How design supports health care wayfinding

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Wayfinding is the process of orienting yourself in space and finding your way from point A to point B. Health care facilities are notoriously complex spaces, especially facilities where growth and expansion often create misalignment between new circulation and existing routes. As a result, wayfinding in health care facilities can be challenging, especially when people are not feeling well, or have physical, cognitive or visual impairments. 

And we all can relate to the stress involved in visiting a new doctor, arriving for a procedure at a different facility or visiting a loved one in an unfamiliar hospital environment. While you may not get lost, the stress of figuring out how to get somewhere can impact the rest of the experience. 

The Center for Health Design’s Knowledge Repository includes numerous studies on wayfinding, three of which are highlighted here. 

A narrative review by Jamshidi and Pati provides a good overview on the foundational theories behind wayfinding in health care and explains why there is still such a great need for research in this area. The authors propose four ways to categorize the different aspects of wayfinding: theories of perception, theories of spatial knowledge development, theories of mental representation of spatial knowledge and theories of spatial cognition. While visual perception is an obvious component of navigation, this review explains the more nuanced cognitive processes that play a role. 

Understanding the cognitive processes involved in wayfinding is especially pertinent in design for dementia-friendly environments. A two-part study from the Netherlands by van Buuren and Mohammadi first examines the theories behind wayfinding for seniors with dementia, then assesses several different inpatient residential care facilities using wayfinding design criteria. The researchers were able to identify certain floor plan typologies that facilitate wayfinding, highlighting how different characteristics of the corridor play a key role in the wayfinding experience.

Several methods have been used over the years to better understand how humans navigate an unfamiliar route. In their study, Ghamari and Goshany used “gaze tracking” with a mobile eye-tracking device to capture where users were looking as they navigated through a health care facility. This technology allows researchers to map the points where the visual gaze moves — they could essentially see through the users’ eyes as they traveled different routes. They found that users looked at signs and architectural features longer and more frequently than other types of information (e.g., maps or artwork) during wayfinding tasks. It’s also interesting to consider these findings in the context of the cognition aspects of wayfinding discussed by Jamshidi and Pati.

The design of the health care environment can either help us find our way or literally send us down the wrong path. A better understanding of the cognitive processes we go through when navigating the health care environment can help us design spaces that ease wayfinding, reducing unnecessary stress and irritation for patients, visitors and even health care staff. To read more on wayfinding and other health care design topics, visit the Knowledge Repository by accessing the link in the box above.

About this column

“Design Discoveries” highlights research from The Center for Health Design’s Knowledge Repository, a user-friendly library of health care design resources. This research effort is supported by the American Society for Health Care Engineering, the American Institute of Architects, the Academy of Architecture for Health Foundation and the Facility Guidelines Institute.