The power of wayfinding: how to make or break a hospital’s brand.

Written by:
  • Adam Longo, Head of Urbanite

Recently, I found myself lost and desperately trying to find the maternity ward in time for my son’s birth in one of Sydney’s biggest hospitals.

In the moments before becoming a first-time father, I found myself reminded of one of the most important rules of hospital experience design: keep users who may be anxious, stressed or panicked top of mind.

As you can imagine, I wholeheartedly confirm this is a good rule to follow.

After 20 minutes of stress and anxiety while trying to orientate myself and use the wayfinding system to no avail, I had to resort to asking a staff member to escort me to the right department (they also had to ask for directions).

Just like that, my experience and opinion of that particular hospital became negative before I had even arrived at the place I was looking for.

For someone with a background in hospital experience and wayfinding design, having this frustrating experience left me wondering what effect this was having on other users. And how many were experiencing the compounding negative effect it has on the general experience with the hospital and its brand.

Wayfinding is typically addressed as an afterthought and the impact it has on the overall user experience of spaces is sometimes not fully appreciated until it’s too late. This is multiplied within healthcare facilities, where not being able to find the location you’re searching for can literally be a matter of life or death.

The birth of your child. Saying goodbye to a loved one. They’re not exactly minor life experiences, and they’re certainly not things you’re going to be OK to miss because you can’t find your way.

My experience during this brief frantic period exemplified the critical importance of wayfinding in health environments and the power it has on the branded experience of an institution.

A lot of the time with wayfinding, if you get it right, nobody will notice. But if you get it wrong, the opinion and the experience of that institution will be destroyed, with visitor behavioural analysis from the US indicating that bad wayfinding leads to one of the, ‘biggest sources of stress within hospitals for both patients and staff’. [1]

Inefficient wayfinding systems have been credited as costing facilities up to $220,000 per year in lost staff productivity[2].  And studies have shown that 95% of users identified wayfinding as being ‘extremely important’ to a successful patient and visitor experience. The frustration of getting lost is also ranked among the top complaints in the majority of hospitals.

With stakes this high, it’s important to see wayfinding systems for health facilities as not just signs, but as integrated and cohesive wayfinding systems. They need the intent to get people from A-B but they also need to calm, engage and soothe.

It’s not just about putting in ‘more signs’, with many sources of frustration in hospitals stemming from, ‘not that there aren’t enough signs, the problem being that there is too many’[3] .

While signs do form part of the system, they need to be layered together with user journey mapping, graphics, placemaking, intuitive cues and digital overlays to truly be successful. It’s the layering of these different experiences along the entire user journey from before you leave your home, to the moment you reach the particular bed bay you’re looking for which create truly successful, unique and brand-enhancing experiences.

Here are my top five wayfinding insights to consider in a healthcare setting.

1. Wayfinding planning needs to start at home.

To truly understand the complete user journey experience, when starting a project we examine the full sequence and the decisions that are made as part of that journey. It’s our aim to make decisions clear and simple, and particularly in a healthcare setting, these decisions need to be made instantly when arriving at a decision point.

This sequence does not just start when a user enters the site but should extend into the initial decision making point; their home. Through using graphics on items such as appointment letters or confirmation emails, elements such as pictograms, colours and forms can start to give hint at what the person should look for when approaching the site. Right through to helping them understand which gate or entry is best suited to the destination they’re approaching.

This is a first touchpoint to introduce a wayfinding system to the user, including incorporating consistent messaging and directional ques that will also be referenced on signage when entering the site. This allows opportunities to introduce elements of the wayfinding system to users before they have even started their journey and begun building the initial elements of mental mapping.

Particularly important for elderly or accessible users is communicating drop-offs or parking facilities closest to their destination to minimise the travel distance when on site. It’s this level of consideration that’s important and is the bedrock for setting up the best wayfinding experience possible.

2. User journey mapping is critical.

With many researchers finding that, ‘the traditional use of signs has failed to overcome the problem of wayfinding in hospitals’[1], communicating non-verbally in healthcare facilities is extremely important. Typically this communication needs to be done at a distance far greater than just physical text can display. Through working with architects at the onset of a project, we can establish intuitive wayfinding cues integrated within the architectural design.

In his seminal book The Image of the City[2], Kevin Lynch argued that people who are unfamiliar with environments tend to orient themselves through the use of ‘mental maps’ and to elements they recognise have meaning. People understand spaces through recognisable elements that provide legibility and emotional security of being in familiar territory. These elements may be as simple as a lowered bulkhead signifying [AL1] a reception desk, a particular door or wall detail at department entry points, or an architectural feature at external entry points that can clearly be identified hundreds of meters away.

It’s the process of looking at user journey mapping to see which key touchpoints are needed, and implementing intuitive ques within the environment that can help identify the points in a non-verbal or descriptive method. Research has shown that one of the key frustrations with hospital wayfinding is inconsistency[3]. If department entry signage all looks different in terms of form, scale, graphic language and positioning, how would a user intuitively know that they are entering a department? Or if the user cannot read English, how do they know they have crossed a particular threshold?  These intuitive ques help solve these problems by adding a consistent layer to the wayfinding system that crosses lingual boundaries.

