Point of View

Prerequisites for Effective Wayfinding Design in Healthcare Environments

Wayfinding design is the design of the system as a whole, rather than its individual elements. The individual elements come together to form a system that adheres as much as possible to the principles of universal design.

Design for all, universal access, and inclusive design are terms for approaches that primarily aim to enhance the accessibility of the interactive system for the broadest possible range of users

It can be concluded though that there is little or no consensus regarding the definition and use of the concept, and con- sequently, there is a risk of bringing less accessibility to the target audience. (Åhman, 2014)

Universal Design

The term "universal design" was originated by Ronald L. Mace, a prominent architect, product designer, and educator. He defined universal design as the practice of creating products and environments that cater to the needs of individuals irrespective of their age, abilities, or socio-economic status

Universal design originates from the concepts of Barrier-free design and accessible design, as proposed by Mace. He suggests that what may be barrier-free for one individual might present a barrier for another. The complexity of this design challenge is such that even experts struggle with it. Merely eliminating the barrier is insufficient; designers need to consider the issue from a more comprehensive perspective. (Åhman , 2014)

The universal design definition is ‘‘The design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design’’ (Connell, et al. 1997)

To further elucidate this definition, the 7 principles of universal design were established (Connell, et al. 1997)

  • Equitable Use: The design is beneficial and appealing to people with a range of abilities.

  • Flexibility in Use: It is designed to suit numerous individual preferences and abilities.

  • Simple and Intuitive Use: This design is straightforward to comprehend, no matter the user's level of experience, knowledge, language proficiency, or concentration.

  • Perceptible Information: The design effectively conveys essential information to the user, regardless of external conditions or the user's ability to perceive sensory information.

  • Tolerance for Error: This design aims to reduce risks and lessen the negative outcomes of any accidental or unintended use.

  • Low Physical Effort: The design enables effective and comfortable use, requiring minimal effort.

  • Size and Space for Approach and Use: The design offers adequate size and space for easy access, reaching, handling, and usage, suitable for users of all body sizes, postures, and mobility levels.

It should be viewed as a design framework rather than a benchmark, as the 7 principles are described too broadly for assessment. It can also serve as a framework for Wayfinding Design, but we would prefer to establish more specific requirements that can be empirically verified. However, there is often a lack of empirical evidence regarding what works and what does not.

Our POV on the prerequisites of wayfinding design in healthcare

Drawing from our extensive experience with wayfinding projects in hospitals, as well as our own research findings and those of others in the academic field, we have identified the initial four prerequisites for wayfinding design in healthcare. As our understanding deepens through ongoing experience and the continual evolution of academic knowledge, these prerequisites are subject to change.

Wayfinding Design should aim to maximize wayfinding efficacy.

It might seem obvious that the purpose of wayfinding design is to ensure people reach their desired destinations. However, in practice, this is often not the case. Wayfinding Design is not thoroughly tested. This means the entire system isn't evaluated for effectiveness or performance. Individual components might be tested, like the readability or comprehensibility of a sign, or a few routes might be assessed, but these are just a limited number of elements in a comprehensive design.

Therefore, we rely on what science tells us about which tools work and which don't. In 1993, Butler et al. found that signage is very effective, but using "You are here" (YAH) maps doesn't significantly improve wayfinding efficacy within buildings. However, not all signage is the same. For instance, there's a big difference between having 20 directional signs at a decision point versus just one.

The same goes for the use of maps. It matters whether you consult a YAH map or carry a map with you while navigating the building, and whether the map includes a pre-marked route so that the user doesn't need to plan the route, or if the YAH indicator dynamically moves with you on a digital map, etc.

The scientific consensus is that allocentric aids are more complex than egocentric aids, making the latter significantly more effective.

Take outs:

  • So refrain from offering YAH mounted maps at entrances or inside the facility, or maps that people can take along, maps on the website, etc

  • Signage is a good idea, but only make sure that at choice points there are not more than 4 directional information items, but still offering directions to all destination inside the hospital.

Wayfinding Design Aimed at Enhancing Wayfinding Experience

When discussing Wayfinding Experience, we focus on cognitive load (the mental effort required to use the system) and whether its use leads to increased stress and anxiety. The system has to be empathetic, and human centered.

Signage

In signage, excessive information use seems to cause cognitive overload, leading to increased stress and anxiety. Therefore, signage with an abundance of textual information should be avoided. Typically, this is done by omitting textual directions, which is not ideal. Designers often opt to code destinations using a letter, number, or a combination of both.

Numerical coding appears to be most effective and to impose the lowest cognitive load, but this still needs to be confirmed by research.

Maps

Research indicates that using maps, both analog and digital, results in significant cognitive load. Adding audio/visual prompts (location-based push notifications) seems essential to enhance both effectiveness and cognitive load, assuming the technology works with high accuracy, which is more an exception than the rule.

Mobile Phone

It is complex for patients to process two interfaces simultaneously: between the patient and the space, and between the patient and the device. Therefore, it's crucial that the cognitive load induced by the wayfinding tool is minimized. User tests show a strong preference for photo navigation over mobile maps with location tracking.

What are your hospital's wayfinding Costs of Confusion?

The costs associated with wayfinding problems for patients and visitors can quickly add up, reaching as much as $250,000 or even exceeding $500,000 annually, depending on various factors.

Eyedog has developed a calculation model that employs 20 parameters to deliver an accurate top-down estimate of the yearly costs attributable to wayfinding difficulties.

If you're interested in receiving this survey, please contact us. The survey takes about 5-10 minutes to complete and serves as an excellent starting point for developing your business case