Photo Credit: Harvest to Table
At a time where the healthcare industry’s margins are razor-thin in the midst of a global pandemic, where does an organization find resources to fund and fuel innovations? Podcaster Zeev Neuwirth, in a discussion with Dr. Roger Ray, talks about the strategic, market-driven imperative for transformation in healthcare; and the financial and operational challenges associated with this. We highly recommend listening to this podcast: it’s called “Threading the Needle of Disruptive Transformation”.
“In nearly any health system … there are still substantial opportunities in unifying, driving out unnecessary variation, and positioning the enterprise to actually deliver value in streamlining [processes] and cost savings. There’s money on the table still to be found to help fuel some of the future-looking realities that we have to get into.”
— Dr. Roger Ray, Chief Physician Executive, The Chartis Group
Neuwrith posits that an organization doesn’t necessarily need to be on the “bleeding edge” of adopting new processes/technologies in order to achieve their aims. In fact, they can follow other entities that have already proven that success. If your organization needs to find the dollars to fund innovations while at the same time improving staff and patient experience, consider these five facts proving that a proactive, comprehensive wayfinding strategy fits that bill:
It’s the single utility that everyone uses.
It saves money.
It builds team cohesion: everyone can contribute.
It solves problems before they happen.
It’s the right thing to do.
One: It’s the single utility that everyone uses.
Along with cooled or heated air, light and the occasional need for a bathroom, a wayfinding system is designed as a ubiquitous utility: everyone at some point needs to use it. Like other utilities, when it’s not working well you know it immediately and you hear about it until the problems are solved. A conversation with a call center, mobile application, pre-visit letter, campus boundary signage, entrance architecture, a hand-held map: all of these are wayfinding utilities, and each needs to be connected fully to the core logic in order to function efficiently.
Unlike other utilities, wayfinding allows you to directly address your culture’s unique aspects. The language that you use — whether greeting people with a friendly hello, referencing a donor-named campus building or using an acronym for a procedure area — is all a part of this wayfinding utility. And it’s important that your new staff and campus guests understand this language, since they may not have the experience to understand your cultural codes.
In the end, a wayfinding system is a utility that enlists everyone: implemented correctly, everyone understands the logic, language and tools, knows how to use them and is able to teach others how to use them as well.
“By the time we’re relying on signage, we’ve already failed that patient in 15 other ways. It’s a system – a philosophy – an intellectual concept. Wayfinding isn’t only about signage!”
— Former Director of Construction and Facility Planning, Gundersen Health System
Two: It saves money.
What does it cost when people can’t find their way? A 1990 study of Emory University Hospital wayfinding titled “The Costs of Confusion”[1] estimated that $220,000 was being wasted per year – that’s $438,000 in today’s dollars. This primarily includes lost staff time, missed appointments and other functional realities but in truth there’s no telling how much potential value is lost to patients choosing to use or recommend another provider, or even staff frustration leading to turnover.
In terms of logistics, a diversified wayfinding system can save other hard costs as well:
Introduce intuitive wayfinding cues to entrances, elevator cores and other key transition points in early planning with architects and engineers, saving design costs down the line;
Reduce the need for static exterior and interior signage using digital tools such as mobile apps and kiosks; and
Reduce the need for paid interpreters and coordinating large numbers of volunteers to escort and direct with comprehensive wayfinding planning.
When static signage is required, enable control from one department with a system of consistent standards and a comprehensive data set. Gundersen Health System in LaCrosse, WI implemented just such a system. Adding in-house capability for printing low-cost inserts, they estimate that at least 50 percent of the original signage inserts have been redone more than once. An interior designer asserted “If we hadn’t had that ability, we would have paid for new signage two, three or four times over.”
She adds, “we used to try every way imaginable, hoping to stumble across a solution. Today, when a signage change is brought to our attention, we have the necessary tools to help identify weak points in communication and make improvements to the systems that support communication rather than attempting to reinvent the program.”
Supporting the old program using their internal sign shop was costing in excess of $55,000 annually for materials alone. In the first year the program was fully implemented, materials costs dropped to just over $15,000. But materials costs are not the only indicator of success; they assert that “the methodology put in place is delivering a qualitative value far in excess of what we ever spent on signage.”
