Wayfinding in Complex Medical Facilities: The Indexicality of Directional Arrows.

OBJECTIVES, PURPOSE, OR AIM: The aim of this article is to contribute to the better design of wayfinding systems by explicating the indexical properties of directional arrows and their consequences for wayfinding behavior. BACKGROUND: The challenges associated with designing for the wayfinding needs of the different groups of users continue to be documented with the poor design of built environments being largely to blame for the wayfinders' inability to navigate complex settings. Directional arrows have been found to be especially problematic in such settings. METHODS: Ethnographic data were collected and analyzed over a period of 3 years in three overlapping phases. The unique adequacy requirement of methods, which stipulates that the methods used to produce a description of a situation should originate from the situation they describe, was adopted. RESULTS: Directional arrows derive their meaning from the position they occupy within the physical environment and from three sources: the spatial configuration of the setting, the positioning of the sign within the setting, and the directional arrow itself. The affordance closest to the sign will be taken as the one which the sign refers to. Wayfinders treat that affordance as being indicated by the arrow until such time as it becomes apparent that it is not. CONCLUSIONS: In response to the need to find lasting solutions to the enduring problems of wayfinding, this article demonstrates how better design of wayfinding systems can be achieved by explicating the indexical properties of directional arrows and their consequences for wayfinding behavior.

Redefining healthcare infrastructure: moving toward integrated solutions.

Currently in the United Kingdom there is a trend to broaden the scope of service provision in the healthcare sector. Not only are new healthcare-related services being provided to the community, but also there is increasing concern for providing services to extend the life cycle of built facilities. This trend is similar to what has been observed in manufacturing, where different approaches are used to combine products and services, generating high-value integrated solutions.This article analyzes integrated-solution approaches that have been adopted in the manufacturing sector and compares them to trends that are emerging in the healthcare sector. The practical implications of these trends in the UK healthcare sector are also pointed out. This study discusses how to improve value generation by combining products and services; it also addresses the need for a value-creating system that is capable of developing and sustaining new healthcare infrastructures.Some of the major changes needed to achieve fully integrated solutions in healthcare-such as supporting policies for innovation and stakeholder engagement-are pointed out. However, understanding the theoretical concept behind such approaches (and thus how value can be generated) and the challenges associated with introducing them into practice seem to be the first steps toward achieving integrated solutions in the healthcare context.