Warning signs

The NHS should not be allowed to enter the next millennium with the outdated signage it displays at some of its sites, says Michael Saunders.

As we approach a new century, when cars are being built with their own onboard navigation systems and medical procedures are becoming increasingly `high tech', why is it still so difficult to find your way around many hospitals?

Despite the fact that in recent years there have been many significant improvements in hospital management and patient care, with the health service generally becoming more `patient focused', the subject of signposting seems to remain a problem for many hospitals. Some common problems which seem to persist include ambiguous directions, inconsistent information, varying styles and flyposted notices, all of which undermine patient confidence.

In some hospitals communications generally and sign-posting specifically are still languishing in a bygone era, with the continued use of the drab brown and white signs included in HTM 65. This standard for new signs in hospitals - HTM 65 Health Signs - was last published in 1984 and, whilst it contained some useful guidelines, is now well past its sell by date in respect of the many different `house styles' which have been adopted by many trusts. A number of newly built hospitals are moving towards an hotel environment approach to their main reception areas and other `front of house' activities, providing a welcome on arrival which helps to put patients at ease. This approach should be should be encouraged more widely especially in hospitals where a pleasant environment is still not considered to be a priority in patient-focused care.

This attitude is beginning to change with senior hospital managers paying more attention to the many different aspects of communications, the future of which holds some interesting possibilities. Indeed the Government is investing more money to encourage the use of technology within the health service, thus perhaps providing an opportunity to move away from the functional fixedness of the old NHS practices and procedures.

MINIMISING SIGNAGE

Traditionally, signs are an important part of the communication process but it is essential to keep the number of signs to a minimum and use simple language, to avoid an information overload and unnecessarily add to an already stressful situation. The intelligent use of colour also proves to be a helpful navigational aid provided that it is used consistently throughout hospital buildings and not simply as a single reference point in the main entrance. In addition the use of pictograms is a universal aid to recognition which should be further encouraged.

The physical environment should be used to clearly define primary circulation routes. Other navigational aids such as landmarks, artworks and colour can assist with wayfinding and also help to soften the environment.

NEW DEVELOPMENTS

There are currently some exciting developments and innovations in communications using electronic devices for active and interactive information displays, including the `virtual receptionist', `talking signs' and 'intelligent buildings'. Touch screens, which are now increasingly commonplace for accessing general information can also be used to provide wayfinding information.

Electronic information points can be used to provide up-to-the minute information or assist with navigation around complex hospital environments. This can be accessed either on demand or activated by automatic response, or continually updated by the hospital network and transmitted as an audio/visual message. This technology also has the ability to address the needs of non-- English speakers or the visually impaired and hard of hearing.

Patient letters and records are also an important part of the communication process and should certainly be consistent with signs and other printed communications. In the future we may also see appointment letters being issued by e-mail. Patient information and medical records may be kept on securely encrypted 'smartcards' which can be carried around by the individual. These may also contain details of any special needs or even the patient's wishes regarding organ donation.

This new technology will provide hospital managers with the opportunity to introduce time-saving, `hands-on' tools for administration and information management. However, it is of fundamental importance to ensure that these new initiatives are co-ordinated with the more traditional forms of communication.

There is an apparent move to revert back to a standardised NHS logo and style for the trusts, the majority of which now have well-established logos and corporate styles with which both patients and staff now clearly identify. This proposed change would mean a loss of identity and is a retrograde step as we approach the new millennium.

Michael Saunders is senior partner in Healthcare Design Consultants and has been working with many trusts in the UK developing wayfinding strategies as well as introducing many information and communication initiatives.

Copyright Wilmington Publishing Ltd. Aug 1999
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