Lost Before They Walk In: How Wayfinding and Arrival Design Shape the Patient Experience

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Melissa Gilkes-Smith: Picture this. A patient has a 9 a.m. appointment. They’ve never been to your facility before. They left the house early because they were nervous about being late. They find the parking lot or what they think is the parking lot, circle it twice, park in what might be the wrong structure, walk toward what looks like the main entrance, and find themselves standing in front of a loading dock. They are now anxious, confused, a little embarrassed, and three minutes late. And they haven’t spoken to a single member of your team yet. That is a patient experience failure, and it happened because of design, not because anything your staff did or didn’t do. Today we are talking about what happens before the patient ever reaches the front desk, the arrival experience, wayfinding, navigation, and the design decisions that determine whether a patient walks through the door feeling prepared or already defeated.

I’m Melissa Jolk Smith. This is Touch Points Moments That Matter. Let’s get into it. Today we are inside Pillar 4 of the nine pillars of patient experience framework, arrival and check-in. And I want to be specific about where we are in that pillar. We are outside the billing. We are in the parking lot. We are at the entrance. We are anywhere a patient is trying to navigate their way to you before they ever reach a human being. Because the patient experience does not begin at check-in, it begins the moment a patient turns into your driveway. And the design of that environment, the signage, the flow, the landmarks, the wayfinding system is already telling them something about your organization.

My guest today spent 40 years solving exactly this problem. Laura Nitschke built her career in architectural graphics, signage, and wayfinding after an early pivot that took her from architectural plan work into environmental design. A move that turned out to be a calling. She specialized in a hospital and healthcare facility projects, specifically because of what she recognized there. Patients arriving in complex environments under conditions of stress and urgency, often for the first time with no margin for confusion. Lauren has since retired and sold her business, and she now, with her husband, raised grass-fed cattle on a ranch in southern Oklahoma, which tells you something about the kind of person she is.

Someone who builds things at last and then finds the next meaningful thing to tend to. Lauren, welcome to Touch Points. I’m so glad you’re here.

Lauren Nitschke: Thank you so much. I’m so glad to be here. It’s really an honor and a privilege to be with you, Melissa, and I’m thankful for this opportunity to address a concern that I did spend many, many years trying to solve.

Melissa Gilkes-Smith: Yeah, I’m excited about the conversation. So before we get into the substance, I want to hear about the pivot in your own words. You had an architectural background, you moved into environmental design, and 40 years later it became your life’s work. What did you see in that first wayfinding project that made you realize this mattered?

Lauren Nitschke: Oh, that’s such a good question. My initial move into architectural graphics was as part of a big commercial architectural firm in Dallas where I worked in the architectural division. And I had a break between projects, and the one-person design team in the environmental graphics space was desperate for some help. And she and I had become good friends, and she went to the management and asked if she could co-opt me for a couple of months to help her, you know, knock out some projects. And I didn’t know a thing about what she was doing, but I was excited to learn because I’d found that I really, really enjoy uh shorter duration projects. Um, I’m more hands-on. I like um I like coming in and being able to um solve solve some of the problems that the architecture created.

And that could be new construction or it could be um, you know, adaptive reuse. It could be a renovation where you know you got there with kind of a scrambled mess and you were trying to help people figure out how to pick their way through it. And um I just I got to work on projects that our architectural firm was designing, and it was primarily, I would call it the jewelry that we put on at the end, and it would be the you know, the the monument sign out in front of the office building, it would be a directory, it would be uh suite signage, very simple stuff, restroom identification, things like that. Now, this is in the days before the Americans with Disabilities Act had passed, and signage was a you know a widely unrecognized discipline because people would literally just write stuff on a piece of paper and tape it to a door.

And that was their own. People still do that. They’d still do that. Of course, that that now is not legal, but um in public spaces anyway, or public access spaces. Uh, but I I was able to pivot into my own business in about a year and a half later and got to do a much wider variety of projects pretty quickly. I didn’t do my first healthcare for quite a while, but uh, you know, office buildings, um, college campuses, which have a lot of similarities with healthcare design, um, very confusing, multiple buildings, people are lost the moment they get on campus, that kind of thing. So uh, you know, I think all of that came together just to help me understand how to walk people through a project to a destination as a first-time visitor.

