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PHOTO BY DEBBIE FRANKE PHOTOGRAPHY

Today’s Facilities, which can be purchased at www.HealthForumOnlineStore.com. They are representative of a widerange of wayfinding projects.

Cohesion in any languageAs the flagship of the largest public, not-for-profit healthsystem in the Southeastern United States, Grady Memo-rial Hospital — built in 1958 and expanded everydecade thereafter — is massive, with 953 beds, 2 millionsquare feet, 22 stories, 11 wings, seven public eleva-tor banks and six public entrances.

Like Atlanta itself, Grady’s patient population iswidely diverse. As identified by the system’sDepartment of Multicultural Affairs, major lan-guages spoken by Grady’s limited English profi-ciency population include Spanish, Mandarin,French, Bengali, Vietnamese, Amharic, Russian,Somali and Arabic.Under the direction of its wayfinding consult-

ant, Grady began a project in fall 2006 to create acomprehensive new signage and wayfinding plan.The plan was conceived to bring cohesion to the

W hen it comes to hospital wayfinding systems,one size doesn’t fit all. While the goals of asystem might be similar from facility to facil-

ity — improving organization outreach, easing familystress, helping patient flow and even aiding emergencymanagement — achieving these goals is vitally depend-ent on a hospital’s unique history, configuration, size andsurrounding community.The following wayfinding case examples were con-

tributed by the hospitals themselves for the bookWayfinding for Healthcare: Best Practices for

A strong corner-stone element atthe perimeter of aproperty can helpdefine the presenceof a campus andgive the firstimpression of ahospital brand.

HOW HOSPITALS HAVE SOLVEDWAYFINDING CHALLENGES

BY RANDY COOPER, SEGD

SUCCESSFULSIGNAGE»

hospital structure and, ultimately, to thesystem’s ancillary buildings.As the plan took shape, some key deci-

sions were made:• The building would be subdivided

into towers, named after the compasspoints; wing designations would keeptheir existing names.• New signs would be color coded and

include the Hablamos Juntos symbols.(The health system had helped to developthese symbols as a participant in theHablamos Juntos/Society for Environmen-tal Graphic Design (SEGD)/Robert WoodJohnson Foundation study to develop uni-versal symbols for health care.) • Elevator banks would be named by

tower location, replacing a nonintuitivealphanumeric naming convention.• The proposed system would be easy

to maintain.Starting in August 2007, Grady’s emer-

gency department served as a beta site,testing prototypes of the signs. A plan tomove forward with permanent signage

hospitalwide is in development.In addition to meeting or exceeding

Culturally and Linguistically AppropriateServices standards and Americans withDisabilities Act; Title VI; and other feder-al, local and accreditation mandates, thenew signage system reflects Grady’songoing efforts — including continuingcollaboration with Hablamos Juntos andSEGD — to eliminate barriers to healthcare access and to encourage use ofappropriate services for the diverse com-munity population.

Cooperation yields resultsTwo highly regarded health care pro vi -ders. One campus. In a nutshell, that isthe problem that brought UniversityHealth Systems of Eastern Carolina (UHS)and East Carolina University (ECU) to itswayfinding consultant in 2008.For more than 30 years, UHS’s flagship

hospital, Pitt County Memorial Hospital(PCMH), has shared a 100-acre parcel inGreenville, N.C., with ECU’s Health Sci-ences Division. With 861 beds, PCMH,the teaching hospital for ECU’s BrodySchool of Medicine, is the state’s fifthlargest hospital and home to the East Car-olina Heart Institute at Pitt County Memo-rial Hospital. The ECU Health SciencesDivision includes the Brody School ofMedicine, the East Carolina Heart Insti-tute at East Carolina University, the col-leges of nursing and allied health sci-ences, and a new school of dentistry.Throughout their 30-plus-year partner-

ship, ECU and UHS have planned way -finding independently, a system that hasproduced signage that advances eachorganization’s distinct brand but gives thecampus an inconsistent look. To servepatients and their families better, as wellas physicians and medical students work-ing in the Medical District, UHS and ECUagreed to jointly develop a master planfor campus wayfinding.Integrating campus signage posed sev-

