Signs of the Times

Signs of the Times

Signages in hospitals today have evolved from mere guiding signs to ones conveying the personality of the brand as well as adding to the customer experience, discovers Sonal Shukla.

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One of the stunning signage boards in Dr LH Hiranandani Hospital, Mumbai

Hospitals are often an intimidating maze of hallways and departments for patients and attendants who are stressed, preoccupied or disoriented. Typically, a patient who walks into a hospital needs to go to a number of different places within the hospital like the outpatient area, then to the billing, doctors’ room, nursing stations, sample collection counters and imaging and radiology counters. Since multiple touch points are involved, signages, also known as way-finding systems, serve an important purpose of guiding the patients. “A thorough, well-planned signage and graphics programme helps a facility operate smoothly, reassures the patients and visitors and enhances its image,” states Dr Shakti K Gupta, author of ‘Modern Trends in Planning and Designing of Hospitals, Principle and Practice’.

Danger Signs

One important purpose served by good signage is to ensure patient and healthcare workers’ safety in the hospital by marking out hazardous/dangerous areas in the hospital. These are signages relating to fire safety, biohazard, radiation and chemicals (laboratory). There are cautionary signs such as ‘No smoking’ and ‘No visitors’. It is also important to distinguish indoor and outdoor signages, as those affect the choice of material, illumination, size of the signboard and lettering.

Apollo Hospital Group has combined floor directions with evacuation maps on each of its floors. These signs help navigate people around each floor, and facilitate their exit with efficiency in case of an emergency. Experts also feel that evacuation during emergency can be a major concern in a healthcare facility.

Broadly two types of graphics are deployed in hospitals, comprising the directional graphics or the signage system, and the branding graphics, including the hospital façade, logo and stationery.

Showing the Way

Hospital signages and graphics greet people well before they come to the hospital as patients. Graphics are displayed on the hospital’s façade as well as on ‘graphic totems’ outside the building. Directional signs indicating the route to the hospital usually start several kilometres away in the form of signboards and roadside signages. Hospital receptions usually display a directory of departments and consultants. Directional signs are placed on the sidewalls, ceiling (hanging) or even the floor. While proper signs are essential for preventing confusion amongst visitors, direct visual cues transmit information better than signs.

Points of Reference

Another important device in orientation is the use of landmarks – easily identified and remembered objects that can be used as points of reference along paths. “Sculptures, paintings, fountains and gazebos often serve this purpose. Such signages are very important for patients with memory disorders, like Alzheimer’s disease, serving as memory pegs for them,” states Dr Rajiv Patni, Resident Administrator, AIIMS, New Delhi.

Setting an Image

In modern hospitals, the signages play an important role in establishing brand salience. No one knows it better than the JCI-accredited Wockhardt Hospital, Mumbai which has rigorous standards and policies. “JCI has certain standards on patient education, patient and family rights and responsibility, facility management and safety, which are partially connected with information including signage,” explains Anil Pinto, Manager, Administration, Wockhardt Hospital, Mumbai.

Signages also increasingly reflect the personality of the hospital brand. A lot of thought goes into developing the signages, keeping in mind the hospital’s brand philosophy and proposition. “Most hospitals are trying to focus on a unique customer experience. Signages have evolved into an essential unit in the delivery of that experience,” feels Anas Wajid, Head, Sales and Marketing, Artemis Health Institute (AHI), Gurgaon. They are being used creatively to delineate spaces, create colours and make people feel comfortable and at ease. Every disease in AHI is associated with a different colour and areas are highlighted accordingly. The hospital conducts various programmes for senior citizens. It has used bigger lettering in the signages for better visibility to those patients. Hyderabad’s Yashoda Hospitals Group identified certain areas where patients wait for some time, like before meeting the doctor or patients’ relatives waiting area. In those areas, public interest messages on ‘How to stay Healthy’, ‘Controlling Diabetes’, ‘Cancer Awareness’, ‘Heart Care’ and ‘First Aid’ are displayed. The encouraging response has helped the hospital to improve its branding and image.