And because I was a first-time visitor on all these projects, whether it was in plan or actually, you know, in person, in physical sense, because the building was already there, um, I was thankful that uh the Lord had blessed me with this 3D visualization, spatial visualization, because whether it was in whether the building was physically there or not, I could read plans well and I could, I could walk myself through the building just by looking at the plans. And I could see it uh not only in plan, but also I could see the in elevation and section in perspective. I could just walk through the building in my head and see where there were bottlenecks or where there were problems, or uh in many cases when it was a renovation, there would be, you know, multiple bottlenecks or places where an elevator bank didn’t go to that that office or that that clinic because it only went to the third floor and you needed to be on the ninth floor.

And to find where that elevator was, it went to the ninth floor was just like, you know, maddening because you couldn’t find it. And you had to, you know, you had to drop some breadcrumbs along the way to let people know what they were looking for.

Melissa Gilkes-Smith: And so one of the things I I want to go back to, so you mentioned um, you know, college campuses, you know, medical office buildings and such, and you pull into that parking lot and there’s so many buildings. And I want to start with a framing that I think that most healthcare organizations have not fully internalized. The patient experience begins in the parking lot, not at check-in, not when the provider walks in. It’s like actually in the parking lot. And from your experience, what is the patient actually experiencing in those first moments of arrival? And why does it so matter so much for everything that follows?

Lauren Nitschke: If it’s a patient in particular, oftentimes they’re coming because of a healthcare need. You know, they’ve got a concern, they’ve got an appointment, they’re nervous about what that’s going to result in, and um apprehensive about the whole process of what is going to unfold afterwards as well. And that getting in the door part should not be a point of tension, but it often is because main entrances aren’t well marked, uh, parking lots for the appropriate building are not well marked. Um, even the campus itself could not be well marked. And you know, you might pull into the wrong driveway and you’re, you know, you’re in another medical facility that’s right next door, but you don’t realize it.

Um, so I think it’s just the the idea that you’re coming in a little bit stressed, you really want to experience a more seamless path into the building, into the parking space, into the building, um, or ballet parking if that’s an option, because a lot of people are mobility uh challenged and may have some some needs for unloading um a wheelchair or a walker or you know, some some device that helps them, you know, get through the building. So um if there is valet parking, if that’s an option, you know, that needs to be very clear right from the get-go, not just I have to go to South Park and and you know, navigate my way up to that main entrance. Um I think that’s just that’s sort of where you start, is just how you get on the campus, on the right campus, and what your parking options are.

So that’s that’s where I start and where I’m going in, the main entrance. That’s that’s the big picture as you come into the campus.

Melissa Gilkes-Smith: A lot of hospitals, a lot of uh larger organizations are are using the valet, you know, more and more these days. It definitely takes a lot of that stress off of um patients who are already nervous, who are already maybe running late because of, you know, life. Um and you know, as you had mentioned previously, the uh the construction, there’s there always seems to be another construction process project happening at a healthcare facility. And so then you have to navigate the detours and to be able to just pull up front where there’s the ballet and hand over your keys and just like walk right in to your appointment is is fantastic. Um so the emotional state of arriving of a the arriving patient is something I think about constantly in patient experience work.

You know, this is these are often people, you know, as mentioned who are anxious about a diagnosis, physical discomfort, running late or navigating an unfamiliar environment. So are there any specific design techniques that you use to um alleviate that anxiety? Um, you know, I know it’s signage and everything, but something in the design of that signage.

Lauren Nitschke: Yes, there is. Um, visibility is huge. You have to understand how far away someone has to view a sign to be able to read it and in plenty of time to make that decision. Do I turn here or do I turn there? You know, which which is it? If this is the visitor entrance and the next one is the employee entrance to the parking area, you know, you’ve got to be able to size your lettering and your sign, which oftentimes is determined by building codes in cities and then towns. But um to get the to get the lettering the right size so that you can view it from an appropriate distance. And so a rule of thumb is about one inch per 50 feet. And so you want to see how far back you’re you’re going to need to make that decision or approach that decision point and size your lettering appropriately.