eral challenges: preserve and strengtheneach entity’s brand, maintain cost effi-ciency and develop a scalable plan thatcould be tailored to the needs of individ-ual buildings.Other issues needed resolving, too: the

lack of distinguishing signage on the Med-ical District’s perimeter, outdated signagedesigns that featured building namesmore prominently than addresses, andthe need to integrate with the city ofGreenville’s own wayfinding initiatives.Further muddling the signage is the

fact that, though the ECU Health SciencesCampus and PCMH each consist of sever-al buildings, each organization uses a sin-gle, central address.The wayfinding consultant helped UHS

and ECU develop a design that lays thefoundation for a phased, multiyear effortto integrate wayfinding across the med-ical campus. Details of the plan includethe following:• A standard sign design that, through

its use of color, reinforces ECU’s andUHS’s respective brands. Teal will be thedominant color on UHS building signs,while ECU signs will feature purple.• A higher profile for street addresses,

which will occupy the top line on exteriorbuilding signage.• Large brick cornerstones marking

strategic entrances to the Medical District.• Incorporation of the city’s existing

signage priorities.• Guidelines for scaling plans up or

» SUCCESSFUL SIGNAGE

GRAPHICS COURTESY OF RANDY COOPER

Grady Memorial Hospital

Location . . . . . . . . . . . . . . . . . . . AtlantaEstablished . . . . . . . . . . . . . . . . . . 1958 Beds . . . . . . . . . . . . . . . . . . . . . . . . 953 Population served . . . . . . . . 2.8 millionInpatient admissions . . . . . . . . . 25,763Outpatient visits. . . . . . . . . . . . 771,322Employees . . . . . . . . . . . . . . . . . . 5,088 Square footage . . . . . . . . . . . . 2 million

UHS and ECU medical campus

Location . . . . . . . . . . . . . Greenville, N.C.Established . . . . . . . . . . . . . . . . . . 1951 Beds . . . . . . . . . . . . . . . . . . . . . . . . 861 Population served . . . . . . . . 1.3 million Inpatient admissions . . . . . . . . . 34,588 Outpatient visits. . . . . . . . . . . . 276,405 Employees . . . . . . . . . . . . . . . . . . 5,588 Square footage . . . . Combined campus

of seven square miles, known locally as the Medical District

ABOVE Poorly executed signage becamevisual clutter. BELOW Grady deals with multi-lingual needs by using icons and pictogramsin static signs and employing multilingualelectronic units in heavy traffic areas.

ABOVE In collaboration with the architect, thewayfinding consultant implemented this siteidentification sign as a beta test for the

entire exterior sign program. BELOW Straight-forward vista signage delineates the hospitalentrance from hundreds of other entrances.

down, making it easier to export plans toother UHS and ECU facilities.• Preservation of each organization’s

current practices for the most local signs.While full implementation of the plan

will take several years, new and replace-ment signs already are reflecting its princi-ples. In October 2008, UHS opened a newinpatient hospice facility. Signage there fol-lows the consultant’s design, as do plac-ards at the new East Carolina Heart Insti-tute at Pitt County Memorial Hospital.

Patron saint leads the wayAfter more than 100 years of service tothe St. Louis metropolitan area, St. Antho-ny’s Medical Center, St. Louis, was remak-ing itself. Changes in all facets of per-formance included a complete overhaulof signage and wayfinding dictated bypatient complaints, lost visitor reportsand visual inspection. The goals were to create a visual hier-

archy that brings signage in line withmore contemporary standards; develop

attractive, utilitarian signage that projectsthe organization’s image; and improvepatient satisfaction scores.Plans were drawn up to start with the

interior of the main hospital building, fol-lowed by implementation in off-site build-ings and, ultimately, external signageboth on and off the main campus. A new-ly remodeled first floor would serve as apilot test site.The wayfinding consultant decided to

