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HCD_2013_Way-finding Study

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HCD_2013_Way-finding Study

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HCD_2013_Way-finding Study

  1. 1. #HCDCon #HCDCon
  2. 2. #HCDCon Lost in the Hospital… What Environmental Cues Do We Seek? | | |
  3. 3. #HCDCon Presenters Tom Harvey FAIA, MPH, FACHA, LEEP AP Vice President/Partner, HKS Architects President, Center for Advanced Design Research & Evaluation Debajyoti Pati, PHD, FIIA, LEED AP Rockwell Endowment Professor, Texas Tech University Director Emeritus, Center for Advanced Design Research & Evaluation Phyllis Kaplan Senior Health Facilities Architect, U.S. Department of Defense Defense Health Agency (DHA) Portfolio Planning and Management Division
  4. 4. #HCDCon Acknowledgements Contributing Organizations Military Health System Texas Health Resources (IRB) Texas Health Presbyterian Hospital Dallas Study Contributors Douglas Willis, RN, BSN, Safety Manager, THPHD Sipra Pati, MA, Research Coordinator, HKS Adeleh Nejati, PhD Candidate, TAMU Shireen Kanakri, PhD Candidate, TAMU
  5. 5. #HCDCon Learning Objectives 1. Identify the range of environmental information sought by visitors during navigation in hospitals. 2. Identify the types of physical design elements used as cognitive anchors in direction-giving behavior.
  6. 6. #HCDCon Agenda The Wayfinding Problem What We Know and Don’t Know Study Background Study Question Method Findings Implications
  7. 7. #HCDCon Wayfinding… An All Too Frequent Challenge
  8. 8. #HCDCon Affects patients and visitors • Impacts satisfaction • Induced stress • Physiological well-being • Psychological well-being Affects staff • Compromises optimal use of staff time • Communication challenges • Challenge to float or agency staff • May impact efficiency of care delivery • May impact care safety A Forethought OF Design
  9. 9. #HCDCon Wayfinding… What We Know and Don’t Know
  10. 10. #HCDCon The “Cognitive Map” Known strategies: • Survey knowledge • Route knowledge Image Credit: http://groups.ischool.berkeley.edu/mentalmaps/
  11. 11. #HCDCon Mini Spatial Representations “Adult human knowledge about their macro-environment are mini-spatial representations with high interconnectivity…” Image Credit: http://www.lifesreplay.com/journal/2011/11/29/yuya- takeda-falling-apart-complex-cities.html The Development of Spatial Representations of Large-Scale Environments Siegel and White, 1975.
  12. 12. #HCDCon Most documented studies are at the urban scale Kevin Lynch,1975. Image of the City. Components of mental maps o Path o Edge o District o Nodes o Landmark Insufficient Focus on Internal Need
  13. 13. #HCDCon What We Know Theory of Perception - Cognition o Environmental Complexity o Cognitive Filters
  14. 14. #HCDCon Five Factors in Wayfinding Carpman and Grant, 1993 • Knowing where you are • Knowing your destination • Knowing the best route • Recognizing the destination upon arrival • Finding the way back
  15. 15. #HCDCon What We Don’t Know 1. Are these theories valid in interior environments? 2. What information do people seek when they navigate for the first time in an unfamiliar environment? • Wayfinding in places not frequently visited. • Navigating the first time vs. subsequent times – the difference? • What features are used to begin forming the cognitive map? • Where is the start point of the action/travel plan? • What features are used during execution of travel?