And make sure that it says, you know, what it needs to say. Again, not just parking, but visitor parking. Also ballet parking, free valet parking. Free valet is huge because that’s another, you know, it’s another stickler for people that they don’t know how much that’s going to cost. And I think clinic clinics and facilities that go ahead and fork over the money to pay the valet and don’t make their patients pay it, that is a huge service to them because then they then they don’t have a hesitation about using the valet. And oftentimes that that is absolutely the most efficient way for people to get into the building is to valet park. So I think anything that removes uh a sticking point for a for a patient or even a visitor is is a really good move to make.

So I like to say free valet parking if I’m going to say valet parking.

Melissa Gilkes-Smith: I appreciate that clarity. Um, because you know, that’s also part of what you know, pillar three is pre-visit communication and communicating that, hey, we have valet parking. It is free to use. This is where you enter, this is how you get to the valet parking, this is what will happen. Um, you know, all really important in this wayfinding process. Yes. Um, so a patient, you know, they they park or they they valet their vehicle, and then that’s where the internal, now you’re going inside the building, and this is where wayfinding can sometimes get confusing. So, you know, the valet parking is great. They see the sign entrance to the building, and then they get in, and it’s like, oh my gosh, there’s like 11 floors.

There’s three different ways to go on this first floor, and I have no idea where I’m going. Right. Right. So I want to spend a few minutes here making sure that our listeners understand what we’re actually talking about when we say wayfinding, because I think the instinct for most healthcare administrators is to hear that word and think we need more signs. And that’s not quite right. Um, can you help us, you know, define wayfinding as a discipline? You know, what is it really?

Lauren Nitschke: Um, it’s a complicated system, actually. It’s not, it’s a whole lot more than signs. You can have a lot of signs that tell you basically nothing. So wayfinding is the process that helps a person understand where they are, where they need to be, how to get there, and when they’ve arrived. And on the flip side, how to get out once they leave that office. And a lot of times that gets ignored, but they want out of there. They want out. So they’ve got to know how to get out. But it’s it’s um, it has to do too with the the campus layout, um, where the parking is, where the entrances are, the department names, any landmarks that might be, you know, inside the building, uh, maps, physical maps or digital maps or importa and directories, um, information kiosks or information desks where there’s actually a human being.

And a lot of people will stop there first and they’ll be given perhaps a map or instructions to go to the department that they’re going to. But I mean, that’s that is a personnel requirement. You’ve got to have someone manning that desk at all times and maybe two people because you don’t want people waiting, you know, for information when they’re late for an appointment already. But there shouldn’t be a sole dependence on an information desk and a person. It should also be very obvious through the signage. And I like to identify one major elevator bank that gets them to all destinations or at least gets them to a very obvious decision point that to make next. And I think one of the most successful projects we worked on was one where there was a new building built adjacent to three older buildings that were connected, all different heights, and they put a sky bridge in between them.

And they wanted the new entrance to the building to be at the new building everybody was used to for 40, 50 years going in the old buildings and navigating around that. But things had moved around. But that sky bridge, rather than doing a tunnel under the street, was a big cue to people driving up that oh, I can get everywhere I need to go by going in this main entrance where it says very clearly main entrance. And then when you got in the lobby, it said main lobby. And there were, you know, large letters mounted up on the walls that pointed to the elevators, that pointed to the information desk, that pointed to the cafeteria, um, just very large. So big bold signage on the wall that you couldn’t miss, basically.

And that one elevator bank that got you where you needed to go.

Melissa Gilkes-Smith: Mm-hmm. What was interesting, one of the things that you said was um the exit part, you know, patients want to get out too. I had a um an experience a few months ago. I um at a doctor’s office, it was a huge office. And when I was brought back, there was a medical assistant who who got me and you know, walked with me all the way around this big building and then brought me to the exam room. But then when the appointment was over, she said, okay, have a nice day. And I’m just like looking at her like, I don’t know how to get out of this building. Or like, where did you bring me? And so she said, Oh, you just follow the exit signs, which were about five inches long by two inches tall, very small signs that were on like the corners, and it just had a little arrow.

And I could follow the signs. I was like, now that I found them. Um, but I was thinking to myself, what if I am somebody who is, you know, elderly, didn’t have, you know, you know, my eyesight wasn’t great, you know, I was having a difficult, you know, problem figuring that out, you know, signage on the exit experience is so important too. My personal preference for healthcare organizations is then if you walked me back here, walk me back out, especially if you have such a large building.