The reception area of Yashoda Hospital greets its patients with easy to understand signages

Apollo Hospital, Hyderabad uses different language signages
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The directory designed by HKS at a children’s hospital in California is playful and high-tech

Colour Coding

With hospital chains in vogue, similar signages and colours inside each hospital help reassure the patients. For instance, all Max Healthcare hospitals look the same, thus a patient feels equally comfortable in a hospital in Panchsheel Park or Noida or Gurgaon. All the signages in Max Healthcare use consistent colour coding, like red for emergency numbers. Green, which forms an essential part of the hospital’s brand identity, is extensively utilised in different signages. On top of all Max Healthcare facilities one can see outdoor signage with the hospital name, which helps the patients to identify the hospital location from a distance.

In Dr LH Hiranandani Hospital, Mumbai the colour theme encompasses the staff uniform and stationary. The same colour theme is used for all the hardboard signages to bring in uniformity except for STOP/caution signages like restricted areas and fire exits, which are in red/green. Graphics are used to bridge the language barrier and to reach out to the illiterate population. Electronic display systems are used across the hospital to cater to dynamic changes in information which need to be passed on to the visitors. The hospital has put up information on its website by way of walkthroughs, images and contact details. The public announcement systems are used during camps to guide the patient to appropriate locations within the hospital.

Apollo Hospitals, Hyderabad has unique colour codes for some of the signages: Acute care/Restricted patient care-Red, Regular patient care areas-Yellow, Diagnostics-Blue, Support Services-Brown, Utilities- Purple, Others-Light blue. The colour coding serves a departmental need besides being visually informative. The overall design, placement and colour code in the hospital is brand consistent, aesthetically coordinated with the décor and ambience, and projects a strong corporate identity.


All the signages in Max Healthcare use consistent colour coding
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Fortis Hospital,Vasant Kunj has used visual graphics in signages
2007083162-7207733 Directional signs designed by HKS for McAllen Medical

Center in the US

Pictures Worth a Thousand Words

“The signage must be comprehensible to children and adults alike”

– Dheeraj Gorukanti

Director

Yashoda Group of Hospitals Hyderabad

By and large, hospital way-finding systems often confuse people, being generally devoid of graphics and written in physicians’ language. For example, terms like Otorhinolaryngology, Interventional Radiology, Oncology, etc may not be understood at all by the person who is supposed to read, and follow, the signs. Hence, it is important to incorporate appropriate graphic elements in the signages. Use of universal symbols, which are easily understood without any help, is very important in the hospital context, feels Dr Patni.

Planning and implementing a hospital signage system is not an easy task. The signage must be comprehensible to children and adults alike, as well as to the diverse, multi-cultural users of the hospital. It must be simple and clear in style for easy recognition. “Even a layman who comes to the hospital for the first time should easily go wherever he wants without the help of anyone,” opines Dheeraj Gorukanti, Director, Yashoda Group of Hospitals, Hyderabad. Moreover, important signages should be a part of hospital design involving the team of architects, interior designers and hospital management.

“The technical terminology has to be complemented with graphics to allow for ease of understanding,” says Sameer Mehta, Facility Planner, Hosmac India. For instance, a negative image of the ribs works well to describe an X-Ray. Ideally, this is complemented with bilingual text ‘ksha kiran’ appearing below ‘X-Ray’. “We would use positive ways to restrict information rather than a blunt message,” explains Mehta. At MD Anderson Cancer Center in Houston TX, however, their culture was all about advanced technology and doctors with superior educations. Terminology used there was selected based on that culture. Many of the department names involved Latin medical terms.

The community culture greatly influences the design of the architecture as well as the signage system that accompanies it. Local language and culture affect the choice of nomenclature and whether a second or even a third language is to be displayed on the sign. Naresh Mathur, AIA, Vice President of HKS, a leader in the healthcare design industry in Dallas, Texas feels that cultural and traditional aspects of the users should not be ignored. “For instance, in a hospital with a primarily Chinese population, we wouldn’t use white on the sign elements because white symbolises death in that culture,” he explains.

