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Digital wayfinding systems in hospitals: A qualitative evaluation based on managerial perceptions and considerations before and after implementation
Abstract
Despite the benefits that digital wayfinding systems offer hospital visitors and patients as well as the hospitals themselves, their actual presence in hospitals is low. This study, carried out in twenty hospitals, presents an evaluation of these systems. Interviews with hospital managers (with and without systems) indicate considerations and evidence-based information that are new to the literature such as reducing task complexity and overall user stress and anxiety; enhancing user control and empowerment; decreasing the amount of time medical staff must devote to providing directions to patients; and reducing rate of delayed and missed appointments. While these systems have considerable potential for assisting the elderly and those with disabilities, this potential is not being realized. Findings may benefit system planners, hospital administrators and eventually provide users with more suitable systems upon which to rely.
... Wayfinding is particularly challenging in hospitals, one of the most complex indoor setting environments that members of the public are likely to navigate (Morag and Pintelon, 2021). The wayfinding complexity of hospitals stems from two related factors. ...
... Hospitals are large, complex, and multifunctional public places that are often comparable to mini cities [5][6][7][8]. The multifunctional nature of hospitals can increase the difficulty of wayfinding to some extent, which is a particular concern in large hospitals [6,[8][9][10]. One study found that 74.2% of hospital users had difficulty finding their way around hospital environments [11], and an additional 12% of patients mentioned the lack of appropriate guidance signage [12]. ...
This study aimed to determine the quality type and importance ranking of hospital signage systems’ usage requirements using the Kano model. This study collected data from 300 users in three hospitals in Guangzhou and evaluated 32 metrics of hospital signage systems. The Kano model questionnaire was used to analyze the quality type of each demand indicator, and the better–worse coefficient was used to calculate the sensitivity and importance ranking of the demand. Of the 32 attributes evaluated by participants, 4 are must-be quality (M), 4 are one-dimensional quality (O), 12 are attractive quality (A), and 12 are indifferent quality (I). The results of this study suggest that the presence of most of the evaluated attributes is associated with maintaining a level of user satisfaction, and the lack of these attributes causes user dissatisfaction. There is a strong demand for basic usage functions and an easy-to-use hospital signage system. In addition, users often wish to add and improve signage functions and have greater expectations for the inclusion of features such as digital intelligence and regional culture in this study. The results of this study show that the Kano model can better derive the user requirements for hospital signage systems and can promote the improvement of hospital signage systems in a more targeted manner, according to the quality type and importance of requirements, providing a research basis for the sustainable development of healthcare services.
... As for the first level, [4] defined a digital wayfinding system as a set of computing devices that are linked to a central server that generates and displays interactive wayfinding information (e.g., a map and directions to reach a desired destination as well as related parameters such as distance and estimated time). Wayfinding in healthcare will benefit patients, visitors, staff, and leaders by reducing medical errors, minimizing frustration, increasing satisfaction, and creating cost savings [5]. ...
Healthcare, like other industries, is increasingly using smart technologies, which also include intelligent/smart wayfinding navigation. The focus of this article, as part of the research project (its second step), was to analyze the economic effectiveness of the introduction of the wayfinding system in a local hospital in the Czech Republic. In the first phase/step of the project, possible variants of the solution were identified, verification of possible functioning, and a questionnaire survey was conducted among employees and patients regarding the waste of time in search of destination and preferences of various forms of navigation. Based on the above, it was decided to develop our own mobile application. To determine the effectiveness of this method of implementation of the new system, economic verification was used by the cost-benefit analysis method. Although the use of this method has not been required in the implementation of funded projects within the European Union since 2021, it was chosen for clarifying the pros and cons in many both investment and non-investment projects. In addition to the net present value calculation, the benefit cost ratio, profitability index, and payback period were used for evaluation. The time saving of medical staff, calculated on the basis of a questionnaire survey in the hospital (the first step of the project), was used as a benefit. The costs used were the salaries paid out in the research project, the investment, and the operating costs over the lifetime of the navigation system, which is estimated at eleven years. Using the above indicators, the implementation of the navigation system was found to be effective, despite the initial high costs. Based on these results, as part of the third step of the project, the navigation system will be implemented in the given hospital—the testing phase was taking place in the last quarter of 2021, and the full implementation is expected during the 2022.
... Dies führt dazu, dass die Wegfindung für Personen erschwert wird und daraus folgend zum Beispiel Behandlungen zu spät begonnen werden können, Personal häufig nach dem Weg gefragt wird oder sich am Empfang Schlangen bilden, da häufiger nach dem Weg gefragt wird und die Wegerklärung länger dauert. (1,2) Das Spitalzentrum Biel (SZB) ist an einer Navigations-App interessiert, da viele Patienten*innen, Besucher*innen und Mitarbeiter*innen sich damit schwertun, sich in den Gebäuden zurechtzufinden. Sogar erfahrene Mitarbeitende haben manchmal Schwierigkeiten Orte, wie zum Beispiel Sitzungszimmer, zu finden. ...