Three: It builds team cohesion: everyone can contribute.
You can impact the culture of your organization by building a team focused on wayfinding. Throughout our projects, we bring together a diverse, interdisciplinary team from all levels and job descriptions who may have never met before. Each of them shares stories from their own perspective about wayfinding challenges; once they collectively see the scale of the problem and its impact on both staff and patients, they work together to change a system that they may have assumed could never be changed.
It’s critical to recruit as many voices as possible to assist in understanding specific challenges. Voices from within and around the organization work together in a collaborative partnership if networked together efficiently and effectively and given access to others who have different information and knowledge. As a result, answers to wayfinding challenges come from within the culture rather than being imposed from the outside. We provide neutral facilitation and decades of wayfinding experience from hundreds of healthcare organizations, resulting in the most productive conversations.
People support what they help create. Cross-disciplinary involvement in co-designing the strategy leads team members to share with their peers, cementing the new logic within the culture. When uninitiated peers or guests need help, proactive training makes each interaction a potential teachable moment. Before launching the logic, language and tools, reference them first in internal communications (including the staff Intranet).
We recruit team members for a dedicated core team from Patient Experience, Marketing Communications, IT, Facilities Management and a C-suite sponsor, such as the COO. We’ve heard stories from everyone from the CEO to greeters, security, PFAC and board members, patient accounts, architects/interior designers, parking and patient transport, gift/coffee shop staff, former patients and staff from every clinical and clerical department. This helps us understand how the system needs to be structured and implemented.
Four: It solves problems before they happen.
How do you measure the positive cost impact of an event that never occurred due to proactive planning?” In his March 2020 book Upstream, Dan Heath shares multiple examples of upstream interventions designed to solve complex problems before they happen. And in an earlier blog post, we compared patient experience design (including wayfinding) to Public Relations: today, business leaders clearly understand the value of an ongoing investment in PR and annual budgets reflect that value.
Similarly, an investment in proactive assessment and design can visualize potential problem areas, identified both by staff and patients, and close the gaps before they become even worse. Upstream dedicates a chapter to building a mindset for preventive investments and their returns, and we recommend you read or stream the book. The upshot of Upstream is that this work may not lead to short-term tangible results and can be difficult to measure, but it takes patience, discipline and consistency to assure these investments pay off. And they do, often exponentially.
A wayfinding strategy simplifies and standardizes a system of communications and behaviors that lessen confusion and stress for staff, patients and families. Like PR, it takes knowledgeable professionals to make necessary adjustments to the system as factors change over time. Unlike PR, it’s an investment you make for the benefit of those least capable of understanding and navigating their healthcare experience. This leads us to our fifth fact regarding wayfinding’s ROI:
Five: It’s the right thing to do.
“Early on in the project we tried hard to find data, measures and metrics that we could use to validate our business plan. We had to come to terms with the fact that we couldn’t put a [monetary] value on the patient experience or our success in managing the degree of change we anticipated. We had to ask ourselves, ‘Is it the right thing to do conceptually? Is it going to benefit our patients?’”
Gundersen Health System’s former Director of Construction and Facility Planning
She provided further perspective on their Upstream mindset: “We knew that we should be concerned with the amount of staff time spent giving directions, but maybe we weren’t going to find a piece of data to validate this. Instead, we saw the potential improvements to the patient experience as an important part of our outward value proposition and our internal core values. We then proceeded with managing costs and maximizing the value of the outcomes as the design process rolled out.”
Like any complex problem with multiple causal factors, it can be difficult to fully quantify the specific benefits of a wayfinding system. For each of our clients, their success is due to the broad approach that their team takes to the entire range of wayfinding communications and the individual responsibility of people within the organization to support the patient experience.
Working together to build a flexible infrastructure for managing constant change is an investment worth making. Doing this allows you to stay true to the spirit of your organizational mission and value proposition. And that, friends, is priceless.
[1] Zimring C. The Costs of Confusion: Non-monetary and Monetary Costs of the Emory University Hospital Wayfinding System. Georgia Institute of Technology; Atlanta, GA, USA: 1990.
