Study Report - 506-21-105.pdf

PROJECT # 506-21-105

FACILITY INTERIOR SIGNAGE REPLACEMENT

ANN ARBOR VAMC

ANN ARBOR, MI 48105

FACILITY INTERIOR SIGNAGE

REPLACEMENT STUDY

December 16, 2021

PREPARED BY

Facility Interior Signage Replacement Project: 506-21-105

FACILITY INTERIOR SIGNAGE REPLACEMENT STUDY

TABLE OF CONTENTS

EXECUTIVE SUMMARY

Project Objective Report Summary

PRINCIPLE 1 – The System Trains You as You Use It Findings Recommendations

PRINCIPLE 2 – Create a Mental Picture Findings Recommendations

PRINCIPLE 3 – Leverage Meaningful Redundancy Findings Recommendations

PRINCIPLE 4 – Keep It Simple Findings Recommendations

PRINCIPLE 5 – Meet the User Where They Are Findings Recommendations

EXECUTIVE SUMMARY

PROJECT OBJECTIVE

The objective for Project 506-21-105 is to replace and upgrade the interior signage and wayfinding systems within the VA Ann Arbor facility, specifically focused on buildings 1E, 1W, 28 and the East parking structure, to improve and modernize the wayfinding system for veterans, staff and all who use the facility.

The current interior signage system has not been assessed in several years.

Renovations, space use moves, and time have made a signage study, re-design, and upgrade necessary.

STUDY SCOPE OF WORK OVERVIEW

The project scope includes an Interior Signage & Wayfinding Study and subsequent Schematic Design, Design Development Documents, Construction Documents, Bid Documents, a Final Construction Release set of documents and Construction Period Services.

In November and December 2021, an Interior Signage & Wayfinding study was completed. The study assessed the following and is summarized in the enclosed report:

1. A comprehensive analysis of current state wayfinding difficulties, inaccuracies, etc.

2. A comprehensive set of recommendations for signage and wayfinding replacements, improvements, modernizations, etc. that consider ease of access, simplicity, VA hospital patients, code compliance as well as modern industry standards and innovations.

REPORT SUMMARY

The enclosed report outlines five key principles for best in class wayfinding systems:

1. The System Trains You As You Use It

A wayfinding system should be logically organized and easy to understand. Its organization should be systematic and repetitious and therefore easy to predict and anticipate what will be encountered as a user moves through a site. Such a wayfinding system allows a user to make a series of decisions about spaces which are unfamiliar to them.

2. Create A Mental Picture Through the process of wayfinding we orient ourselves to a physical environment in order to navigate through it. In order to do so, we must be able to create, in our mind’s eye, a mental picture of the unknown environment. To create this mental picture, individual areas within an environment must be memorable and distinct from one another. This allows a user create a sense of where they are at any given location based on context to the other areas.

3. Leverage Meaningful Redundancy The way that each individual approaches wayfinding through a space is unique to that individual, their relatable past experiences and their preferences for memorization. For some individuals, it is easier to remember written information such as words, letters or numbers, while others find it easier to recall visual elements like color and imagery. By deploying redundant memory aids that reinforce one another (ex: letter plus color plus visual; architecture plus interior design plus signage), wayfinding systems can appeal to a variety of individual preferences.

In addition, these redundant memory aids assist in creating distinct and memorable context (to support the principle of “Create A Mental Picture”) between important areas in the wayfinding journey. In order to maximize memorability, best practice is to utilize the same set of memory aids for a similar contextual objectives (ex: different floors, different elevators, different buildings, etc.).

4. Keep It Simple Successful wayfinding systems are so easy to use, we barely recognize the amount of decisions they enable us to make. These systems provide the type information we need exactly when we realize we need it in order to make decisions. The information is delivered in a way that is succinct, consistent and easy to scan utilizing simple terms that are easily understood by as many people as possible.

5. Meet the User Where They Are Effective wayfinding systems are designed to support the needs of first-time users traversing an unfamiliar space. These systems are broadly accessible and take into account audience characteristics such as visual acuity, emotional state of mind, technological adoption, etc. They deploy approaches that are mainstream in order to make unfamiliar experiences more relatable and familiar (ex: greeters at the main entrances, GPS navigation aids, etc.).

Based on the analysis of the VA Ann Arbor facility, key findings and recommendations are outlined below.

FINDING 1

The navigation system is fragmented and not aligned to a single framework.

