By Pam Sethi, Ian Chalmers & Katrina Chiu

Navigation, or “wayfinding”, is a critical aspect of the healthcare experience, shaping the way patients, caregivers, hospital staff and visitors perceive and experience the quality of care they receive. A positive hospital interaction can leave the main users – patients – feeling supported and satisfied with their recovery, improving their trust in healthcare providers and the overall healthcare system. However, a difficult journey in an already stressful environment exacerbates the discomfort and anxiety of accessing healthcare services. The onus is on a well-planned navigation system to provide both patients and staff with adequate information and intuitive communication to get patients from place to place.

At Pivot Design Group, we set out to address this multifaceted problem at North York General Hospital (NYGH) in Toronto. Through a combination of design research, human-centered design practice, and a holistic approach to understanding patients, we explored various environmental, physical and emotional touchpoints and challenges that contribute to wayfinding obstacles. By identifying areas for further growth and opportunity, we proposed actionable and tangible design solutions to improve the patient and caregiver experience.

Over the span of a few months, researchers took a dive into collecting observational data – examining visitors’ interactions with the hospital space, and how they engaged with various directories and visual signage. We were able to observe their responses as they occurred organically, and make deductions based on verbal and non-verbal cues, such as body language and emotional signals (e.g. distress, frustration, ease). We constructed six emerging themes to frame and organize our data: visual directories, staff touchpoints, use of space, accessibility, tone and setting, and physical attributes.

Taking a holistic approach to understanding the patient, caregiver or family member experience, we also considered key pre-arrival planning and preparation activities prior to arriving at the hospital. This challenged researchers to conceptualize wayfinding problems beyond the normal scope of research. The team layered additional data to the exploration by including interviews with staff volunteers, which allowed us to better understand their experiences and challenges. In their interviews, staff volunteers noted the most common pain points and areas of concern based on their direct interactions with patients and visitors (e.g. inconsistent language of medical terminology, hallways with no directions), most of which confirmed our previous observational findings.

Our approach is unique in that human-centered design requires a thorough deliberation of the patient’s journey from start to finish. In the context of a hospital, what did the patient undergo prior to their arrival that would warrant for extra guidance or reassurance? What are they most likely to pay attention to? Is the visitor satisfied with the overall experience? This higher-level abstraction was challenging, but also pushed our thinking to take notice of pain points that would have otherwise gone unnoticed. Accessibility was a stand-out theme amongst the observation sites – NYGH’s community makes up a broad range of demographics and come from varied racial, ethnic, and socio-economic backgrounds;  the hospital’s signage should be tailored to a diverse community, particularly for those unfamiliar with medical environments and terminology.

When reviewing our findings, we were able to distinguish between short-term and long-term implementation for proposed solutions. Simple interactions in key areas, like noticing patients often approaching staff or other visitors asking for the time, pointed to what could be accomplished with incremental, quick changes to the physical space. Adding clocks in key high-traffic areas is an example of a simple and cost-effective solution to help alleviate the anxiety of waiting and time-related pressures experienced by visitors.

We also proposed long-term solutions. For example, for high congestion in key entrances with overwhelming and unclear signage, we considered the option to implement an onsite, a digital interface directory or other tools such as a virtual concierge desk that could be widely used wayfinding resource. This long-term solution could act as a first point of reference upon entry, and provide general wayfinding support for the rest of the visitor’s journey. Without centering around the patient’s hospital journey using a design lens, these small-scale but significant nuances would likely have been missed.

The wayfinding initiative shows the importance of conducting informed design research to find diverse solutions that cater specifically to patients’ feelings, needs and experiences. By applying empathy and taking a patient-centered approach, we were able to develop unbiased and objective forward-thinking suggestions and future measures that will benefit the patients, visitors, and caregivers of NYGH throughout their hospital system journey. Although just a first step in the process, Pivot Design Group hopes to continue our contributions in piloting a few of the practical recommendations that emerged from the original initiative, bearing in mind the critical intersection of healthcare systems and human-centered design.

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