Specialist Clinics Wayfinding Standards Final Report - Project Review Department of Human Services 13 August 2008 This document is not to be copied without permission Growth Solutions Group Strategy & Marketing Introduction and Contents Contents Page Executive Summary 3 Chapter 1 Recommendations 4 Recommendations summary 5 Wayfinding recommendations 6 Setting expectations of a visit 7 This document provides a project overview, research findings Core wayfinding principles 8 and recommendations identified by Growth Solutions Group Use of the word ‘outpatients’ 9 (GSG) for design standards to create consistent and patient- Hierarchy of information 10 friendly wayfinding and signage across Victorian Hospital Appointment letter 11 Outpatient Departments. Key signage content 12 Implementation 14 The Specialist Clinics Wayfinding Guidelines is presented in Taking a whole-of-hospital approach 15 conjunction with this report, in the form of an outpatients- only wayfinding design guidelines manual, for distribution to Chapter 2 Findings 16 hospitals for implementation. Outpatient visits 17 Patient journey 18 Patient interview findings 19 Staff interview findings 23 Site visit findings 26 Chapter 3 Project Overview 28 Context and aims 29 Project Scope, issues and timing 30 Timeframe 31 Site visits and interviews completed 32 2 Executive summary Based on the positive potential impact on outpatient experience, DHS should implement a generic ‘address paradigm’ wayfinding system for outpatients across Victorian public hospitals, as detailed in the accompanying Specialist Clinics Wayfinding Guidelines document. Further work should be done to extend these principles to the entire hospital and all patients, visitors and users. • GSG was engaged by the Outpatients Reform Team, DHS, to develop signage design standards and a Specialist Clinics Wayfinding Guidelines document which will equip hospitals to improve their outpatient wayfinding and experience, plus explore a new name and identity for Outpatient Departments. • GSG worked to a four month project timeframe between April-July 2008. Key activities and deliverables included visits to four reference hospitals and interviews with patients, staff and the Outpatient Experience Sub-Committee. • The key findings were that: - Outpatient visits make up a large proportion of total visits to hospitals and outpatient clinics are key destinations. - Although each patient is different, the outpatient experience follows a predictable process with opportunities for setting expectations and improving the patient’s experience. - The complexity of many hospital sites, combined with the locations of clinics and the varied mobility and cognitive needs of many patients gives rise to a need for improving patient wayfinding. - The term ‘outpatients’ does not hold relevant meaning for patients. • In summary, the recommendations, which form the basis of the Specialist Clinics Wayfinding Guidelines document (presented as a separate document) are: - To improve patients’ ability to find their way to an outpatient clinic, a generic and standardised information system should be introduced that treats destinations as ‘addresses’. - The ‘wayfinding’ communication should be separated from the ‘expectations-setting’ communication and the medical explanations. - Create a wayfinding system that is generic, universal and internally consistent between verbal, written and signage communications - De-emphasise (or remove) the word ‘outpatient’ and use generic destination markers for wayfinding. • It became clear during the project that a whole-of-hospital wayfinding solution is now needed that builds on the outpatient wayfinding work but considers the full range of visitors and relationship between different services and parts of the hospital. 3 Chapter 1 - Recommendations 4 Recommendations summary By applying a set of patient oriented wayfinding principles to an outpatients journey, Victorian hospitals can improve the experience of patients visiting outpatient clinics. The Specialist Clinics Wayfinding Guidelines document that accompanies this report can be used to implement best practice principles across the state, however DHS needs to consider how a whole-of-hospital system can be developed. Recommendations on the wayfinding solution: • These recommendations form the basis of the • To improve patients’ ability to find their way to an Specialist Clinics Wayfinding Guidelines document outpatient clinic, a generic and standardised developed by GSG. information system should be introduced that treats destinations as ‘addresses’. Further work: • The ‘wayfinding’ communication should be separated • The wayfinding solution for outpatient visits raises from the ‘expectations-setting’ communication and questions about how it links in with other hospital the medical explanations. journeys. • Create a wayfinding system that is generic, universal • In order to provide a wayfinding solutions that and internally consistent between verbal, written and works for outpatients but is also integrated and signage communications consistent with the rest of the hospital, a • De-emphasise (or remove) the word ‘outpatient’ and wayfinding solution needs to be developed for use generic destination markers for wayfinding. whole-of-hospital planning. 5 Wayfinding recommendations To improve patients’ ability to find their way to an outpatient clinic, a generic and standardised information system should be introduced that treats destinations as ‘addresses’. Further, other communication methods should be used to help set patients expectations of their visit. Where do I go for my appointment? We recommend (and when?) • Wayfinding should use a • This is a standard wayfinding question - it is generic and standardised like asking for an address ‘address’ paradigm designed exclusively for getting first- • DHS should create a standard system for time visitors to specific key describing key hospital destinations destinations within a hospital Critical • Words used in the wayfinding patient system should therefore be questions generic and well-understood by the general (uninformed) public (reducing the use of complex What should I expect, and what is medical words for wayfinding expected of me? purposes) • This is a separate communication, including • ‘Expectation-setting’ verbal instructions from a GP, phone information should be instructions, an appointment letter, a leaflet, separated from signage and waiting room video screens, verbal communicated through other instructions from clerical staff means, but is an important part of the patient journey 6 Setting expectations of a visit Patient experience can be improved by designing information and communications that set expectations of an outpatient visit - reducing confusion and helping patients plan appropriately for the experience. Patient question Content of answer Method of communication Where do I go? Standard wayfinding instructions In an appointment letter, use of [warn of distance if will be an issue] screens, moving words On signage, e.g. 500m from car park When do I go there? Clear date and time In an appointment letter How long will it take? Estimated duration range In an appointment letter Verbal updates at clinic reception Possibly on signage What preparation do I need? No need to fast (no anesthetic will be In an appointment letter administered) What do I need to bring? X-rays, appointment card, medicare card... In an appointment letter What is the purpose of the What I’m being treated for GP or specialist verbal advice visit? What stage this is In an appointment letter The type of visit, e.g. consultation with a doctor for diagnostic purpose Note that no surgery or procedure will be done on the day How much will it cost? Public hospital - no charge Verbal on request What can I expect the next Typical process of diagnosis, treatment Specialist verbal advice in at a stage will be? plan, treatment, follow-up consultation Who will see me? An individual doctor’s name if possible, or Specialist or GP verbal advice the nature of the specialist 7 Core wayfinding principles Hospital signage and wayfinding systems should be designed to make it easy for first time visitors. Where journeys are complex, they should be broken up into stages through navigation to key hubs / destinations. The wayfinding system needs to be Design principles within hospitals designed with these principles in mind: 1. Use landmarks, architectural features and 1. Design for the people who have the most central ‘hubs’ within hospitals as key difficulty finding their way (i.e. the elderly, navigation points those with limited English, vision impairment 2. Break up complex journeys by directing or mobility problems) patients first to key navigation points, then 2. Reduce complexity and remove any words or supply secondary navigation information to symbols that are unnecessary or do not find a more detailed location (start broad, contribute to patient understanding then zoom in) 3. Ensure absolute internal consistency (i.e. 3. Not all destinations in a hospital need to have words and symbols always mean the same signage - there is a hierarchy of information thing within a single hospital system) based on total visitor numbers - label the destinations that account for 80% of visits 4. Aim for as much external consistency as possible* (i.e. consistent systems across all 4. At each journey decision point, list hospitals in Victoria) - a patient may visit destinations that ‘break off’ from the main many different hospitals over time path,