accessible Design

� Meets mandatory requirements for accessibility

� Service specific user groups

Adaptable Design

� Readily adjustable when need arises

� Considers possible change of use during life span

Inclusive (Universal) Design

� Serves every user in the safest possible and most convenient way by providing for an independent and equal way of living

� Goes beyond the minimum requirements of accessible design

Design Approaches


What does this mean for design?


� Provide the same means of use for all users; identical whenever possible, equivalent when not

� Avoid segregating or stigmatising any users

� Provisions for privacy, security and safety should be equally available to all users

1. Equitable Use

The design is useful and marketable to any group of users

2. Flexibility in Use

The design accommodates a wide range

of individual preferences and abilities

� Provide choice in methods of use

� Accommodate right and left handed access and use

� Facilitate the user’s accuracy and precision

� Provide adaptability to the user’s pace


� Eliminate unnecessary complexity

� Be consistent with user expectations and intuition

� Accommodate a wide range of literacy and language skills

� Provide effective prompting for sequential actions

� Provide timely feedback during and after task completion

3. Simple and Intuitive Use

Use of the design is easy to understand, regardless of the

user’s experience, knowledge, language skills or

current concentration level


� Use different modes (pictorial, verbal, tactile) for presentation of essential information

� Provide adequate contrast between essential information and its surroundings

� Maximise ‘legibility’ of essential information in all sensory modalities

� Differentiate elements in ways that can be described (easy to give instructions or directions)

� Provide compatibility with a variety of techniques or devices used by people with sensory limitations

4. Perceptible Information

The design communicates the necessary information

effectively to the user regardless of ambient conditions

of the user’s sensory abilities


� Arrange elements to minimise hazards and errors

� most used elements, most accessible

� hazardous elements eliminated, isolated or shielded

� Provide warnings of hazards and errors

� Provide fail-safe features

� Discourage unconscious actions in tasks that require vigilance

5. Tolerance for Error

The design minimises hazards and the adverse

consequences of accidents or unintended actions


� Allow user to maintain a neutral body position

� Use reasonable operating forces

� Minimise repetitive actions

� Minimise sustained physical effort

6. Low Physical Effort

The design can be used efficiently and comfortably and

with a minimum of fatigue


� Provide a clear line of sight to important elements for any seated or standing user

� Make reach to all components comfortable for any seated or standing user

� Accommodate variations in hand and grip size

� Provide adequate space for the use of assistive devices or personal assistance

Appropriate size and space are provided for approach, reach

manipulation and use regardless of user’s body size,

posture or mobility

7. Size and Space for Approach and Use


Systems Engineering Initiative for Patient Safety


DIAL-F model with service users as active members in a falls management system

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HTA developed iteratively with visits to:

� Coronary Care Unit

� Medical Ward (Older People)

� Orthopaedic (Trauma)

Top level activities:

Falls Risks through the Eyes of an Older Hospital In-Patient: Hierarchical Task Analysis


Step 1: Decide to go to the toilet


Step 4: Locate the Toilet


� How much has it changed practice?

� Individual – yes (especially younger & sports players)

� Society – legacy design and plans to improve access

� What does it mean for design?

� Opportunity to make a step change from medical/economic models

of disability using accessible/adaptable design to….

Inclusive Design (social model of disability) as the

minimum standard

2012 Paralympics


Thank you

Dr Sue Hignett Architects for Health Designing for Impairment

Technology

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