Objectives: We tested a modified co-design process to develop a set of high-level design principles for visual identification systems (VIS) for hospitalised people with dementia.

Design: We designed and ran remote workshops in three phases with carers of people with dementia and healthcare staff. In phase 1 we presented participants with scenarios based on findings from prior research, prompting participants to discuss their own experiences of VIS. Phase 2 used more future-focused scenarios, prompting participants to co-design improved VIS. In phase 3, a set of provisional design principles developed from our analysis of phases 1 and 2 data were discussed.

Setting: Online workshops.

Participants: A total of 26 carers and 9 healthcare staff took part in a pilot and three separate workshops.

Results: We identified a set of six dementia-friendly design principles for improving the effectiveness of VIS: 1) The hospital trust provides a professionally-trained workforce and an appropriate culture of care; 2) The symbol is easily recognisable and well understood; 3) Key personal information is readily available and accessible; 4) Key personal information is integrated into the Electronic Patient Record; 5) Relatives and carers are involved in providing key information and monitoring care; 6) The principles need to function as a system to be successful. Participants suggested that, in addition to the use of an identifier and key personal information, professional standards training, effective information and records management, and improved means to involve carers and/or families were key to the effective operation of VIS, leading us to expand a narrow understanding of a VIS.

Conclusion: Using scenario-led co-design approach can help trigger useful discussions with staff and carer groups, identify current problems with VIS, and develop a set of high-level design principles for their improvement. These principles reveal day-to-day frictions that require further attention and resolution.