Lauren Nitschke: Yes, I agree. I agree. That’s that’s really critical. And it’s a good distinction between a building that’s fairly easy to navigate and one that’s very complex. And healthcare facilities can certainly be that just that. And getting somebody back to radiology or an imaging uh area is, you know, sometimes that’s sort of back of house spaces, and you know, all that stuff goes on sort of behind the curtain and people don’t know where it is. And like you said, you don’t know how to get back out. You’re in the back of house. Exactly.

Melissa Gilkes-Smith: So your background is unique in this field, architectural plan creation, graphic design, and what you described as a God-given aptitude for three-dimensional visualization. What does seeing space in three dimensions give you as a wayfinding designer that someone without that background might miss?

Lauren Nitschke: Oh gosh, it seems so obvious to me. You know, the ability to see a building without walls. Walk in and just see the outside of the building and know how spaces are connected, how spaces are connected both uh walking on the same level. Say I’m on level two, but I need to get to level five. It’s being able to see in my mind how that building works, how I get from where I am on level two to where I need to be to get to level five. And it just it sort of like removes the visual barriers in my brain that I can see the path of least resistance to get there. And I can see where there’s failures to patient failures, because a lot of times these are, I mean, people have worked there a long time and they know the back of house ways to get way places.

And but patients don’t know those things. They’ve never been in the building before. So it’s not old hat to them, it’s something brand new. So I think that being able to vis visualize that in addition to putting myself in the position of being a first-time visitor is is definitely an advantage over just the ability to have a graphic design aptitude. Well, many times that’s very, I mean, we think of graphic design, we think of print graphics and um digital graphics on a on a computer screen, which is very 2D, and you need to be able to think in 3D to interface with architectural planning.

Melissa Gilkes-Smith: So, with all of your experience, you’ve walked into facilities that were doing this well and facilities that were to put it charitably not. Um what are the most consistent failure patterns you have seen in hospital and medical office arrival design?

Lauren Nitschke: Lack of definition of a main space, like a main lobby where things, all the things you need go off of that main lobby. They’re not hidden behind another corridor or another corner. Um, they are right there in that lobby. And I think that’s that is the best architectural planning is to make sure that when someone comes in, the main destinations are easy to find, right there. And having to, you know, direct somebody around the corner, down the hall to the main elevator bank is very confusing. Um, because you get to you get to that corner and you go, oh, do they say go right or left? Which way do I go? And if you can’t see the elevator bank or can’t see any signage, you know, designating the elevator bank, you may go down the wrong side and you know, then you’re lost.

So I think that whole main lobby thing is is just huge. It’s a great, it’s a great way to greet visitors, like we know you’re here, we care about your your destination process, and we’re gonna make it easy for you.

Melissa Gilkes-Smith: So let’s go back to that that hospital that you worked on where they had redesigned the the entrance to be a new entrance after what 25, 30, 40 years of everybody knowing exactly where that entrance is. And so now you have the construction project, now you have a new entrance, um, a new wayfinding system. What happens to patients when the physical environment has been updated, but the navigational system hasn’t kept up? And this even like should be during construction too, because detours and I mean that can be a nightmare.

Lauren Nitschke: And it was. It was. We did a lot of temporary signage during the construction of the of the new building because it was literally across the street. It was across a one-way street. So, you know, traffic was limited to going one way on that. And, you know, if you got into the middle of the construction, you couldn’t turn around. So very, very specific signage about temporary parking and the pathway that you had to go into the old building, but then how to get to the elevator banks that took you to all the destinations in that old building. It was, like I said, it was, I think it was three old buildings. One was a four-story, one was a five-story, and one was a nine-story. But they were connected in sequential order.

So the first elevator bank you came to only went to the fourth floor. And it didn’t even connect to the to the fourth floor of the building next door. And, you know, people who worked there knew that, but people who didn’t work there had no clue and they would be so lost. And so there was just so much uh temporary signage that we created for the construction part because people were going to be so disoriented by the construction to begin with, because they weren’t parking where they were used to parking. They were in a totally different location. The old parking lot was the construction site.

