Find­ing your way around a hos­pi­tal

Way-find­ing isn’t just about sig­nage any longer

Modern Healthcare - - Front Page - Andis Robeznieks

Ac­cord­ing to Craig Knowles, three out of four peo­ple vis­it­ing a hos­pi­tal are head­ing to­ward a des­ti­na­tion they’ve never been to be­fore. Not sur­pris­ingly then, he says, one of the big­gest com­plaints hos­pi­tal vis­i­tors have is get­ting lost.

“Most peo­ple who are com­ing to your hos­pi­tal have never been there be­fore and are very stressed,” says Knowles, gen­eral man­ager of Log­icJunc­tion, a Beach­wood, Ohio-based soft­ware com­pany spe­cial­iz­ing in hos­pi­tal wayfind­ing tools. “Hos­pi­tal build­ings get placed wher­ever they find real es­tate, and then a cam­pus can just grow and grow. Ev­ery­one is al­ways build­ing and tear­ing down or mov­ing.”

Log­icJunc­tion started in Atlanta and then moved to the Cleve­land area and got into the hos­pi­tal way-find­ing busi­ness around 2009 with a cus­tom-built touch-screen kiosk at Lake Health’s West Med­i­cal Cen­ter in Wil­loughby, Ohio. “At Lake West, they had to shut down the main el­e­va­tor in the hos­pi­tal,” Knowles re­calls, so the in­for­ma­tion was in­putted into the wayfind­ing kiosk and vis­i­tors were given al­ter­nate routes. In­struc­tions are given via text or au­dio spo­ken by an on­screen avatar that has mul­ti­ple lan­guage op­tions.

Log­icJunc­tion then recre­ated that ap­pli­ca­tion in trip­li­cate with three kiosks in­stalled at Lake Health’s TriPoint Med­i­cal Cen­ter in Con­cord Town­ship be­fore tack­ling its first megapro­ject: Cleve­land Clinic.

“The Cleve­land Clinic has many, many build­ings and is al­ways in a state of flux,” Knowles says, ex­plain­ing that the way-find­ing sys­tem there keeps track of the ever-chang­ing land­scape and has be­come a pop­u­lar tool for new staff ori­en­ta­tion.

The com­pany is now do­ing the same at 615-bed Sara­sota (Fla.) Me­mo­rial Hos­pi­tal, which is in the mid­dle of a $250 mil­lion, 220-bed re­place­ment ren­o­va­tion pro­ject that in­cludes a new $186 mil­lion pa­tient tower.

“They’re build­ing a huge ad­di­tion right in the mid­dle of ev­ery­thing,” Knowles says, ex­plain­ing the need for a so­phis­ti­cated way-find­ing tool.

Al­though Log­icJunc­tion’s tech­nol­ogy can send travel in­struc­tions as a phone text mes­sage or as an e-mail, Knowles says iPhone ap­pli­ca­tions may not be worth the cost (about an ad­di­tional $150,000 to $170,000) just be­cause of the de­mo­graph­ics of the tar­get au­di­ence.

Not all way-find­ing el­e­ments are high-tech. They can in­clude your stan­dard direc­tional signs and, for cam­puses that evolved in a some­what hap­haz­ard fash­ion, they can in­cor­po­rate new ar­chi­tec­tural fea­tures that help tie to­gether dis­parate sec­tions and cre­ate a sense of unity.

“With new con­struc­tion, I find it to be a much eas­ier pro­ject than a ren­o­va­tion,” says Chris Bauer, man­ag­ing prin­ci­pal of fo­cusEGD, a Dal­las-based en­vi­ron­men­tal graph­ics de­sign firm, who de­scribes how land­scape fea­tures, art­work or atri­ums, ma­jor build­ing en­trances, cafes or other con­structed fea­tures can be used as land­marks that help ori­ent first-time vis­i­tors.

Bauer also rec­om­mends break­ing down large build­ings into “zones,” such as what was done with the 250-bed, 2 mil­lion-square-foot Seat­tle Chil­dren’s Hos­pi­tal, a seven-story struc­ture built into a hill­side that al­lows it to have en­trances on its first, fourth, fifth and sixth floors.

“Wher­ever you’re com­ing in from, you feel like you’re on the first floor,” she says, adding that the size of the 1953-vintage build­ing (retro­fit­ted in 1978) also in­creased the need for wayfind­ing. “Two mil­lion square feet,” she says. “The gen­eral pub­lic can’t get their arms around that, so it’s bro­ken into smaller zones.”

Of­ten, these can be sim­ply la­beled Zone A, Zone B and so on, but at Seat­tle Chil­dren’s there is the bal­loon zone, gi­raffe zone, rocket zone and whale zone. Sim­i­larly, in the process where the Na­tional Naval Med­i­cal Cen­ter in Bethesda, Md., is merg­ing with the Wal­ter Reed Army Med­i­cal Cen­ter in Wash­ing­ton to be­come in Septem­ber the Wal­ter Reed Na­tional Mil­i­tary Med­i­cal Cen­ter, Bauer says her team adapted by “learn­ing the lan­guage” and cul­ture of the mil­i­tary health­care sys­tem—even though they may have thought it wouldn’t be un­der­stood by a ma­jor­ity of the gen­eral pub­lic.

They also had to be sub­tle and sen­si­tive in chang­ing a Navy hos­pi­tal into an in­sti­tu­tion serv­ing all mil­i­tary branches. She says mil­i­tary­themed icons were cre­ated to guide vis­i­tors through the seven new zones of the hos­pi­tal such as the Hero Zone, which in­cludes trib­utes to dec­o­rated med­i­cal per­son­nel from each branch.

Bauer says they were asked to do the same for the new $394 mil­lion Naval Hos­pi­tal Camp Pendle­ton (Calif.) re­place­ment fa­cil­ity that is set to open in 2014, but she says zon­ing would not work there. So, in­stead, an “an­chor­ing” tech­nique is be­ing em­ployed us­ing the main north and south el­e­va­tor banks. “Not ev­ery tech­nique is ap­pro­pri­ate for ev­ery build­ing,” she says.

At the Vet­eran Af­fairs Depart­ment Long Beach (Calif.) Health­care Sys­tem’s new Blind Re­ha­bil­i­ta­tion Cen­ter, Out­pa­tient Clinic and Ed­u­ca­tional Re­source Cen­ter, a de­sign fea­tur­ing roofs with ex­tended canopies de­signed to mimic un­du­lat­ing waves was in­cor­po­rated into the new build­ings that quickly es­tab­lishes where the en­trances are while adding a uni­fy­ing el­e­ment to the cam­pus.

“We took the op­por­tu­nity at Long Beach to give them a whole new im­age and a whole new uni­fy­ing look to the front of their fa­cil­ity,” says Scott Mackey, as­so­ciate prin­ci­pal at Lee, Burkhart, Liu ar­chi­tects. “Signs are OK, but it’s a whole lot eas­ier to ori­ent your­self with a ma­jor ar­chi­tec­tural form—when you see those wave forms, it draws you to them aes­thet­i­cally.”

He calls the waves “a grand ges­ture” and notes how, orig­i­nally, the new fa­cil­i­ties were to be built on va­cant sites in­de­pen­dent of each other and with a hodge podge of build­ing fa­cades, but now there is “a struc­tural vis­ual iden­tity.”

Whether it’s an in­ter­ac­tive kiosk or the use of a de­sign el­e­ment, such as the rooftop waves used at a VA fa­cil­ity in Long Beach, Calif., be­low, way-find­ing has changed.

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