Proceed with caution

Designing signs for hospitals used to be easy. The HTM 65 document told you exactly how many brown signs you needed, what size they should be, where they should go and what they should say.
    
Then Foundation Trusts came along, closely followed by PFI Hospitals. These initiatives encouraged hospitals to think like individual entities with ‘brands’ and ‘landmarks’ and ‘wayfinding initiatives’. The brown signs were swept aside.
    
Did it make it easier for patients, staff and visitors to find their way around? I’m not so sure. These are the most commonly used wayfinding devices.

Colour coding
Colour coding works by dividing a complex site into manageable ‘chunks’ and allocating each ‘chunk’ a different colour. For example, in a multi storey building, each floor can be allocated a different colour and this will be picked up in the signing. However, there are only four clearly different colours (red, yellow, blue and green). If you need to use more than four colours, you will have to use either complex colours like purple, (a mix of red and blue) or tones of colour like pink (a mix of red and white). The problem is that many of us have some degree of colour perception impairment and our interpretation of complex or tonal colours becomes subjective and the whole system can fall apart.

Landmarking
This device draws on the traditional model for giving directions, ‘turn left at the lights, then straight on past the pub and its opposite the Post Office’, we orientate ourselves from landmark to landmark. We try to do the same thing to orientate ourselves inside buildings and use features like lifts, artworks or plants as landmarks. However, often there aren’t enough building elements for this to work or they aren’t distinctive enough and so architects and designers have taken to introduce landmarks into building interiors. These can take the form of more plants or artworks but often will consist of large-scale photographic prints.
    
This device will only work if the images are carefully selected. In order for people to view theses images as landmarks, they have to be iconographic, completely unrelated and require no prior knowledge of the subject matter. For example, having an oak tree and a willow tree as separate landmarks will not work as people may not distinguish between the two, they are just ‘trees’.

Line following
The principle is that people follow a colour coded line, usually painted onto floor or wall surfaces from the point of entry to the eventual destination, sort of; ‘follow the yellow brick road’. This idea became popular in the 1970s but was found to be problematic in several areas; painted lines on floor surfaces are outside the normal field of vision and can go un-noticed, painting on the walls can be difficult and costly to maintain and there are limits to the number of lines that can be shown (see Colour Coding). Line following has been largely discredited as a useful wayfinding tool.

Symbols and pictograms
Signs are designed to communicate simple ideas to large groups of people. However, we live in a multi-cultural society and we can no longer assume that hospital patients and visitors, or indeed staff, will have English as their first language.
    
One of the ways that designers have tackled this problem is to use symbols or pictograms in place of written information. This is usually restricted to key facilities: lifts, toilets, catering, pharmacy etc. but there have been attempts to use symbols and pictograms to signify medical departments. I think this is pushing the limits of the use of symbols. They need to be instantly recognisable to work, people will simply not try and work out what a symbol means.
    
Symbols can be as culturally specific as the written word; this is particularly true in depictations of the human form, which is inappropriate in many cultures. The use of symbols and pictograms should be limited to those familiar designs set out by the International Standards Organisation (ISO) or designs closely related to these and used with supporting written text.

Maps and plans
Maps and plans are a 2D description of a 3D space and most of us have a basic understanding of how maps work. There are some considerations that make maps and plans easier to understand. Firstly, they should have a ‘you are here’ point, which shows the viewer where he is in the context of the overall sight. Then there is a decision to be made regarding map orientation, there are two options ‘true north’ or ‘heads up’.
    
True north, is the conventional way of displaying maps on signs, where the north point is always at the top of the sign, regardless of which way the sign is facing. If the sign is facing any other way than north, we are required to ‘flip’ the map over in our mind to make it understandable. The principle reason that maps have been displayed in this way historically has everything to do with the cost of production and nothing to do with making them understandable. Conventional reproduction technologies, like silkscreen printing, means that it is a great deal cheaper to print lots of maps the same way.
    
The alternative is ‘heads up‘ orientation. This means that maps are individually orientated to face the same direction as the sign. This is only practical because of developments in digital printing technologies, which have made printing one-off maps almost as cheap as multiples.
    
There is a debate as to which orientation is the easiest for people to use, in my opinion; it is ‘heads up’ mapping.
    
If they are used carefully, wayfinding devices can support and enhance clear and consistent directional signing but they are not a substitute, nor can they cure badly designed and inconsistently applied directional signing. I’m not calling for the return of the brown signs but I advocate caution when using wayfinding devices. You may end up making your building more difficult to navigate.