Melissa Gilkes-Smith: Yeah. That makes me think of um when you’re at convention centers and all of these conference centers where it’s kind of like, you know, oh, you’re you’re going to be in tower one, and that you take the you go up to the second floor, make a right, and then you take the elevator or the escalator, and then, you know, oh, and then you’re, you know, your second session, that’s over in tower two. You have to come back down through the it’s like, oh my gosh, you know, I’m all over the place, and I have to have a a map where it’s you are here. So, they are helpful. I have seen um a uh recently visited a healthcare organization that actually had an app. And so it would, you would tell them, you know, where you were, you’re in the lobby, and where you needed to be.

And the app gave you, it was it’s kind of like Google Maps, but for within that healthcare organization, um, it was useful. It had a little bit of a delay, um, especially when you got into the elevator. But it was something where technology is helping, you know, with the wayfinding, you know, issues.

Lauren Nitschke: I I think that’s great. I really do. Um, and that’s that it’s technology being used to the best benefit in wayfinding. And it’s it’s great if you have good internet signal, like you said, in the elevators, you’ll typically drop a signal and it wouldn’t catch up with you so quickly. It’s kind of like, I mean, I go back to the old pre-digital world of maps go, paper maps. You know, you could find your destination on a paper map, but it didn’t tell you anything about how to get there. It didn’t tell you about road closures, it didn’t tell you about car accidents, it didn’t tell you about emergency vehicles, you know, on the side of the road or whatever. It didn’t tell you any of that. So you just had to go pick your way through and try to navigate it yourself.

Then we got to um, you know, Google Maps. Well, you could you could pull up something on a map, but if you didn’t press the button that says directions, you still had to figure out on your own how to get there. And when you press directions, then it will map out several routes for you. Now, as long as you’ve got a signal and can stay on that, stay with your signal and and navigate it as you go, you’re good. But I think one of the things that’s really helped is just the um uh Waze is an app that’s really pretty good at it. But Google Maps has gotten better too, where it it’ll you you’ll have your destination, but it backs you up to where you are and it doesn’t give you the long view of where you’re going.

It just says in 3.5 miles, you’re you’re going to turn left onto blah, blah, blah street. And then it’ll tell you in 500 feet, turn right into the entrance. You know, stink things like that. It doesn’t, it doesn’t give you the option of going, okay, way out there, I can, I think I can see it, I think I’m good. It gives you those breadcrumbs, I would call them. Breadcrumbs. It gives you the next step, the next step, the next step. And that’s what I think the most effective wayfinding does that. Instead of giving you, you know, 17 different locations right there in the main lobby, it gives you where the main elevators are. And there’s a directory by the main elevators that tells you what floor you’re going to for your destination.

So you can press the right elevator button, and when you get off the elevator, there’s your next breadcrumb. It’s a kios that says, you know, this is that way, that it’s that way. Um, sweet so-and-so and so-and-so, straight ahead. And there’s a map along with it that shows you where you are for people who are visual, want a map, but you’ve also got the, you know, the the signage itself that’s that you can read that tells you the next steps. And then when you get closer to where you’re going, you’re gonna have another directional sign, and then you’re gonna have a sweet sign that’s obvious. Welcome, you know, you’re here.

Melissa Gilkes-Smith: And those electronic kiosks are great, especially when, you know, you can they’re um uh interactive and you can, you know, it show you, it’ll show you like the map of where to go, and you just kind of press on, you know, what um office you’re going to when they work, of course. Too many times I’ve walked in and you know, it’s like, oh, here’s our electric, you know, electronic kiosk, and there’s nothing else there. It’s just you have to use this, but there’s an error on the screen. And, you know, I always say to um any of my clients that, hey, if you’re the manager, an office manager here, one of your duties, one of your first jobs when you walk in in the morning is walk in like a patient. And if you see that, oh, the kiosk is down, or oh, there’s the signage is weird.

What happened to the sign that was here yesterday? You know, um, did it fall down? Somebody didn’t replace it. You know, you should be walking through like a patient is arriving to your practice. And then if there’s any issues, notify the necessary person to fix that before your patients come in. So every day you should be walking in with a fresh set of eyes like a patient. That is excellent advice.

Lauren Nitschke: I hope it’s followed.