  16. 16. #HCDCon Current Designer’s Tools Designers use a wide array of strategies to optimize navigation: • Signs • Maps • Artwork • Landmark • Color • Spatial configuration • Alpha-numerical labels
  17. 17. #HCDCon Tools of the Navigator Which strategies are used during wayfinding? o Understanding current location o Knowing destination o Developing route choice o Realizing arrival at destination o Findings one’s way back
  18. 18. #HCDCon Wayfinding… Study Background
  19. 19. #HCDCon MHS FIRM U.S. Department of Defense Facility Innovation & Research Model (FIRM) • Established an MHS FIRM Research Framework • Tested through multiple Validation Studies Identifying Elements of the Healthcare Environment that Contribute to Wayfinding U.S. Department of Defense Military Health System
  20. 20. #HCDCon Wayfinding… Study Question
  21. 21. #HCDCon Question 1 What aspects of the physical, social, and organizational environment aid in wayfinding decision making?
  22. 22. #HCDCon Question 2 What types of information are being sought by visitors as they navigate in healthcare facilities?
  23. 23. #HCDCon Question 3 What role do design of interior environmental cues play in the wayfinding process? • Color • Art • Visible Landmarks • Maps • Interactive Kiosks • Visual Signage
  24. 24. #HCDCon WAYFINDING… Study Method
  25. 25. #HCDCon Study Setting Texas Health Presbyterian Hospital Dallas • Main Building • Hamon Tower • Professional Building 1
  26. 26. #HCDCon Campus HAMON TOWER ADDITION MAIN TOWER BUILDING PROFESSIONAL BUILDING 1 OTHER MOBs WOMEN’S CENTER BEHAVIORAL HEALTH BUILDING Public Site Entrances (2) Staff / ED Entrance
  27. 27. #HCDCon Vertical Circulation Elements HAMON TOWER ADDITION MAIN TOWER BUILDING PROFESSIONAL BUILDING 1 WOMEN’S CENTER BEHAVIORAL HEALTH BUILDING PP P S Esc
  28. 28. #HCDCon Horizontal Circulation Elements HAMON TOWER ADDITION MAIN TOWER BUILDING PROFESSIONAL BUILDING 1 WOMEN’S CENTER BEHAVIORAL HEALTH BUILDING PP P S Esc c P P
  29. 29. #HCDCon Destinations External Starting Point 1 Parking Lot 2 Patient Room 4 Cafeteria 5 Imaging Check-in 6 Chapel 7 Surgery Waiting 8 Admission 9 Parking Lot 12 Interv. Center 11 Prof. Building 10 Main Lobby 3
  30. 30. #HCDCon
  31. 31. #HCDCon
  32. 32. #HCDCon
  33. 33. #HCDCon Patient / Visitor Direction-seeking Age groups – 5 decades starting at 20 Gender – 50% male / 50% female Recruitment criteria… • Never visited this hospital site • No architects or interior designers • No visual impairment Subjects
  34. 34. #HCDCon Subjects Employee Direction-giving Any full-time employee of the Hospital Recruitment: • Visual identification by presence of ID card. • Staff approached at each of the destinations on the patient/ visitor routes
  35. 35. #HCDCon Data Types and Instruments Visitor • Verbal protocol • Audio recording • Route maps • Photographs • Questionnaire Employee • Verbal directions • Audio recording Participants articulated/ recorded their decision-making thoughts... I-Pad Tracking of Routes Features and Signs Observed
  36. 36. #HCDCon Wayfinding… Preliminary Findings
  37. 37. #HCDCon Understanding where one is (where am I?) Two types of ‘where I am’ situations • Start point – Travel plan • En route – Travel execution • Continuous assessment Understanding where is the destination (where to go?) • Especially where it is in relation to where I am Two Broad Aspects to Wayfinding 1
  38. 38. #HCDCon Understanding how to go to the destination from where one is (at a point of time) • Is there a way to predict that I am on the right path? o Circulation system assessment (elevators, hallways…) o Continuous ‘where I am’ assessment • Is there a way to predict what the destination looks like? (More importantly) how to get back to where one is (was) – this is critical, since among all the ‘where one is’, people seem to select one or more former locations as anchor points. Two Broad Aspects to Wayfinding 2
  39. 39. #HCDCon Where am I? Where to go? How to go there? People seem to rely entirely on • Maps • Signs Elements Supporting Wayfinding
  40. 40. #HCDCon Elements Supporting Wayfinding Maps • Expectations to find the exact name on the map • Main focus on: o Paths o Circulation o Districts
  41. 41. #HCDCon Elements Supporting Wayfinding Signs: • Labeling systems/ nomenclature • Numbering systems • Directional signs (with arrows) • Chronology/ Order of information • Patterns
  42. 42. #HCDCon Do other elements contribute?