RECOMMENDATIONS:

1. Align navigation tools to support the site’s six key decision points.

2. Update pre-visit post card content to align with wayfinding framework.

3. Rectify inaccurate / missing content.

4. Prioritize identification of patient facing, unescorted arrival points and reduce emphasis on non-patient facing arrival points.

5. Evaluate internal decision-making rights for wayfinding influencing operations.

FINDING 2

The existing building sub-sections are appropriate for the site navigation needs, but are not sufficiently identified.

RECOMMENDATIONS:

1. Leverage the existing building sub-sections (Freedom, Central, Liberty, Independence) to:

a. Provide memorable context and sense of place within the large building footprint

b. Reinforce the locations of the elevators

2. Evaluate the geographic boundaries of the Central Building to optimize intuitiveness.

3. Enhance and visually reinforce the sub-sections and elevators through an integrated strategy utilizing architecture, interior design and signage visual cues.

4. Reduce visual activity between key emphasis points. If everything is emphasized, then nothing is emphasized.

5. Continue to locate patient-facing arrival points along the primary “circular” pathway throughout the medical center for wayfinding ease.

FINDING 3

Understanding the system logic at the site is challenging due to similar strategies being utilized across a variety of decision types.

1. Use individual strategies (e.g., color) selectively to reinforce similar decision types.

2. For building sub-sections, it is recommended to use the following distinct elements between sub-sections:

a. Color

b. Name

c. Image thematically associated with sub-section name

3. It is recommended that the imagery associated with each building sub-section and being deployed within the elevators be evaluated.

a. Current imagery (eagle, Liberty bell, VA seal, American flag) are not a universally associated symbols distinctly representing each sub-section name

4. Multiple projects currently in design and/or construction present the opportunity to enhance the future wayfinding strategy.

a. It is recommended that the use of the color green within the parking garage elevator be re-evaluated.

i. Within the building sub-sections, each elevator will deploy the color of that sub-section.

ii. Because the parking garage is deploying color by parking level, deploying a single color for the elevator that is the same as one of the level colors can create confusion.

b. It is recommended that the use of interior finish colors to designate specific PACT Teams be re-evaluated.

i. Best practice is to avoid use of semi-permanent material installations to designate operational approaches that may change over time.

c. It is recommended that the main corridor finish upgrades be re-evaluated as follows:

i. It is recommended that the sub-section colors integrated into the finishes that be re-evaluated as it is likely to change in order to increase distinctiveness between color hues.

ii. Color accents are present within the interior finish upgrades (ex: blue wall finish near Phlebotomy). In order to support the visual hierarchy and color by sub-section principles and recommendations outlined within this report, use of color accents is recommended to be re-evaluated.

iii. Floor patterning is planned to highlight destinations and architectural details throughout the primary corridor. Re-evaluation of the patterning is recommended to ensure visual emphasis is on elevators and key patient-facing destinations with reduced emphasis in between these locations.

5. Re-organize signage messaging to eliminate unnecessary redundancy.

FINDING 4

Inconsistency and complexity within the system increases confusion for patients and staff.

RECOMMENDATIONS:

1. Eliminate the internal use of historical building numbers for patient facing buildings

(ie, 1E, 1W, 28, etc.).

2. Simplify the quantity of and naming of named arrival points, where possible making them as simple as possible to identify and discern between.

3. Leverage progressive disclosure to simplify the quantity of messages per sign.

4. Deploy system that is flexible to support change over time while minimizing effort in maintaining the system.

5. Ensure the navigation system supports the ease of navigation for the code response teams.

a. Evaluate the benefits of revising the existing architectural room numbering system to provide additional room numbers for the quantity of rooms to be identified and to adjust the system to be more logical.

FINDING 5

System lacks orientation to first-time user.

1. Carefully curate the arrival locations to set the tone for the wayfinding experience.

2. Ensure signage is right sized, well-lit and optimized for the line of sight.

3. Deploy a navigation system and solutions to support operational flexibility over time.

4. Designate an FTE to keep first-time users in mind and provide oversight and consistency of the wayfinding system over time as well as ensure integration between the signage, interiors and communications related to wayfinding.

5. Integrate an updated wayfinding curriculum into staff training program.

CONCLUSION

A comprehensive approach is required to improve the current Ann Arbor wayfinding experience. To become an effective wayfinding system, consistency of wayfinding messaging and experience must be intentionally coordinated between pre-visit information delivered in writing, online or verbally; in person interactions; all on-site physical signage; and the intuitive visual cues delivered through architecture and interior design. This intentional approach will require leadership support and cross-departmental collaboration in order to build sustained improvement over time.

