When Golisano Children’s Hospital sought input about its current wayfinding and signage program from patient and family focus groups to help guide the design of a new eight-story, $145 million facility in Rochester, N.Y., it got some brutally honest feedback. “Your current hospital lobby is too stressful.” “I can’t make sense of this wayfinding.” “When I just need to get to cardiology, I don’t remember if that unit is named after someone. I just want to get to my child as quickly as possible.”

Elizabeth Lattimore, chief administrative officer at Golisano Children’s Hospital, says the hospital’s wayfinding had been added on to over the 40 years in the building and lacked cohesiveness and brand consistency. In the lobby, department names and arrows pointing in different directions were mounted on large posts, while on the upper floors individual departments had been allowed to choose their own signage and even artwork. “Coordination didn’t exist,” she says. “It was whatever the nurse manager at the time liked.”

Determined not to repeat these same mistakes in its new 245,000-square-foot replacement building, which opened to patients in July 2015, the hospital took the feedback it received from parents, patients, and staff to create a more cohesive approach to its environmental graphics, wayfinding, and signage programs. “We knew we were going to get one shot at this,” Lattimore says. “It had to be transformational.”


Creating the right journey

The first step was choosing an overarching theme that would be timeless and engaging, and would unite all of the spaces throughout the building, Lattimore says. “We really wanted a hospital that was a journey and that when you enter it, you’re entering a theme that carries throughout the building,” she says.

Graphic design firm ArtHouse Design (Denver) was hired by Ballinger Architects (Philadelphia), the architecture and interior design firm on the new project, to develop the new theming, wayfinding, and environmental graphics package. Several theming options were presented to Golisano and, in the end, the hospital chose “upstate New York geography” as a unifying concept to bring nature into the setting, celebrate the region’s four seasons, and appeal to its broad base of patients, many of whom must drive several hours to reach the hospital.

Each floor was assigned a specific location based on the different landscapes within the region, including lake, meadow, glen, park, city, mountain, and sky, says Beth Rosa, senior environmental graphic designer at ArtHouse Design. That theme is translated into an icon, color palette, and coordinating elements on each floor, including large-scale stock photography images for the waiting areas and nurses’ stations, patient room graphics, and interactive elements in the hallways.

Patients and families are introduced to the wayfinding system when they check in on the first floor and receive a name badge with the icon of their assigned floor. “All you have to know is your icon,” Lattimore says, noting that it also appears in building directories and as a 5-foot-diameter backlit sign as you enter onto each floor from the elevator. “You see that and know you’re in the right place.”

As visitors progress from an elevator lobby into a floor’s waiting area, they find additional elements that reinforce that floor’s theme, including a 12-by-8-foot impact graphic of a child engaged in an activity related to that floor’s geographical area. For example, the ground level features a lake theme with shades of blue and images of kids playing in water and jumping off a dock, while the third floor has a meadow theme with a yellow color palette and graphics that include images of flowers, cows, and grass.

Rosa says it was important to layer the icons, imagery, and colors to appeal to different ages and populations. “People remember or see things in different ways,” she says. “Some people will remember numbers, some people will remember a theme, others a color, and know they’re in the right place.”

The hospital’s donor signage program was also redesigned using different materials, graphics, and sizes of signs to create a hierarchy for different levels of giving. For example, plaques for significant donors feature pictures and details about the donor’s work, while smaller-level donor signs will have less information.

A main donor wall ties together all of the colors and themes from each floor into a multipanel statement in the atrium. ArtHouse worked with a fabricator to reconfigure off-the-shelf poster frames with three layers of graphics, including an image on the bottom layer that relates to the geographical theme; a transparent colored layer in the middle that corresponds to one of the hospital’s floor colors; and a top layer with the donor names, which can be easily replaced as updates are needed. Special wall mounts are used to make the frames appear to float from the wall and edge-lit LEDS give it a glowing effect within the space. “The metal, glass, and plexi have a rich look when seen together in layers,” says Marty Gregg, principal and creative director at ArtHouse Design. “The finishes sparkle and the signage looks elegant.”


Layering on the fun

Illustrations and vector graphics are put to work in some of the specialty departments to serve as positive distractions as well as hide medical equipment—for example, silhouettes of kids fishing or playing on a swing are used on the walls in the imaging department. However, not all of the graphic elements are designed to stand out immediately.

“You see some of these things, but I don’t want you to see everything at once because, unfortunately, a lot of these kids come back to this hospital again and again,” Gregg says. On those repeat visits, he says there’s still more for children and family members to notice, such as the cut-out shapes of leaves and airplanes featured in light fixtures installed in the hallway ceilings of patient floors.

In the Level III NICU, graphics not only help with wayfinding but also create a nursery-like setting and provide a sense of privacy within the patient rooms. High-impact rigid vinyl graphics of tree silhouettes and different colored birds are displayed on the footwalls, coordinating with each of the five NICU neighborhoods. Each of the 68 rooms also has a three-panel glass door that features an interlayer of botanical-shaped graphics displayed on the door’s bottom half to create some privacy for families while still allowing staff to see inside the room. While it was important to choose colorful images and shapes, Lattimore says that the staff was concerned that certain colors, including blue, yellow, and green, could reflect onto patients and make them appear sicker. The solution was to use more muted colors, such as a warm gray color, on the walls and place brighter tones on the doors so they wouldn’t affect patient care.


Achieving the right look

The project team met with focus groups, staff members, and the hospital’s patient advisory committee throughout planning and construction to gather feedback on images, colors, and more to ensure their goals were achieved. Nearly every sign type was mocked up and installed so that the staff could see and touch the individual pieces as well as test their durability against the hospital’s cleaning protocol. Feedback was gathered to direct additional tweaks and changes, including sizes and material choice.

For e
xample, Gregg says the directories in the elevator lobbies originally had half-round globes that looked like a big water droplet over each icon. But because the hospital was concerned about dust collection, the element was flattened. Some of the dimensional signage was also changed from one-quarter-inch in size to one-eighth-inch to still have some dimension but not stick out as much. “It’s mostly little tweaks that the public probably won’t notice, but people who are rubbing a rag over something every day are going to notice,” he says. “We’re just trying to make it as streamlined as possible.”

Another challenge was using stock photography to fill all of the imaging needs for the new program. “That took some digging to find Rochester-specific graphics and make sure they were suitable for all the different demographics that the hospital was looking for,” Gregg says. “We created relationships with lots of stock photography people who were able to give us pictures of happy kids at recognizable areas [in upstate New York].”

Rosa says another key to success was working early in the planning stages with the architect to identify and build in support structures and lighting for key signage and wayfinding elements, such as recessed walls in the waiting areas. “If it’s hard to tell the line between what the architect did and what we did, then we did a good job,” she says. “Everything should be so thoughtfully integrated that you can’t tell who did what.”

Anne DiNardo is senior editor of Healthcare Design. She can be reached at anne.dinardo@emeraldexpo.com.

For more information and images on Golisano Children’s Hospital, including how interactive play elements are incorporated onto several floors of its new facility, check out Healthcare Design’s June/July issue.