3. Using environmental graphics reduces stress.

Hospital terminology and nomenclature is long and confusing. At its basic core, a sign with just words should not be solely relied upon. Wayfinding systems need to address vision impaired and multi-lingual requirements and should allow for some form of navigation with non-written cues.

The use of environmental graphics and colours, along with pictograms representing departments and areas, adds another layer to the hospital wayfinding experience. If a user in a hospital knows the department they’re searching for has a fish pictogram representing it, then they can simply follow the fish pictogram to their destination without the need for the written word.  This is done particularly well in enhancing children’s hospitals where departments can take on the lives of the pictogram characters which represent them. And while adding a playful overlay for children, this adds a more colourful and intuitive wayfinding element for adults.

Colour can be used to delineate floor or wing groupings allowing users to know that they are staying in the red wing area as opposed to a lengthy Diagnostic Cardiology and Radiography Treatment Wing.

Large scale environmental graphics can also be included to actively display the function of the department through the action depicted in the graphics. They can also take on the character of elements unique to that hospital’s location. A good example is the Northern Beaches Hospital in Sydney, which treats each department as a unique piece of flora.

In particular, blue and green landscape graphic tones have been proven to, ‘provoke evolutionary psychological emotional responses to images of flourishing natural environments’[1] within hospitals.

4. Digital overlays tie everything together.

The use of digital wayfinding has been prevalent in healthcare for many years in the form of digital map kiosks and department listings. With the recent hesitations around public touch screens and the resurgence of QR codes due to the COVID pandemic, digital wayfinding solutions are now moving away from the traditional digital touch screen. They’re now taking the form of a ‘grab and go’ digital system which allow the user to quickly orientate themselves at a location, then have information ‘thrown’ to their mobile device. They can then take the info with them on the journey towards their destination. These systems have been traditionally used at University campus locations but are now becoming more common in healthcare facilities.

While digital overlays can aid in the functional aspect of wayfinding, they can also add to the user experience of hospital settings. Typically seen in children’s hospitals, interactive and engaging digital walls and installations add character and placemaking opportunities to locations, adding a sense of play or level of interest not typically seen in healthcare settings.

The use of digital within these healthcare facilities should never be underestimated as a method for storytelling, reducing anxiety and stress for users and reducing operational costs when functionality, such as auto check-ins are incorporated into them.

5. Wayfinding is critical for positive user experience.

Healthcare facilities are critical and sensitive locations where wayfinding is the first opportunity and ‘front door’ of the experience. It has the power to create a positive catalyst throughout the entire site experience, or inversely, forever taint it.

When my wife was in the maternity ward at the height of COVID restrictions and I couldn’t stay with her, I ended up walking back and forth to the car park about 50 times. It wasn’t until about the 20th time that I started to memory map my route due to the large amount of identical corridors and spaces. Each time I took this journey, I constantly envisioned implementing the initiatives mentioned above and imagined the change in experience and satisfaction it would deliver every user who entered the doors of the hospital.

At Urbanite our process is to work with architects, developers and stakeholders as early as possible in the planning process to embed these initiatives into every project to ensure they have a successful experiential and wayfinding ‘system’. Not just, ‘more signs’.

Although a year ago, those 20 minutes of stress and anxiety I experienced – the thought of potentially missing the birth of my son – is the first thing I think of whenever I hear that particular hospital’s name. My story is testament to this and is a constant driver for us to ensure we are always putting the user experience at the forefront.

1 “Wayfinding in Hospitals: Solving the Maze” J. Carpman (1986) Society of Environmental Graphics Designers Annual Conference Summarized by Sherri Lankford Jacksonville State University

2 “Poor Healthcare Wayfinding has Hidden Cost for Healthcare Wayfinding” H.Augur (2018) www.kontakt.com https://kontakt.io/blog/healthcare-wayfinding-in-hospital/

3 “The Hospital improves the health of its signage” D.Christen (2020) www.invivomagazine.com ,< https://www.invivomagazine.com/en/mens_sana/innovation/article/204/the-hospital-improves-the-health-of-its-signage>

4 “Wayfinding : embedding knowledge in hospital environments “ Rooke, Clementinah Ndhlovu, Tzortzopoulos, Patricia, Koskela, Lauri and Rooke, John (2009) In: HaCIRIC International Conference 2009 – Improving healthcare infrastructures through innovation, 2-3rd April 2009, Hilton Metropole Hotel, Brighton.

5 Kevin Lynch, “The Image of the City”, The MIT Press, 1960

6 “Modern Healthcare Mega Complexes Are Getting So Large That People Are Actually Getting Lost Inside Hospital Buildings”, Uncredited (2017) wwww.medilita.com <https://www.medelita.com/blog/lost-inside-hospital-mega-complexes-wayfinding>

7 “Visual art in hospitals: case studies and review of the evidence” L.Lankston (2010), JR Soc Med 103(12): 490–499.

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