Areas outside of signage and the design of the physical environment that will be impacted by these recommendations and which will need planning and support include:

1. Patient communication systems that deploy clinical location information to patients such as Cerner, mailed post cards, etc.

2. Systems using current room numbers such as fire alarm panels, equipment tracking, inventory systems, logistics, etc.

3. Staff and volunteer training programs.

4. Internal decision-making processes for check-in/arrival locations, communication about clinic locations, etc.

5. Emergency management programs, online interactive mapping tool and other programs that utilize mapping for communication (includes Badge Buddy program).

PRINCIPLE 1 – The System Trains You As You Use It

PRINCIPLE 1

The System Trains You as You Use It

A wayfinding system should be logically organized and easy to understand. Its organization should be systematic and repetitious and therefore easy to predict and anticipate what will be encountered as a user moves through a site. Such a wayfinding system allows a user to make a series of decisions about spaces which are unfamiliar to them.

FINDING

The existing navigation system is fragmented and not aligned to a single framework.

Wayfinding systems are built upon frameworks that guide users through the decisions needed to navigate from point A to point B. All tools deployed within the system must consistently align to the framework in order to be effective.

The following is observed within the existing VA Ann Arbor System:

1. Key communication points within the framework are missing / inconsistent.

Examples include:

a. Pre-visit post card content does not support the existing framework.

For example, directions to the MRI guide to a room number (C304). The existing wayfinding system does not include directions for room numbers.

b. Directories do not include all clinical appointments that patients are seeking.

For example, neither MRI nor Orthopaedics are listed on the directories.

c. Directional signs do not consistently direct to the other buildings and entrances located on that floor.

d. Messages on some directional signs are incorrect, in conflict with each other, inconsistent with other identification signs, or missing key destinations.

For example, in the sign below in the Liberty Building, on floor 1 has two signs on the opposite side of the hall from one another. Both direct to the Outpatient Pharmacy, but in two different directions – one straight ahead in the photo and one behind the picture taker in the photo.

2. Check-in locations and clinic entrances are identified in visually equal manners.

Depending on which is encountered first while walking through the corridors, this creates confusion for patients on where they should be arriving.

Examples: PV Lab, Specialty Clinic F, Specialty Clinic G, Prosthetics, Orthotics, Dental.

In the image below on the left, the sign identifies the check-in location for Prosthetics, Orthotics and two Specialty Clinics. The image below on the right identifies the Prosthetics & Orthotics clinic itself.

3. There are internal process barriers to maintaining the system over time.

a. Pre-visit post card content is directed by departmental preferences without a coordination process in place that ensures alignment with wayfinding.

b. Check-in / registration locations are changed post construction by departments without a coordination process in place that ensures alignment with wayfinding.

c. Clinic locations vary daily/weekly and there are numerous renovations ongoing requiring significant, frequent wayfinding updates and increasing opportunity for error.

RECOMMENDATIONS

1. Align navigation tools to support the site’s six key decision points (shown below).

2. Update pre-visit post card content to align with wayfinding framework.

3. Rectify inaccurate / missing content.

4. Prioritize identification of patient facing, unescorted arrival points and reduce emphasis on non-patient facing arrival points.

5. Evaluate internal decision-making rights for wayfinding influencing operations.

PRINCIPLE 2 – Create a Mental Picture

PRINCIPLE 2

Create a Mental Picture

Through the process of wayfinding we orient ourselves to a physical environment in order to navigate through it. In order to do so, we must be able to create, in our mind’s eye, a mental picture of the unknown environment. To create this mental picture, individual areas within an environment must be memorable and distinct from one another. This allows a user create a sense of where they are at any given location based on context to the other areas.

The existing building sub-sections (Freedom, Liberty, Central and Independence) are appropriate for the site navigation needs, but are not sufficiently identified.

The following is observed within the existing VA Ann Arbor System:

1. The buildings have excellent horizontal connectivity between them on all floors, with the exception of the Freedom building which has non-public facing mechanical spaces on floors 2, 4, 6 and 8.

a. The Freedom Elevator is the first elevator one arrives to after the Main Lobby and is most likely the elevator one would choose to get to their destination’s floor.

b. Due to the Freedom Elevator’s lack of access to floors 2, 4, 6 and 8, guiding patients to the elevator which will access the building their destination is in is the most critical component the wayfinding system must support.

