Healing for hospital signs that don't work

May 17, 2010
This is a symbol to represent dermatology services, originally created by UC student Emily Boland. Credit: Original design by UC student Emily Boland. Refinement by Mies Hora.

Hospitals are large, complex institutions housing innumerable units, sections and visitor destinations.

And in the United States alone, diversity is increasing within most locales, making it difficult to comply with federal requirements for text signs in patients' languages. In addition, about half of all Americans - approximately 90 million - cannot read well enough to navigate a hospital's written signs.

These challenges have led to a new project, funded by the Robert Wood Johnson Foundation, called "Signs that Work."

It includes 28 signage symbols made by professional designers in 2006 and the new addition of 22 symbols by student designers from four universities.

Fifteen of those 22 new student designs were created by students at the University of Cincinnati's internationally ranked School of Design, part of UC's College of Design, Architecture, Art, and Planning (DAAP). All the student designs were recently refined by international symbols expert and designer Mies Hora and are now being integrated into a system totaling 50 symbols.

Oscar Fernández , UC associate professor of design and leader of the UC portion of the project, will present on "Signs that Work" June 2 at the annual national conference of the Society for Environmental Graphic Design (SEGD) in Washington, D.C.

Overseeing the project in its entirety is Yolanda Partida, director of Hablamos Juntos (We Speak Together), based at UCSF Fresno Center for Medical Education & Research.

PROJECT BACKGROUND

The project was developed in five phases:

  • Professional designers from the SEGD developed a core set of symbols to use on signage anywhere. That resulted in a base set of 28 signage symbols currently in use at national test sites.
  • Student designers expanded the system with additional symbols. (This occurred in early 2009.)
  • The students' designs were tested with English and non-English speakers in three Midwestern cities. Ultimately, 22 student-designed symbols tested well enough to be integrated into the new signage system. (Testing took place in late 2009.)
  • The students' designs were refined in order to standardize them into the larger symbol system. (Spring 2010)
  • These students' designs will be integrated into the existing signage system over the summer of 2010 and tested at four national hospital sites beginning in August 2010.
Project leader Partida explained, "It's our plan that other hospitals will learn about the new symbols via the four test sites. Hospitals belong to a host of specialty and general associations, and these associations provide recognition for innovation, community engagement and health literacy projects."

She added, "The entire system of new health-care signage with symbols will be made available to any hospital or health-care setting wanting to implement them."

The 22 additional health signage symbols created by students will be integrated into the base system already being tested at

  • Grady Memorial Hospital, Atlanta, Ga., the largest hospital in the state.
  • International Community Health Services, Seattle, Wash.
  • The Children's Mercy Hospital, Kansas City, Mo.
  • Women and Infants Hospital of Rhode Island, Providence, R.I.
George Smith, Grady architectural project manager, welcomes the new addition of symbols to the signage at Grady. He explained, "In using the original set of 28 SEGD symbols, we found some gaps - areas we'd like to direct people to that we didn't have a symbol for. Burn unit would be one example of that. "

This is a symbol to represent mental health services, originally created by UC student Paige Farwick. Credit: UC student Paige Farwick, with refinement by Mies Hora.

Overall, he said, signage symbols are the way of the future as part of a larger wayfinding approach that allows visitors and patients to have a sense of autonomy and control upon entering a health center.

Smith added, "We've identified 26 language groups that use our facility, which spans 22 stories and 12 wings. If we had to use text to communicate on our signs, we'd have run out of wall space long ago. In the long run, the use of signage symbols will save us money in terms of implementation and updates."

STUDENTS CONTRIBUTE TO "SIGNS THAT WORK"

One symbol (representing dermatology) by UC digital design student Emily Boland, 21, of Milford, Ohio, will be integrated into the health symbol system. She explained that working on a dermatology symbol - with its "close up" on a face - was especially challenging because the original 28 symbols by professional designers (that the students added to) did not include any "face" icons, only body icons.

She stated, "As student designers, we had to ask and test some basic parameters: What was the best way to show a face? How much is too much? How much is not enough?"

Added Boland, "I'm excited to have my work make it through the different levels and reviews for final inclusion. But, it's hard to credit one person for the creation of any one symbol. We worked together as a class. We brought in other students from other disciplines within the college to see how they would interpret the symbols."

Brian Labus, who worked on the health symbols project as a graphic design senior, is now graduated and working as a designer with Turner Duckworth in San Francisco. Three of his symbol designs (neurology, radiology and ultrasound) will be included in the new expanded system.

Said Labus, "I'm really excited about it. It's very cool that this work is now being implemented because it was a very challenging project to try and communicate the differences between the different imaging methods. On a school project, you're not always sure whether you're hitting the optimum solutions or what a client is hoping for. This is a great affirmation that we were on target."

Other schools participating in the project were the California Polytechnic State University, Iowa State University and Kent State University.

Explore further: Experts call for higher exam pass marks to close performance gap between international and UK medical graduates

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