Wayfinding Concepts for Hospitals: How to optimise pedestrian navigation in a stressful environment using Mathematics


In this article we will discuss the most common wayfinding concepts in the health care sector in the context of the evolution of content communication and distribution. Also we give some insights how the introduction of mathematics might lead to better wayfinding concepts.

In the past decades, we have witnessed a global trend where distribution of information and content has slowly shifted from homogenized mass distribution towards a personalized distribution of content. In the era of all things digital, consumers have higher expectations: they want their interactions with businesses and the products and services to be personalized.

In the early days we had newspapers, TV and radio broadcasting content for the masses. More personalization lead to narrowcasting, where content was distributed to a narrow audience instead of a broader public at large (TV channels, music on CD’s, video in cinema’s). Today we have entered the era of mass personalization, where content distribution is highly personalized enabling every person to read, see and listen to his personalized content at the moment and location of choice (for example: YouTube, Netflix, Spotify, Podcasts, your Facebook timeline, etc.)

The evolution of Wayfinding Systems

Wayfinding systems benefit from the technological advancements that became part of our daily life. High-definition displays, touch-screen kiosks, and online information are examples of these developments. With the widespread of smartphones and their concurrent applications, location- aware apps are developed to guide people navigation. They provide a new dimension to traditional wayfinding systems by generating maps that show the shortest path to a desired destination. Moreover, augmented reality (AR) is becoming part of these developments, in which digital information is provided through a phone’s camera.


Signage and Environmental Graphics

The main purpose of signs and environmental graphics is to communicate, to convey information such that the receiver may make cognitive decisions based on the information provided. For guidance, we use directional signs showing the location of services and facilities with directional arrows. 

Signage is a broadcasting medium, communicating information about the environment to the largest common denominator of a larger group providing an overload of information that is not relevant on that location at that moment. The largest source of confusion when trying to navigate in a complicated health care environment is not that there is a lack of information. On the contrary. There is often too much information, with far too many signs and graphics leading in too many different directions.

Following colored lines seem to be a smart way of guiding people around, but in complex environoments as hospitals it has its serious down sides. First of all, people who are color blind obviously have troubles identifying the right color on the wall or floor. But most importantly: a medium sized hospital already has 100 locations (entrances, clinics, shops, cafetaria, etc). This means if you have just one entrance, you already need 99 colored lines to show a path to all the other destinations. In Hospitals people tend to visit multiple locations during their visit so this means you need to refer to any location from any location. This means 100 * 99 = 9900 coloured lines. That is obviously not going to work.

Regular signage with location names is for the same reason a problem. You get tons of signs and people are overwhelmed by the infomation provided at intersections. And, when for example a nurse station moves, you have a huge challenge to change the signs.

The value of "You-are-here"-maps is questionable. There is scientic research that says that using maps does not have any positive impact on the wayfinding performance. In fact, wayfinders attending to such wall-mounted maps lost time without gaining any navigational advantage. (1)

Good results can be acchieved by implementing a numbering system by assigning a number to a physical location in the building. Tell people for example to get to "54" instead of a medical name that is very hard to remember (like "Amniocentesis" or "Venous Doppler", etc)

Directional signs look like:


This concept has many advantages:

  1. you never have to change your signs when a location moves.
  2. all locations are reachable from all locations
  3. at every intersection you can refer to any location
  4. you dont need tons of signs
  5. you can't get lost as at every junction you can pick up your navigation
  6. no language problems

The big disadvantage in this method is that it is very hard to get ONE array per direction. When assigning randomly unique numbers to physical locations inside the building, you will end up with multiple arrays per direction like this:


This is just an example to show the meaning of a 'broken array'. In fact, when you assign numbers to locations randomly you will end up with 10-20 arrays per intersection.  

Obviously, the more arrays, the more directional signs you will get. The cognitive load for wayfinders will exponentially grow and the wayfinding system will be completely useless. 


Mathematics to the rescue

The challenge is to assign unique numbers to physical locations in a way that the number of directional arrays are minimized, potentitally equaling the number of directions a pedestrian can choose from at any intersection!

This is a very complex computational problem and is significantly compromised by the architectural setup of the building. We are conducting research in this field and use advanced mathematics to solve this problem. The research has not been completed for 100% but the results so far seem to be very promising for this wayfinding concept.


Mobile Wayfinding; more mathematics!

The emergence of digital signage and narrowcasting made it possible to deliver targeted messages and content through kiosks and digital screens winnowing down irrelevant information.

Since smartphones have become an indispensable part of our day, it’s evident that they are the automatic response to any needs we may have, whether it be searching for information, entertainment, and even wayfinding. Smartphone personalization is the principle tendency of today and businesses need to be conscious of their customer needs for information in the right place and at the right time. This is where mobile wayfinding comes in, offering highly personalized, easy updatable, directional information at the right moment and the right location. 

It has been very challenging until today, to define wayfinding systems that can deal with every user group of the population. User groups can be different concerning age, social relations, cultural relations, job relations, physical and mental capability. Mobile wayfinding unlocks possibilities to offer tailor made instructions and routes for people that need special attention. 
Some people need specific routing due to a physical impairment or because they have a child in a stroller that withholds them taking elevators and escalators. Foreigners, who are not able to read signs need instructions in a language they master. Low-literacy, obstructing people from reading anything at all, older people needing special assistance due to visual impairment, bending forward postures, etc. Mobile Wayfinding has the potential to overcome all the hurdles that traditional wayfinding concepts encounter and thus the potential to help all these user groups finding their way inside complex buildings like hospitals.

All thanks to Mathematical theories like Trigonometry, Graph Theory, Dijkstra, Pedestrian Dead Reckoning, extended Kalman filtering, etc.

More research is required on the different mobile wayfinding concepts, in order to make any viable claims on the wayfinding performance of pedestrians in the built environment. However, navigation supported by visual representations of landmarks and/or images show very promising results.

To be continued...


  1. Butler, D. L., Acquino, A. L., Hissong, A. A., & Scott, P. A. (1993). Wayfinding by newcomers in a complex building. Human Factors, 35(1), 159-173.