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What makes hospital wayfinding so complex?

First, it is important to determine what is meant by wayfinding. Depending on whom you ask, the definition usually focuses on signs. However, a sign is only a device to facilitate navigation, a tool for communicating information. So, a more accurate definition of wayfinding is the process of cognitive mapping, a sense of spatial orientation used to find our way from place to place, and the ability to remember and recall that information when the journey is repeated.

The complexities in hospital wayfinding can be categorized into three distinct areas:

1) cognitive recognition

2) human behavior, and

3) architecture.

Neuroscience and Wayfinding

In 2014, a team of neuroscientists was awarded the Nobel Prize in Physiology or Medicine for identifying cell structures in two areas of the brain. “Place cells”, or areas of the brain that create maps of our environment had been identified in the 1960’s. More recently, the team discovered another area of “grid cells” that constitute a coordinate system that allows for spatial navigation. Together, these two areas of the brain constitute a comprehensive positioning system, essentially an individual’s on board GPS. It provides each of us a sense of place, and the ability to remember pathways we experience; processes critical for finding our way. Therefore a wayfinding program needs to take into consideration not just WHERE to place signs, but HOW people interpret information.

Human Behavior and Wayfinding

Staff and employees familiar with protocol and procedure and the physical limitations of the building, are often unable to comprehend the obstacles that confound visitors. Medical, cultural, and local or regional naming conventions can obscure rather than clarify meaning. Alterations to the building, new technology, and trends in popular culture often result in new naming conventions. For personnel employed at the facility for any significant time, letting go of legacy terms can be difficult. The South Wing will always be the South Wing, no matter what you decide to call it today.

Architecture is Only Part of the Solution

Informed spatial planning defines buildings that work and the success or failure of future building users (Evans and McCoy, 1998). Spatial planning, articulation of built elements, and circulation system design are commonly the responsibility of architects, site designers, the engineering team, interior designers, and building owners and administrators. Unfortunately, most architects and designers are not trained in wayfinding design. These team members may underestimate the need for wayfinding expertise and internal wayfinding leadership, and overlook the detailed, long-term vision that wayfinding requires. In addition, many may not be properly informed of government codes and sign-related regulations and requirements and may not understand how an integrated wayfinding program can promote facility use and customer satisfaction.

Successful Wayfinding Programs Address Each Category

Wayfinding is the art of using landmarks, signage, pathways, and environmental cues to help first-time visitors navigate and experience a site without confusion. These cues should be well planned, seamlessly connected and aesthetically pleasing so visitors have a positive first impression highlighted by a sense of security, comfort and well-being. Multidisciplinary design teams can create visual cues and landmarks, lighting, art, and architectural features that embed wayfinding into the very core of the building to create more intuitive pathways. Such a plan would consider each of the complexities outlined above with equal importance. The cost of implementing such a plan, far outweighs the costs associated with the distractions to your staff and employees, the negative impact on your brand, and the added hardship and anxiety for your patients.

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