incorporate an award-winning signagesystem that had been used successfully inother organizations around the UnitedStates, incorporating St. Anthony’s imageon the major and most important direc-tional signs. Adapting lessons learnedfrom the pilot, the next phases incorpo-rated the following features:• Color-coordinated signage matching

distinctive colors assigned to each floor;• Large, wall-mounted floor numbers

that included secondary directories inplain view of all elevators;• A series of ceiling- and wall-mounted

signs routing visitors from the parking lotto the correct entrances and elevators forthe connected medical office building andto the main hospital lobby, and routingthem from one facility to the next;• Large, building-mounted and free-

standing, off-site signs to direct attentionto St. Anthony’s three urgent care centersand to indicate where in those buildingsphysicians’ offices were located;• A large, building-mounted sign high-

lighting the new women’s services com-ponent of a facility that also housed anoutpatient surgery center, a senior centerand physicians’ offices, which wereannounced on a freestanding yard signnear the parking area entrance; and• Topography modification, landscap-

ing, and new identity sculptures andentrance portals to soften and define theentire campus, which had grown haphaz-ardly over the years.Over the course of about three years,

the medical center completely renovatedall interior signage and wayfinding in allits facilities and partially installed a new-ly designed exterior wayfinding concept.The program evolved into an entirestreetscape redevelopment project,including landscaping, grading, new sig-nage and large sculptural crosses.All of the organization’s objectives were

met, including an increase in patient satis-faction scores with regard to patients’ feel-ings of comfort, ease of getting aroundand overall impression of the facility.

Successful value engineering In 2003, Rockdale Medical Center (RMC),Conyers, Ga., broke ground on its newEast Tower, which would house multipleservice lines and the main entrance of thefacility, and changed its name from Rock-dale Hospital and Health System to Rock-dale Medical Center; a new logo alsoreflected the name change. The two events warranted new exterior

signage to guide patients and visitors tothe correct entrance and relocated servic-es, and a new interior signage system forthe new tower.The RMC signage committee included

the chief operating officer; the director ofmarketing and strategic planning; thedirector of facilities; the construction proj-ect manager; a representative of thearchitectural firm hired for the project;and the facility’s communications coordi-nator, who served as project leader. The

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TOP RIGHT MAPS BY MED MAPS

ABOVE A complete interior signage system iscolor coded per floor to aid visitors in findingtheir way. BELOW Whether a simple change-able-letter unit or sophisticated touch-screentechnology, the directory must communicate

who and what resides in the facility.

ABOVE Visitor guides in English and Spanishprovide floor plans to facilitate wayfinding whileat the site. BELOW An integral part of thewayfinding program is to provide directionalinformation on the facility’s website to directpatients and visitors to the correct entrance.

St. Anthony’s Medical Center

Location . . . . . . . . . . . . . . . . . St. LouisEstablished . . . . . . . . . . . . . . . . . . 1900Beds . . . . . . . . . . . . . . . . . . . . . . . . 767 Population served . . . . . . . . . . 714,935 Inpatient admissions . . . . . . . . . 30,829 Outpatient visits. . . . . . . . . . . . 408,145 Employees . . . . . . . . . more than 4,000 Square footage . . . . . . . . . . . 1,099,107

Rockdale Medical Center

Location . . . . . . . . . . . . . . Conyers, Ga.Established . . . . . . . . . . . . . . . . . . 1954 Beds . . . . . . . . . . . . . . . . . . . . . . . . 154 Population served . . . . . . . . . . 179,000Inpatient admissions . . . . . . . . . . 8,268Outpatient visits. . . . . . . . . . . . 111,441Employees . . . . . . . . . . . . . . . . . . . . 738Square footage . . . . . . . . . . . . 484,000

committee hired a well-respected archi-tectural signage firm and set about toname the hospital’s five entrances, threeof which were on the same side of thefacility. Using a combination of compasspoints and service lines, they settled onNorth, South, East (the main entrance),Emergency and Day Surgery. The marketing and physician relations

