Issue 2 : Wayfinding in the ED

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1. Define in 10-20 words.

  • Process of using spatial and environmental information to find our way in the ED without getting lost or taking too much time to arrive at our destination.

2. Research: What information were you able to find on the web or from readings?

  • Addition of signage resulted in a 13% increase in rate of travel, a 50% decrease in wrong turns, and a 62% decrease in backtracking across the five settings. (O’Neill, Environment and Behavior, Vol. 23, No. 5, 553-574 (1991))
  • A study at Univ of Wisconsin – Madison used an experimental design with 3 conditions – no signage, textual and graphic. Graphic signage produced the greatest rate of travel, but textual signage was the most effective in reducing wayfinding errors, such as wrong turns and backtracking. Overall, the addition of signage resulted in a 13% increase in rate of travel, a 50% decrease in wrong turns, and a 62% decrease in backtracking. (Effects of Signage and Floor Plan Configuration on Wayfinding Accuracy – Michael J.O’Neil)
  • Ensuring visibility of the destination for each trip within the process of a hospital visit is a key to make patients' wayfinding easy. Departments should be placed so that patients' can see the next place to go. Light courts and atriums are useful for providing both horizontal and vertical visual access as well as comprehension of the overall structure. Whether the staff can use visual explanations such as "go to that place over there" could be a possible indicator of good design. (Hospital Planning and Wayfinding – Kawashima and Hirotaka)
  • From the Experts: Visuals are important.

3. How can the problem be measured?

  • Timed trials for patients/family members to get to different parts of the ED on their own and study the paths traveled
  • Do there need to be tightly secured areas?
  • Where are the patients being escorted and where are they directed?
  • How many options does the patient have to move?
  • How many places do patients more independently?
  • Where does the family go?

COMMENTS: Ackerman There are few places I want patients to go without escort. As a general rule patients are taken to radiology and other parts of the hospital rather than having to find it themselves. Family members and friends on the other hand don't usually have an escort. Many of the places they want to go (e.g. the smoking area, the cafetiria) I don't know where they are so I can't direct them. Other way-finding issues - how do I get home after discharge? Where is the nearest (or on my way home) 24hour pharmacy? Where do I go for my follow-up testing/clinic visit? Within the ED the common destinations are - telephone, bathroom, water/food and where is my stretcher/room?