Melissa Gilkes-Smith: A few, yes. Yeah. Um let’s talk about legibility when it comes to signage, because I think there’s a tendency in design to make things beautiful at the expense of making them readable. And what does legibility actually mean in healthcare wayfinding context?

Lauren Nitschke: Thankfully, the Americans with Disabilities Act has given us guidance on what we can use and what we cannot use if you are adhering to those guidelines. And there typically will be an ADA inspection, you know, in any facility before it opens, before they get their certificate of occupancy. You’re gonna have to have that ADA, you know, fire inspection, all the things are gonna come through and go through it. So legibility is huge, contrast is huge. Um, one of my pet peeves is red letters on a black background or black letters on a red background. It’s just almost impossible to read from any distance whatsoever. And just, you know, the contrast, it’s it’s almost like as close to black and white as you can get it for signage.

And the design can be very nice, but it should never interfere with the message part of it. Um it can enhance you know the enjoyable visa visual experience with a with the signage system, but it should never be the primary thing. The information is what you’re trying to communicate and make sure that you know it hit it fits within ADA uh constraints with uh legibility. Uh, and it’s changed over the years, but basically, you know, letters have to be at least 5’8 inches tall, they have to be in all caps, they have to have a braille interpretation. The braille’s always located in approximately the same place, and um, you have to use eggshell paint, you can’t use shiny paint. Um, so things like that are spelled out within the the guidelines for ADA, and that’s really helpful.

Also, signage that is um above a certain height in where you’ve located the sign, like a sign up on the wall or an overhead sign, you know, there’s a minimum size for letters to be there as well. Uh also the spacing between letters, you know, sometimes people will cram letters together to try to fit it on a sign, and that’s that’s hard to read too. So there are guidelines on that as well. So I think as long as people stick to the ADA as like your starting point, and then realize that whole thing about from 50 feet back, you’ve got to have at least one inch in visibility in height, typically three to four or five inches, even if you’re walking down a long corridor to see a sign and have it contrasted with its background.

Does that answer what you need to know?

Melissa Gilkes-Smith: Absolutely. No, that’s really helpful. You know, you can actually go to um the uh the ADA website and I’m sure find that information directly and just use those guidelines so you don’t have to, you know, figure it out yourself. That’s really helpful. Right. So I want to give our list So I want to give our listeners something practical to take away because I know some of them are sitting in facilities right now that have wayfinding problems they can feel, but they can’t quite name. So if you’re a practice administrator or facilities director, you wanted to conduct a basic wayfinding audit on your own, where would you start?

Lauren Nitschke: Um, I would start, like you said, first of all, with yourself. You know, come in as a new patient or, you know, bring in a friend that’s not familiar with the facility and walk through it with them. Um, you know, going further than that, even a small focus group of, you know, no never been there before visitors that you could put together to have them walk through and try to figure out where they’re going, give them different destinations and have them try to figure it out. And then make, you know, in their phone, maybe phone notes about, I can, I can’t find this, you know, this is this is vague, this sign doesn’t make sense. Um, but fresh eyes would be the most important thing. I think it’s really hard for some people who have been there for a good long while to have those fresh eyes.

So I think somebody, whether it’s a consultant or a friend who just agrees to come help you, uh, a designer, an architect, somebody who can come in and really, you know, scrutinize where the where the trouble points are and help you figure out a way to solve them.

Melissa Gilkes-Smith: I like that idea of a focus group, especially when you have, you know, different ages, different demographics. Um so what are some quick wins, maybe uh high impact, low-cost improvements that most facilities can make without any major capital investment?

Lauren Nitschke: Um, printing out maps is a pretty simple thing to do. You know, be sure that you’ve identified where most people are going to go. And maybe there is a directional map to each of those major destinations that you can give people that’s complete with you know verbal instructions plus a map. Uh that’s just a paper that you hand them when they come in the door at the information desk. That’s that’s a quick, easy way to get people uh where they’re going without a major expense. I would just make sure that when you do that, when you do put the map on, when you do put the verbiage on, that again, you’ve already taken you’ve already done this uh survey and that you realize you know exactly what patient information is needed to be on there.

And maps need to be very, very simple, very graphic. Um, not I like maps that are to scale. They’re not just blobs scattered on a piece of paper with connecting points, that it’s really a map of that facility, but you don’t identify every single room in the facility. You identify major departments, levels, you know, elevator banks, things like that, where people are going to be making those decisions.

