Different ways to approach wayfinding

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Finding one’s way in an unfamiliar place is a complex decision-making process that is subject to a myriad of influences. Three recent research studies available through The Center for Health Design’s Knowledge Repository explored wayfinding using different techniques.

First, Morag and colleagues examined the wayfinding requirements of people with diverse needs using a phased process that included a review of literature, rating architectural features and quantifying values for architectural elements. Twenty-eight college students (13 with mobility disabilities and 15 with cognitive disabilities) were recruited to navigate a route from a hospital’s main lobby to a second-floor clinic. Each participant was accompanied by a researcher who recorded participant feedback at decision points along the route.

Visual affordance (i.e., visibility) was the most influential feature for both mobility and cognitively impaired individuals compared to other architectural factors considered. Another interesting finding was that neither participant group selected the shortest route, suggesting that different user groups have different orientation preferences. This study highlights the complexity of wayfinding research and outlines a structured process that can be expanded to include a broader variety of features and users.

In another study, Cai and team extended their wayfinding study outdoors. Seven months after the renovation of a hospital’s drop-off zone, entrance canopy, entrance lobby and connecting path between the parking garage and the new lobby, researchers used campus maps and facility plans to create axial maps representing a holistic arrival experience. The team then conducted observations of traffic and pedestrian movement in the respective areas. They integrated space syntax data (e.g., axial mapping and heat maps) with observation data (e.g., user profiles and behaviors) to form a nuanced appreciation for how the space functioned.

This not only served as a post-occupancy evaluation but also provided insights into how the redesigned space was uniquely meeting the needs of different user groups. Both the traffic and pedestrian mapping demonstrated high wayfinding intelligibility due to the correlation between connection and integration values. The findings reinforced the importance of designing arrival zones with a holistic perspective.

Finally, a team led by Asli explored preferences regarding visual cues (i.e., stripes) in a health care environment. Researchers created six different versions of a hallway photograph: three differed by the color of visual cue (warm, cool or a combination) and the other three differed by the location of visual cue (middle of the wall, bottom of the wall or on the floor). Adult participants were recruited from a hospital laboratory waiting room to answer questions on their wayfinding ability (navigation, orientation, spatial anxiety and distance estimation) and indicate which photo of each set they preferred.

Young adults (19-34 years old) preferred mixed color stripes on the floor; early middle-aged adults (35-49 years old) favored warm colored stripes in the middle of the wall; and late middle-aged adults (50-65 years old) preferred warm colored stripes at the bottom of the wall. Participants’ self-assessment of their wayfinding abilities was highest in the young-adult group. In general, findings indicate the need to accommodate a variety of stakeholder groups with varied cuing preferences.

Using evidence in design can facilitate user navigation of complex health care environments. To learn more about this and other topics, go to The Center for Health Design’s Knowledge Repository. 

Research used for this column

The following research citations from The Center for Health Design’s Knowledge Repository of health care design resources were used by the author when writing this column:

• I. Morag et al., “Improving Wayfinding in Hospitals for People with Diverse Needs and Abilities: An Exploratory Approach Based on Multi-Criteria Decision Making,” Applied Ergonomics, vol. 114 (2024): article 104149.
• H. Cai et al., “Exploring Campus Configuration and Patient Arrival Behaviors at Large Hospitals: An Integrated Post-Occupancy Evaluation (POE) Protocol,” HERD: Health Environments Research & Design Journal, 2024, in press.
• A. A. Asli et al., “Adults’ Visual Cue Preferences and Wayfinding Abilities in Healthcare Centers,” HERD: Health Environments Research & Design Journal, vol. 16, no. 3 (2023): 104–18.

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.