In every hospital I have ever set foot in, I easily got lost. The signs and maps on the wall did not always lead me to where I needed to be, and indoor Google Maps still does not seem to be a thing, no matter how long I wait. If I were lucky in these instances, I’d stumble across someone who could give me directions. However, others could not always help me get to where I needed to be.
The need to ask someone for the right direction may be a minor inconvenience in the grand scheme of things, but it becomes problematic when help is not readily available. Think about situations such as needing to find the ER, elevator, or even the closest restroom. Wrong turns and missing room numbers are rather common in healthcare buildings, and maps do not immediately reflect relocated spaces. There’s nothing more frustrating than being late to a lecture or meeting because you just could not find the room.
I knew I was not the only one who felt this way, because I had to help numerous individuals who were lost at Stony Brook University Hospital. New interns, medical students, and visiting professors all seemed to share the same sentiment — finding ways within the hospital should not be this complicated. Hospitals may not always be the most welcoming places for visitors, but efforts should be made to minimize transit-related frustrations.
The failure of “wayfinding” — the informational system that helps people navigate space — is a systems issue that is frequently ignored in the hospital. How one wastes time finding their way may not be a major concern to management compared to controlling for infectious diseases on the general medicine floor or reducing door-to-imaging time for stroke patients. Yet we must recognize that system issues, such as wayfinding, should not be ignored because preventable frustrations can add up and eventually affect every user of the system. There is no reason to add undue stress to an already stressful environment that everyone is in.
I began to further understand how pervasive this issue is when I saw how it sets up a systemic barrier for individuals with disabilities. As I listened to patients and family members, I was informed that optimizing pathways can be difficult at times because wheelchair-accessible elevators are not always nearby. Signs and arrows were often unintuitive and at times incorrect, leading them in the wrong direction. Reading them multiple times was common, and sometimes they only added to confusion, even though they were meant to be helpful and straightforward.
I initially blamed these wayfinding issues on poor architectural design, simply thinking that the way spaces were allocated was not created with those who navigated them in mind. However, even the most well-mapped floor plans could be difficult to navigate if the arrows pointed oddly at dead ends, the maps did not include all the room numbers, and certain doors and rooms were hidden in a corridor, only discoverable by those who worked there.
Often, these inconveniences are easily ignored because they do not cause the whole system to fail. The best approach to tackle such a situation is to listen to those with the worst experience using the system and make quick modifications to improve the experience. Designing signs and arrows that make sense is much easier and cheaper than building a new space from scratch.
If we consider hospitals to be places of healing and spaces that welcome patients and visitors, we must pay close attention to environmental factors, such as wayfinding, and minimize uncertainty. Perhaps we, as clinicians, have long neglected factors beyond those that impact our immediate clinical duties. The ongoing emphasis on situational awareness must consider how user-friendly the hospital is for everyone, not just in the clinical workspace.
I would encourage taking proactive steps to prevent recurring small issues as we notice them. Have you been tricked by that same arrow on the way to your noon conference? Was that room number on the map updated when your department relocated? When was the last time you got lost on the new floor, even though the administration had informed everyone that there shouldn’t be any confusing signs?
We won’t be able to solve every environmental issue in the hospital, but the space can always be improved when we, as users, actively give feedback to those who design it. We may not have regarded ourselves as users of the hospital system, but patients are definitely not the only users. We, as physicians, should consider ourselves users and actively voice our opinions about what we notice. Our perspectives on these problems could certainly change the way everyone else experiences the issue we have all been facing for too long.
Who knows? Your pitch to the administration could help that one patient or colleague who lacks direction finally get on track and not be late to the meeting again.
What wayfinding frustrations and successes have you experienced at your hospital or clinic? Share below!