2. The overall footprint of the VA Ann Arbor Medical Center is large and walking distances therefore long.

a. The existing footprint is broken up into smaller sub-sections (Freedom, Liberty, Central and Independence).

b. There is currently one elevator located in each sub-section. A new elevator accessing

3 floors is planned to be added near the ED entrance.

3. The current sub-sections and their elevators are not currently explicitly apparent to patients.

a. The existing architecture and interior design do not reinforce sub-sections.

i. The existing interior finishes do not relate to the sub-section color coding.

For example, the finishes surrounding the Freedom elevators are teal, not maroon. See image above.

ii. The spatial hierarchy within the physical environment does not consistently reinforce the elevators and sometimes reinforces other destinations more.

Below is the corridor to the Independence elevators. It is a primary pathway and key decision point, but not visually differentiated from other corridors.

The Central Elevators are not visually emphasized, other than the small sign placed in low lighting conditions when walking west from the Freedom Elevators.

The Specialty Care Clinic past it is more visually pronounced and welcoming.

Below is the PACT Primary Care arrival point. The enlarged volume of space, specialty lighting, specialty ceiling material and change in flooring highlight its importance. Its visual importance is greater than any of the four elevator lobbies.

4. The existing signage, which aims to clarify and distinguish sub-sections, is not distinctive enough.

a. The color used to signify the Freedom and Central buildings is visually similar, especially in low light.

b. The neutral sign color used for typical signs is very similar to the Independence color particularly in low light and when not immediately next to one another.

c. The use of color coding and the placement of color-coded signs could be improved for greater clarity.

For example, signs directing to different sub-sections could always include the subsection color as background to assist with reinforcing the building’s color. In the image below, Central which is gray and Liberty which is maroon are both on blue backgrounds.

For example, there is currently inconsistent deployment of the color-coded signs with incorrect colors in a specific sub-section. Below, the blue overhead sign is placed in the maroon section.

For example, the placement of color-coded signs at thresholds creates confusion.

Blue can be seen in the foreground directional sign. The next sign, still inside the Liberty Building, is a gray sign that identifies the entry to the Central Pavilion. On the next sign, inside the Central Pavilion, Blue is visible again. The message on this sign identifies the entry to the Liberty Building. If the back sides of the two identification signs matched the sign immediately before it, this confusion could be eliminated.

1. Leverage the existing building sub-sections (Freedom, Central, Liberty, Independence) to:

a. Provide memorable context and sense of place within the large building footprint.

b. Reinforce the locations of the elevators.

2. Evaluate the geographic boundaries of the Central Building to optimize intuitiveness.

3. Enhance and visually reinforce the sub-sections and elevators through an integrated strategy utilizing architecture, interior design and signage to create visual cues.

4. Reduce visual activity between key emphasis points. If everything is emphasized, then nothing is emphasized.

5. Continue to locate patient-facing arrival points along the primary “circular” pathway throughout the medical center for wayfinding ease.

PRINCIPLE 3 – Leverage Meaningful Redundancy

PRINCIPLE 3

Leverage Meaningful Redundancy

The way that each individual approaches wayfinding through a space is unique to that individual, their relatable past experiences and their preferences for memorization. For some individuals, it is easier to remember written information such as words, letters or numbers, while others find it easier to recall visual elements like color and imagery. By deploying redundant memory aids that reinforce one another (ex: letter plus color plus visual; architecture plus interior design plus signage), wayfinding systems can appeal to a variety of individual preferences.

In addition, these redundant memory aids assist in creating distinct and memorable context (to support the principle of “Create A Mental Picture”) between important areas in the wayfinding journey. In order to maximize memorability, best practice is to utilize the same set of memory aids for a similar contextual objectives (ex: different floors, different elevators, different buildings, etc.).

Understanding the system logic is challenging due to similar strategies (ex: color coding, use of letters/numbers in labeling, etc.) being utilized differently across a variety of decision types.

