Since its founding in 2006, FORMATION has taken a special interest in designing and consulting for healthcare. We continue to be drawn towards this work because it allows us to make a direct positive impact on people’s lives at both an individual and institutional scale.

We take a holistic approach to patient experience, using contextual research to look deeply at the intersections between user journeys, systems, and the built environment in order to design solutions that are both expressive and resourceful. fig. a, fig. b

This integrative, research-based approach allows us to deliver improved experience and cost savings simultaneously by breaking down departmental silos to identify shared needs.

Site assets CTMF fig D 1 Site assets CTMF fig D 4 Site assets CTMF fig D 2 Site assets CTMF fig D 3
fig. a
Contextual research process
Experience map
fig. b Experience map showing patient, family, and staff journeys at CHRISTUS Mother Frances Hospital. Diagrammatic artifacts like these help us synthesize information from different interviews and identify inflection points where experiences can be improved.


CHRISTUS unit quietness shhh
fig. c "We try to keep [noise levels on the unit] as low as possible but this is a main hallway." ⟨STF.02⟩

Our work has helped institutions recapture Medicare/Medicaid reimbursements through the improvement of HCAHPS scores related to wayfinding, unit quietness, and overall quality of experience.

We contextualize HCAHPS data with qualitative contextual sense data gleaned from in-person interviews and shadows with patients and staff fig. c in order to understand how patient experience at a particular hospital—and in some cases, in a particular patient unit—can be improved both within and beyond the framework of HCAHPS.

In many cases, we have uncovered correlations between low-performing HCAHPS measures and seemingly unrelated conditions that can be improved by strategic design interventions. fig. d

CHRISTUS unit quietness scores anim CHRISTUS unit quietness anim 2 CHRISTUS unit quietness cafeteria
fig. d
Two units at CHRISTUS Mother Frances Hospital were performing significantly worse than average on HCAHPS measures related to unit quietness. Our research found that these low scores were the direct result of poor wayfinding, as public paths to and from key destinations bisected these particular units.


fig. e Pain points during a campus arrival experience.

One of the most significant ways we can intervene in the built environment to improve patient experience is through wayfinding. Hospitals are innately stressful for patients and their loved ones. Stress causes any confusion posed by inadequate wayfinding to be magnified—likewise, feeling lost and unsure of how to proceed can increase a patient’s stress. fig. e

More than just signage, a successful wayfinding system in a complex environment like a hospital campus encompasses all of the multi-sensory signals a space sends to its occupants. These cues, when deployed thoughtfully and systematically, can help occupants navigate intuitively and distinguish between public spaces and off-limits staff-facing areas.

Hospitals are used by many groups at the same time; each of these user groups has different information needs and a successful wayfinding system will respond to each group in kind. We work directly with patients, family members, caregivers, and support staff to understand how they use the space, what they tend to call things, and where they lose their way.

While large-scale healthcare environments often face similar wayfinding challenges (confusing nomenclature, a lack of imageable landmarks among monotonous corridors, little distinction between staff-facing and public-facing areas, to name a few), what users tell us about how they navigate a flawed existing condition helps us determine the appropriate wayfinding framework(s) for a particular campus. fig. f

We believe that a successful wayfinding solution allows a space to become seamlessly legible to its occupants: good wayfinding is so intuitive as to become almost invisible.

fig. f
At Nicklaus Children's Hospital in Miami, we recommended a wayfinding system based on simple, colorful symbols to speak to the hospital's international patient base. These symbols were deployed consistently across exterior signage, interior signage, and digital communications.


Nationwide map after Nationwide campus expansion 01
fig. g
For Nationwide Children's Hospital, we developed a path-based orientation system that connects public destinations like stops along a subway line. After instituting this system in its existing buildings, Nationwide was able to extend the system and double the size of its campus without incurring public wayfinding issues.

We find that hospital campuses almost always grow without a master plan, morphing over the course of decades with many generations of buildings coexisting on the same campus. There is often a sense that the next new building will solve problems created by existing—often aging—infrastructure. In our experience, new construction only tends to shine a brighter light on entrenched problems caused by a lack of campus-wide growth planning.

We work with hospitals to develop holistic master plans for phased renovation and future growth that save money and improve patient experience by anticipating future changes and unifying old and new construction both visually and systematically. fig. g

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