  43. 43. #HCDCon Other Cues: Logical Clustering of Functions Space Planning • Café must be close to lobby • Admissions would be near the entrance/ lobby • Children’s play area indicates waiting area close by. Elements Supporting Wayfinding
  44. 44. #HCDCon Other Cues: Furniture Arrangement Furnishings • If there is seating, it must be a waiting area • One subject indicated that comfortable couches indicated a waiting area Elements Supporting Wayfinding
  45. 45. #HCDCon Logical pairing of interior elements Interior Architecture • Admissions could mean ‘windows’/ windows indicated that it could be admissions Elements Supporting Wayfinding
  46. 46. #HCDCon Structural Elements Structure • deep columns implied elevator bank Elements Supporting Wayfinding
  47. 47. #HCDCon Architectural Features and Visual Access Architecture • External view of an area – looking at its width the subject inferred that it did not have the capacity to hold a waiting area or that they were headed in the right direction • Visual access of spaces via multi- level atrium Elements Supporting Wayfinding
  48. 48. #HCDCon What about all the other design elements we incorporate?
  49. 49. #HCDCon What Role Do Other Features Play?
  50. 50. #HCDCon Developing familiarity Develop mental map • Where people made mistakes • Funny or odd sounding names Like while one is hiking in the wilderness: • People use any natural element as markers • Or create markers (leave pebbles on ones path) What Role Do Other Features Play?
  51. 51. #HCDCon Other Design Elements Help Serve As Familiarity Markers What Role Do Other Features Play? • Information desks/ counters (manned or not) • Vertical circulation (especially when visually unique such as escalators • Artwork/ sculptures (people did not focus on the content/ subject of the landmark) • Views to exterior and exterior elements (exterior signs and labels, visible from inside, served important function) All of these can be termed as landmarks. Every landmark is a pebble.
  52. 52. #HCDCon Implications
  53. 53. #HCDCon Nomenclature and Numbering System • Represents the initiation of the cognitive process • Even before people look for signs and maps Key Concept 1: What’s in a Name?
  54. 54. #HCDCon Anchor Point Use and Characteristics • A place close to an exterior entrance and vertical circulation: o Doesn’t need to be the entrance people used to enter the facility • Multiple activities • Presence of people • (Expected) presence of maps and directional signs • Even if this anchor point had not been very effective in offering adequate help in locating their destinations, subjects still sought to return to these anchor points to orient themselves. o Home base. o Where everything is o Where I feel safe o That’s where I get help Key Concept 2: The Mother Ship
  55. 55. #HCDCon Familiarity, Familiarity, Familiarity (Think of the Jungle) People tend to immediately start working on developing familiarity of “nodes”, “edges” along a path • With directional signs, maps, plausible location of maps, information boards … • Higher the complexity (types of activities, people, artwork) easier the development of familiarity Key Concept 3: Fight or Flight
  56. 56. #HCDCon Path (streets, sidewalks, trails, other channels in which people travel) o Where am I; where am I going (maps, directional signs…) Edge (perceived boundaries such as walls, buildings, and shorelines) o Hallway edge functions (familiarity) District (large sections of the facility distinguished by some identity) o Where am I; where am I going (maps, directional signs…) Node (focal points, intersections or loci) o BOTH (MOST IMPORTANT) Landmark (readily identifiable objects which serve as external reference points) o Familiarity Key Concept 4: Cognitive Markers
  57. 57. #HCDCon Thank You! #HCDCon Thank you for your attention…
  58. 58. #HCDCon #HCDCon

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