The following is observed within the existing VA Ann Arbor System:

1. Similar strategies are deployed to indicate different types of decisions.

a. Color is used to differentiate between:

i. Building sub-sections and their associated elevators

ii. Garage levels

iii. PACT Primary Care teams

2. Alphabetic characters are used to differentiate between:

a. Garage levels

b. Building levels

c. Specialty Care Clinics

d. PACT Primary Care sub-waiting

e. Corridors within clinics

f. Phlebotomy bays

g. Room number zones

h. Exam rooms

i. Rooms within Suites

3. Numerals are used to differentiate:

a. Building levels

b. Stations

c. Stairs

d. Exam rooms

e. Rooms through Architectural Numbers

f. Process Steps

4. More redundancy is deployed than needed in some instances.

For example, many destinations, such as the location below ,are identified by Station Number, Name and Architectural Room Number. All 3 redundant names are not needed to locate a destination.

1. Use individual strategies (e.g., color) selectively to reinforce similar decision types.

2. For building sub-sections, it is recommended to use the following elements to distinguish between sub-sections:

a. Color

b. Name

c. Image thematically associated with sub-section name

3. It is recommended that the imagery associated with each building sub-section and being deployed within the elevators be evaluated.

a. Current imagery (eagle, Liberty bell, VA seal, American flag) are not a universally associated symbols distinctly representing each sub-section name.

Below are the images currently associated with the sub-section name.

4. Multiple projects currently in design and/or construction present the opportunity to enhance the future wayfinding strategy

a. It is recommended that the use of the color green within the parking garage elevator be re-evaluated.

i. Within the building sub-sections, each elevator will deploy the color of that sub-section.

ii. Because the parking garage is deploying color by parking level, deploying a single color for the elevator that is the same as one of the level colors can create confusion.

The matrix to the right represents the current planned garage level names and colors.

5. It is recommended that the use of interior finish colors to designate specific PACT Teams be re-evaluated.

a. Best practice is to avoid use of semi-permanent material installations to designate operational approaches that may change over time.

The image to the right is a floorplan representing the flooring finish colors planned for the PACT Primary Care team space.

6. It is recommended that the main corridor finish upgrades be re-evaluated as follows:

a. It is recommended that the sub-section colors integrated into the finishes that be re-evaluated to ensure ease of change of material / color hue as the sub-section colors are likely to change in order to increase distinctiveness between the colors.

For example, colorful accent bands matching the existing sub-section colors are incorporated into the interior finishes. If these colors are updated, it will impact finishes currently being planned for construction.

b. Color accents are present within the interior finish upgrades.

For example, see image below. A blue wall accent color is used within the Freedom building. The freedom building is designated as maroon.

In order to support the visual hierarchy and color by sub-section principles and recommendations outlined within this report, use of color accents is recommended to be re-evaluated.

c. Floor patterning is planned to highlight destinations and architectural details throughout the primary corridor. It is recommended that a similar floor patterning strategy be applied throughout all buildings and on all renovated floors, where possible. It is recommended that the patterning provide visual emphasis is on elevators as a primary emphasis point, key patient-facing check-in destinations as a secondary emphasis point and to reduce emphasis in between these locations.

In addition, it’s recommended that similar colors and patterning are used to highlight similar destination types.

In the image below, the striped two-tone patterning is planned at elevators and cool gray accents are planned at clinical check-in areas.

7. Re-organize signage messaging to eliminate unnecessary redundancy.

a. Three approaches (shown below) have been explored within the study phase.

Each leverages a single framework outlined in Principle 1 and eliminates a different redundancy. The three approaches will be stress tested within the upcoming phase to validate the approach with the greatest positive impacts.

Approach 1 –

Approach 2 –

Approach 3 –

PRINCIPLE 4 – Keep It Simple

PRINCIPLE 4

Keep It Simple

Successful wayfinding systems are so easy to use, we barely recognize the amount of decisions they enable us to make. These systems provide the type information we need exactly when we realize we need it in order to make decisions. The information is delivered in a way that is succinct, consistent and easy to scan utilizing simple terms that are easily understood by as many people as possible.

Inconsistency and complexity within the system increases confusion for patients and staff.

The following is observed within the existing VA Ann Arbor System:

1. Named destinations listed on signs are inconsistent due to numerous names for the same destination.

2. Building numbers are frequently used by staff instead of names. This creates a cultural divide between staff and patients and confusion for staff discerning between two different systems.

Destination Other Names That Appear in the System

Freedom Building 1E Clinical Addition Rotunda

Liberty Building 1W Original Hospital Building

East Wing West Wing

Independence Building 28 (CLC) Extended Care Center

Veteran Welcome Center

Main Hospital/Lobby Medical Center Lobby Main Lobby

North Main Entrance Pavilion Main Lobby Pavilion

Visitor Parking 29 Parking Parking Garage North Parking Garage

East Parking Structure (EPS) Patient Parking Structure Visitor Parking

PRINCIPLE 4 – Keep It Simple

3. Inconsistencies and inaccuracies exist within the content listed on the existing signs.

a. The frequency of clinic location changes increases the frequency of updates within the system, and in turn increases the likelihood of inaccuracies over time.