Apollo Hospital, Hyderabad uses English, Hindi and Telugu. Floor directions and floor identification are the first signs that one sees after getting off the elevator. All room numbers in a given corridor are indicated with directions marked, and restrooms for men and women are graphically marked. Emergency fire exits are indicated through bold arrow marks marking the floor direction to the exit point and thereon to the emergency exit. “Overall, we take care to ensure that our signage is simple and user-friendly,” says Y Subrahmanyam, GM, Operations, Apollo Healthcity, Hyderabad.

Local Planning

According to experts, it is very important to define the mission of the hospital and study the attributes of the population to be served before designing its signage system. An ophthalmic centre can best install high contrast signs, large lettering, auditory information systems and Braille or tactile signages. A paediatric centre would be well advised to use bright and cheerful graphics to create a friendly ambience.

Each project requires a slightly different approach though the process is generally the same. Small projects may require simpler way-finding systems and fewer sign types than medium or larger ones. Additions to existing facilities require an understanding of how the new and old will function together and perhaps redoing of the existing space completely to make a successful system. Some are just exterior programmes; some just interior programmes; some are both—plus donor recognition systems and decorative graphics. The process of research, planning, design and documentation is then applied to each. The objectives of the signage system and budget should be clearly spelt out.

“The local/target language of dominance must be considered. Graphical representations are essential to address the language barrier and illiterate target group,” opines Dr Akash Rajpal, Manager, Medical Services, Dr LH Hiranandani Hospital, Mumbai. Thereafter, the hospital administrators should plan the system in detail with the architects and interior designers. Various aspects of the signage such as shape, size, colours, language, materials and siting should be determined.

  • Dr Aninda Chatterjee, Hospital Superintendent, BM Birla Heart Research Centre, Kolkata, cautions against cramping of too many signages, mixing it up with advertising matter and unsafe hanging from the ceiling.

  • Instead of materials which require maintenance, the hospital should buy durable and rugged signage.

  • Creating the entire list at one go can save costs and uniformity. “Signage assignment should not be exclusively left to Projects. Integration of marketing and operations (medical and support services) in the process is important,” feels Vijay Gupta, Marketing Manager, Max Healthcare, New Delhi.

  • It is often necessary to integrate new practices with the old or existing ones when updating the signage system in a hospital.

  • Aspects such as area, visibility, frequency of movement should be given due consideration before choosing a type of signage. Some hospitals keep too much lighted signage inside the hospitals including neons. This is a bad practice and distracts the patients, causing them inconvenience.

  • Signage should not appear artificial and inappropriate. It must look like a part of the design and architecture.

A Creative Journey

“Efforts are already underway to develop universal symbols in healthcare in India”

– Chris Bauer Vice President and Director of Environmental Graphic Design

HKS

Creative signages in hospitals are those that are aligned to the fundamental function of being a value-added service, and at the same time are aesthetically designed to blend with the exterior and interior designs of the hospital. Identifications that are internally illuminated in soft lighting for high visibility, way-finding directional signage that is effective and colour-coordinated, informative wall-mounted directories, modular directional signs, brass or aluminium lettering that reflect light etc can all be used as creative signage.

“The effort usually is to produce a unique yet effective signage system that has visually communicative symbols and directions, while maintaining consistency in terms of lettering, style, appearance and font,” says Subrahmanyam. Creative signage also could minimise dependence of manned staff to guide the patient or visitor. “They should be precise to the service being provided and be self explanatory and brief as far as possible. However, there are some terms which cannot be avoided specially for non patient areas like CSSD,” explains Dr Rajpal. Electronic signboards are the recent trends where content can be changed as appropriate from time to time.

Signs Ahead

More interactive and ‘smart’ signs are being developed today. “These ‘smart’ signs will be affordable and customisable. “Audible message signs are also being researched although there are issues with noise and multiple messaging as one walks a corridor. Cost right now is prohibitive,” informs Mathur. Says Chris Bauer, Vice President and Director of Environmental Graphic Design, HKS, “Efforts are already underway to develop universal symbols in healthcare. The universal signs would be helpful in way-finding for the medical tourist international patients in India.”

sonal.shukla@expressindia.com