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Wayfinding in Healthcare Periodically Ehc is engaged to conduct work “above and beyond” the traditional campus master plan. Wayfinding is one of those issues with which facilities often struggle, and the result of poor spatial orientation leaves patients, visitors with frustration and a disappointing first impression. Looking back at client studies, the disconnect typically comes By JAMES G. between the desire EASTER, JR. to create an envi- Principal, Easter ronment where Healthcare respect, care, Consulting (Ehc) treatment and healing had been the watchwords and instead creating a maze of doors, elevators, hallways, signs, bells, intercom messaging, large, unfriendly waiting areas, open holding areas, equipment parking, crowded care spaces, and unfamiliar faces. In newer replacement facilities, these conditions have been significantly improved and often eliminated, but many older hospitals still face the wayfinding problem. The future of healthcare transformation points to smaller and more family friendly facilities. This paradigm shift is occurring at a rapid rate as systems merge, consolidate and re-distribute resources into more nimble and accessible shorter stay, ambulatory care styles of design and construction. In our earlier planning engagements, we learned that leadership was extremely frustrated with this growing list of complaints that they received from

patients, guests, family members separate admitting and billing and friends. A loss of customers entrances. For those onsite to became a concern as well, since visit an admitted patient, the newer facilities just didn’t seem to routing might be easier, but have the same problem. Many of the security process could be a the complaints related to signage, nightmare. access, flow patterns/hallways, We have found that on an crowded rooms, slow elevators, acute care campus of medium safety/security measures, inconsize there are 30 or more desvenient disruptions and an overtinating points one might seek all “unwelcoming” image. These out. The good news is there are are also the factors mentioned by a number of ways to reduce the clients when describing the need stress and avoid the negative to conduct a campus master plan experience by improving the (CMP). What are the differences situation. First, assess the situbetween a CMP and a wayfindation, interview the stakeholding plan (WFP)? ers, study the campus conditions A CMP Leads to major hos(buildings, roads, entryways, pital improvements, relocation of signage and existing conditions) departments and the re-sizing of and carefully record the visual Art pieces can add both beauty and a geographic reference point. services. Hallways are re-routed implications. The resulting and major spatial conditions are images tell a story that begins the walkways and pathways, but without the improved. A CMP is more expensive. initial improvement process. benefit of a CMP. A WFP leads to signage updates, The first, immediate intervention for directional support, facelifts, technology this dilemma requires a detailed WFP. The apps and process improvements leading analysis begins with a 40,000-foot look at to better practices and changes in human the market through programs like Google behavior. A WFP is less expensive. Earth and MapQuest to see the regional In most cases, the original hospital aspects of the campus in relationship to that was constructed some 40+ years ago, the larger community. Wayfinding begins has grown exponentially over the years, on the drive from home to the hospital and evolved from the “place where you with community considerations includwere born” to the larger, unwieldy caming signage and bus routes and continues pus you are now visiting. Buildings have with campus considerations including been added, adjacent to other buildings, directional assistance to parking lots and and hallway connectors and elevators garages, front door drop-offs, emergency haven’t been developed to define clear entries, and a myriad of other destinations and navigable traffic routes. The building in and around what might have become has become a “campus of multiple builda sprawling campus with medical office ings,” and the hospital has grown into a buildings, outpatient clinics and imaging “new town environ” made up of numercenters, a freestanding cancer center or ous, diverse buildings and services – all rehabilitation space, laboratory or even vying for entry/exit, convenient linkages,

A Case Study Interviews with stakeholders are revealing and often paint a picture of the campus that is both process and people oriented. The ability to capture this message and relay it to the board of directors, who are typically the ultimate decision-makers when it comes to allocating funds, is key to implementing a wayfinding master plan. Below are several quotes from initial interviews with a hospital client in the Atlanta area, which was a classic example of the smaller hospital that grew into a major campus: “Floors don’t align, elevators are poorly designated, and destinations aren’t understood by staff.” “Why can’t we have clear maps and floor plans with routes designated without extraneous materials?” “Can’t find the Mother/Baby area, and the cafeteria is in an off-beat pathway to the basement.” “All signs are different, seem to be in conflict, and the lighting is horrible.” “We love the plants and flowers and the sculpture … helps us find our way back from the basement.” “We were here to visit my mom, took forever to find the elevators and then we waited and waited.” To address these concerns and improve wayfinding, Ehc took the following 12 steps: • Review the existing CMP, WFP and Strategic Plan (SP ) … integrate the findings, goals and objectives. • Communicate the “agreed to WFP Process” to ensure awareness and understanding of actions to be taken along with best-in-practice milestones. • Inventory existing exterior and interior signage (record visually and prepare impressions). • Identify the words and terms used for messaging (seek consistency and simplicity of message). • Re-align placement of signs, hierarchy of message, building character, and directional imagery. • Prepare a comprehensive interior finish, artwork, and graphic standard. • Develop criteria and recommendations for facelift, branding, and community image enhancements. • Prepare WFP orientation maps, instructional materials, and conduct volunteer staff training. • Work on “wellness” incentives to encourage building user modifications and fitness measures. • Explore music, art and cultural themes that benefit the traveler who is making the trip. • Develop a “green” and sustainability theme for the community. • Develop “universally understood” methods and conduct routine WFP updates.

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Well placed, clearly marked signage is a staple of effective wayfinding.

There are also excellent tools and resources to help with the process. The Veteran’s Administration has developed an “Integrated Wayfinding and Recommended Technologies” program. This report is one of the best example of best practices for the public and private sector. In the introduction, the VA suggests: “An expanded definition of the term wayfinding recognizes that visitors use multiple cures and tools to find their destination … from the spatial relationships manifested by the architecture to the lighting and the interior spaces. A new class of wayfinding tools has emerged with the technology revolution. Global positioning systems (GPS) devices, websites, apps, and on-site touch screens can be effective tools to help people along their journey. The smartphone has become our own personal navigation device.” With forethought and planning, there is no reason why facilities … even those that have grown convoluted over years of expansion … can’t significantly improve wayfinding and the overall experience for patients, visitors and staff.

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