4. Staff have difficulty responding to codes due to out of sequence room numbering and the fact that the existing navigation system does not guide toward room numbers.

a. The current room numbering system is limited and does not have enough digits to support the quantity of rooms that need to be numbered within a zone. This exacerbates the sequencing challenges.

5. Directional signs include long lists of destinations. Best-in-class wayfinding systems seek to limit the quantity of messages on a sign to six or fewer. Most directional signs within the VA Ann Arbor exceed six messages per sign.

a. The current signs do not utilize a systematic progressive disclosure approach.

1. Eliminate the internal use of historical building numbers for patient facing buildings (ie, 1E, 1W, 28, etc.).

2. Simplify the quantity of and naming of named arrival points, where possible making them as simple as possible to identify and discern between.

3. Leverage progressive disclosure to simplify the quantity of messages per sign.

4. Deploy system that is flexible to support change over time while minimizing effort in maintaining the system.

5. Ensure the navigation system supports the ease of navigation for the code response teams.

a. Revise the existing architectural room numbering system to provide additional room numbers for the quantity of rooms to be identified and to adjust the system to be more logical.

Option Room Numbering System Room Number Example

Current System Corridor Letter + Floor + 2 Digits A158

Recommended Building Letter + Floor + 3 Digits L1062

PRINCIPLE 5 – Meet the User Where They Are

PRINCIPLE 5

Meet the User Where They Are

Effective wayfinding systems are designed to support the needs of first-time users traversing an unfamiliar space. These systems are broadly accessible and take into account audience characteristics such as visual acuity, emotional state of mind, technological adoption, etc.

They deploy approaches that are mainstream in order to make unfamiliar experiences more relatable and familiar (ex: greeters at the main entrances, GPS navigation aids, etc.).

System lacks orientation to first-time user.

The following is observed within the existing VA Ann Arbor System:

1. The entrances for the building are confusing.

a. The entrance to the main lobby from the garage lacks clarity of where the user is and where they should proceed to next and misses the opportunity to orient a first-time visitor to the navigation system and how to use it.

i. There are numerous desks and many signs (both permanent and temporary) for the patient to sort through.

ii. Neither directional signs nor directories are not visible, creating a lack of clarity of the user’s current location and where to go past the main lobby.

iii. The lobby space can be noisy due to numerous staff seated at the volunteer desk or adjacent seating areas.

2. The ED entrance is the only entrance open after hours and on weekends.

a. Patients are frequently confused by the lack of access from the main entrance.

b. Navigation from the ED entrance to other locations within the buildings are challenging.

3. Existing sign messages are undersized at major decision points, placed outside of the line of sight and at times difficult to read due to low lighting. This scenario can create additional anxiety and confusion for first time patients who may miss key orientation aids.

For example, in the image below, the gray overhead directional sign and a Station (Station 1-2) sign are placed near the ceiling in a dimly lit location. Based on the required viewing distance, importance of the messages and all of the other competing visual cues in the space, both signs are undersized.

4. The system includes named and unnamed destinations. The named locations teach patients to look for the name of their clinical destination. Additionally, due to their inability to support frequently changing content, directories and other communication exclude clinics that are located within multi-practice locations (ex: Specialty Clinic F, G, etc.). This leaves the patient unable to find the information they need to self-navigate to a space without asking for assistance.

5. A web and mobile based mapping tool exist for patient use (see image below). It requires patients to enter their current location and the name of their destination. This requires the patient to know where they are in order to input current location. Map and plan based tools are frequently challenging for audiences to understand and translate to what they see in front of them.

1. Carefully curate the arrival locations to set the tone for the wayfinding experience.

2. Ensure signage is right sized to support legibility and visual hierarchy within the space, well-lit and placement is optimized for the line of sight.

3. Deploy a navigation system and solutions to support operational flexibility over time.

4. Designate an FTE to keep first-time users in mind and provide oversight and consistency of the wayfinding system over time as well as ensure integration between the signage, interiors and communications related to wayfinding.

5. Integrate an updated wayfinding curriculum into staff training program.