No previous systematic attempt had been made to rethink the ambulance as a workspace that allows clinicians to treat patients more effectively. Frontline clinicians and paramedic crews comment that their input is rarely sought to improve the design of the treatment space and little research has been published. Matthews built on his earlier research for Future Ambulance (NPSA, 2005–06) and Smart Pods: Taking Healthcare to the Community (EPSRC, 2007–10) to direct the design of a full-size ambulance interior treatment space. His distinctive contribution as an industrial design engineer was to lead on research into the ambulance as workspace, focusing on systematic approaches to patient safety and resulting in the Working Wall concept.
Matthew’s work identified instances of poor locations for equipment, illogical positioning of consumables, and infection-control hazards caused by difficult-to-clean areas and poor design. He observed ambulance crews on shifts, analysed observational data with them and produced evidence-based design briefs. A co-design process then proposed, ranked and developed solutions for iterative evaluation by clinicians, leading to the prototyping of the demonstrator unit.
The Working Wall lays out equipment and consumables along one interior wall of the ambulance treatment space. Items fall to hand as and when required during typical treatments, and new facilities (eg hand washing) are provided. Improvements in hygiene and infection control, clinical efficiency and technical performance were demonstrated through qualitative and quantitative methods, and evaluated in simulations.
Matthews wrote academic and trade articles (eg World Health Design Journal, Ambulance Today, 2011) and conference papers (eg ‘Include’, UK, 2011). The project won major awards from the Design for All Foundation (2013); Victor J. Papanek Foundation, Vienna (2012); Design Museum 2012 Design of the Year, Transport Award; Industrial Designers Society of America, International Design Excellence Awards (2012). BBC World interviewed Matthews about his innovation (2011).