Melissa Gilkes-Smith: And this could also be a part of your pre-visit communication. You know, it could be part of the appointment reminders, how to be prepared for your visit. It’s, you know, an easy uh text with a any of the texting technology that it feels like everybody is using these days. Just have a link in the text, and this is how you get to our office from the parking lot to include the free free valet parking, right? Yes, absolutely. Yeah.

Lauren Nitschke: So that’s that’s great too. I think when the when that’s another thing that would the technology part of it would be um websites. And like you said, just having having that available for people to look at the facility website and go to the map to locate where they’re where they’re going. And you know, in the streets around it and with their one way or you know, where the parking is, just give them you know some context for when they arrive. They’ve already seen this on a plan. And most people now are using you know map apps on their phone and uh you know, they’re familiar with looking at a map. Um, you know, people used to say, Oh, I can’t read maps, I can’t read maps, but everybody has to read maps now.

You just, you just kind of have to. So the more familiar somebody can become via the website, the better. And that’s that’s not, you know, you’re not on a phone with somebody where you’re trying to look at it and get lost and you’re embarrassed and all that. It’s just something you can investigate on your own, you know, on your own time and make sure that you are clear on, you know, where you’re going before you get there.

Melissa Gilkes-Smith: Yeah. So last question. For the healthcare administrator listening right now who has never thought of wayfinding as a patient experience strategy, what do you want them to walk away with after this conversation?

Lauren Nitschke: That wayfinding is definitely part of your patient care. It’s part of your user care. Um, it’s it communicates that you don’t only care about their health, you care about their mental state when they arrive. You want them to feel that they have been seen before they’re even seen. And just to realize that um there are internal assumptions that I think a lot of a lot of people use when they work there. They work there a long time and they think everybody knows how to get there. They think everybody knows that this elevator bank doesn’t go to that floor. And um, those are just institutional blind spots, I would call them. And just to be aware that those exist. And the first-time users are going to get caught in all of those traps that the blind spots produce.

So just um put on that cap as a first-time user, walk through your facility, see if you can find your way to someplace that you’re not familiar with, perhaps. Um, you know, not your own clinic, but maybe somebody else’s or an imaging area or something like that where the where the public would have to go. Um and just realize, too, that a lot of a lot of healthcare facilities get in a bad position because the departments are fragmented. Um, there’s a communications department that does the website, there’s a facilities that maintains the facility, there’s the administration that may be naming, you know, these various locations, and they may not be names that the public’s familiar with. So, you know, don’t get into code names.

Um, if you’ve got code names all over your signage, you need to change that and make sure that it’s public-facing common language. And I think there’s some guidelines online about that. The CDC may have come up with some guidelines on um, you know, just functional language that the public will understand. A bunch of abbreviations after everything means zero to the public.

Melissa Gilkes-Smith: Mm-hmm. From a uh from a marine wife who knows all of the acronyms. Um, when I I I, you know, those abbreviations I know well to not speak to certain people about, yeah, you know, when when we’re doing this and we, you know, uh PCS and, you know, so yeah, I’m really careful with those abbreviations. Um, so what you’ve given us today is a way of seeing something that most of us walk past every day without even really looking at it. The sign that’s too small, the entrance that’s unclear, the parking structure that sends patients in the wrong directions. These are not minor inconveniences. They are patient experience failures and they are fixable. Here’s your challenge this week: walk into your facility through the main patient entrance, not the staff entrance, and navigate it as you have never seen or been there before.

Follow the signs. Count every moment where you’re not sure which way to go. That uncertainty is what your patients are experiencing, and it is with your power, within your power to change it. Lauren, thank you for 40 years of work that made healthcare environments more human for the people navigating them and for bringing that expertise to this conversation today. It has been a genuine pleasure.

Lauren Nitschke: Oh, thank you. I really enjoyed it very much. You were a very gracious host, and I appreciate the opportunity to communicate these things. Thank you. This was wonderful.

Melissa Gilkes-Smith: This was great. So every interaction is a moment that matters. I’m Melissa Jill Smith, and this is Touchpoints. If this conversation moved you, subscribe wherever you listen and connect with me on LinkedIn. I’ll see you at the next Touch Point.