departments undertook responsibility toeducate local physicians’ staffs on how toguide their patients to the correct locationusing new directional maps that were dis-tributed to the physicians’ offices andplaced on the hospital’s website.The committee chose modular exterior

signage to display the new entrance des-ignations and an interior signage systemthat complemented the new tower’s Planetree-inspired design. The result was

aesthetically pleasing but, unfor-tunately, too expensive to use inthe remainder of the facility ashad been planned.Once all the new construction

was complete, RMC was facedwith the dilemma of having fivedifferent interior signage sys-tems, none of which wasdesigned to allow for in-housemaintenance. In 2006, RMCbrought in a design consultant toperform a wayfinding needs sur-vey and then develop an afford-able sixth system that wouldcomplement the new one in theEast Tower. The solution wascard stock inserts that could beupdated easily by RMC staff usingexisting software and laser print-ers, allowing changes to be madein minutes instead of weeks. Thisnew system is being used for allnew projects and to replace exist-ing signage throughout the facility.

Address system comes to rescueThe main campus of the Iowa Health Sys-tem’s The Finley Hospital in Dubuque,includes the hospital, Wendt RegionalCancer Center and a medical office build-ing, all of which are interconnected.Over the years, the hospital’s signage

system had been neglected. No one per-son was responsible for signage — eachdepartment and area was posting its own;and no numbering system was in placefor rooms other than patient rooms.After five additions over the previous

50 years, finding one’s way around thehospital was problematic; indeed,wayfinding was one of the top complaintson patient surveys.Once approval was received to proceed

with a wayfinding and signage study, asearch was conducted and a consultingfirm selected to perform the work. Itscharge was to evaluate the current situa-tion and develop recommendations forimproving the wayfinding at Finley,including helping to create a room-num-bering system for the hospital.Following interviews with administration,

managers, employees, patients and visitors,the consultant recommended a wayfindingand numbering system based on a citystreet and address concept, as follows:• Corridors were given the names of

well-known streets in Dubuque.• Departments were given a street

address and numbers.• Signage for departments and direc-

tional signs were put in place to resemblelocal street signs.• Department marker signs at en trances

feature historical pictures of The FinleyHospital and its various departments.• A scrolling digital electronic sign tells

patients visiting the multi-use clinic onthe third floor which type of clinic isbeing held that day. The sign is changedeasily each day by clinic staff using aremote control device.The results were immediate. The

number of wayfinding complaints frompatients and visitors has dropped virtual-ly to zero. In fact, the hospital has re -ceived many compliments on the lookand effectiveness of the new signs anddirectories. Identification of rooms andoffices throughout the building hasenhanced both life safety and energymanagement systems. HFM

Randy Cooper, SEGD, is an award-winning designer,

a nationally recognized author and speaker, and

the owner and president of Cooper Sign & Graphics,

Atlanta. This article is excerpted from his book

Wayfinding for Health care: Best Practices for

Today’s Facilities, which can be

purchased at www.HealthForum

OnlineStore.com. Cooper can be

reached via his e-mail address at

rcooper@signsystems.com.

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Defining areas by color, compiling a comprehensive alpha -numeric classification system and assigning room numberswere keys to wayfinding success at Grady Memorial Hospital.

» SUCCESSFUL SIGNAGE

GRAPHICS COURTESY OF RANDY COOPER

The Finley Hospital

Location . . . . . . . . . . . . Dubuque, IowaEstablished . . . . . . . . . . . . . . . . . . 1890Beds . . . . . . . . . . . . . . . . . . . . . . . . 142 Population served . . . . . . . . . . . 90,000Inpatient admissions . . . . . . . . . . 8,610Outpatient visits . . . . . . . . . . . . . 37,661Employees . . . . . . . . . . . . . . . . . . . . 930Square footage . . . . . . . . . . . . 247,335

ABOVE Signposts are used to reinforce the hall-ways named for local roads in the directionalprogram. BELOW Historic sepia-printed photosadd interest throughout the building and make

each major area unique.