We implemented a prototype of an indoor navigation app that uses Augmented Reality for localization and showing the way. The position and orientation of the device is determined by the view of the camera only. For localisation we use multiple points clouds, "Area Targets" from the Vuforia SDK. An Area Target is a set of data (so called "point cloud") which contains information of unique points in the environment. A navigation can be started from any position of the supported area, which is on two floors and in total 690 m² big. The app can be extended to support much larger areas by adding more Area Targets. We conducted two usability tests with total 20 people. Most of the people agreed that with such an app indoor navigation is easier than a 2D map or spoken information.
Bilgi teknolojileri ile giderek daha da küresel hale gelen dünyamızda
dijitalleşme her alanda kullanılmaya ve karşımıza çıkmaya devam etmektedir.
Dijitalleşmenin temelinde insanoğlunun hayat mücadelesini kolaylaştırmaya
yönelik hedeflerin olduğunu söyleyebiliriz. Sağlığımız da bunlardan birisidir.
Sağlık alanında yapılan dijital yatırımlar sadece hayatımızı kolaylaştırmak için
değil, aynı zamanda sağlık hizmetlerinden daha kaliteli ve etkin
yararlanabilmemizi sağlamayı amaçlamaktadır.
Bu bölümde, genel olarak dijital hastane kavramı anlatılmaya
çalışılacaktır. Önce sağlık hizmetlerindeki dijital dönüşüm, sağlık 4.0 ve dijital
sağlık sistemleri belirtilecektir. Daha sonra ise dijital hastane kavramı ve
amaçlarından bahsedilecektir.
This study examines the impact of the sound environment on spatial knowledge acquisition in a virtual outpatient polyclinic. Outpatient polyclinics have a salient role in determining early outpatient treatments of COVID-19 to prevent hospitalization or death and reduce the burden on hospitals. However, they have not been widely investigated in the literature. The studies on spatial knowledge have identified environmental elements mainly related to vision with no focus on sound. Currently, there is limited research on the effect of sound environment on spatial knowledge acquisition in virtual outpatient polyclinics. In this study, a virtual simulated outpatient polyclinic has been created with varying levels of visual and audio cues. Eighty participants were assigned to one of the four groups: a control (no visual signage), a visual (visual signage), an only audio (no landmarks and no visual signage), and an audio-visual group. The virtual environment was presented as a video walkthrough with passive exploration to test spatial knowledge acquisition with tasks based on the landmark-route-survey model. The results showed that a combination of visual signage and sound environment resulted in higher spatial knowledge acquisition. No significant difference was found between the performance of the visual group and the control group that shows that signage alone cannot aid spatial knowledge in virtual outpatient polyclinics. Data from the only audio group suggests that landmarks associated with sound can compensate for the lack of visual landmarks that may help design a wayfinding system for users with visual disabilities.
Background
Wayfinding is an exceedingly complicated cognitive process, especially in complex environments such as hospitals, shopping centers and airports. Inhabitants of such large environments can become lost very easily if they are unfamiliar with the environment. Although they may eventually be able to discover the route to a specific destination, interacting with conventional wayfinding aids, such as consulting a map, understanding signs, and asking people for directions, can be very time-consuming.
Methods
The research presented in this paper developed a customized instrument (questionnaire) with factors identified as influencing the cognitive process of wayfinding, and conducted an explorative study to investigate user experience and requirements of wayfinding in complex environments; in this paper, a hospital was chosen as the context.
Results
The results demonstrate that current wayfinding aids are insufficient to support a person's natural navigational behaviors in the environment. Augmented Reality (AR), which is an innovative concept of enabling digital information to be superimposed onto a real view in real time and context, has great potential to supplement current wayfinding aids. Therefore, we also conceived, developed and implemented an AR-based wayfinding system based on the user requirements identified by the aforementioned instrument.
Conclusion
The AR-based wayfinding system was partially validated through case studies, which concluded that AR significantly reduced the time and cognition workload of human wayfinding behaviors.
One of the challenging problems for indoor wireless multifloor positioning systems is the presence of reference node (RN) failures, which cause the values of received signal strength (RSS) to be missed during the online positioning phase of the location fingerprinting technique. This leads to performance degradation in terms of floor accuracy, which in turn affects other localization procedures. This paper presents a robust floor determination algorithm called Robust Mean of Sum-RSS (RMoS), which can accurately determine the floor on which mobile objects are located and can work under either the fault-free scenario or the RN-failure scenarios. The proposed fault tolerance floor algorithm is based on the mean of the summation of the strongest RSSs obtained from the IEEE 802.15.4 Wireless Sensor Networks (WSNs) during the online phase. The performance of the proposed algorithm is compared with those of different floor determination algorithms in literature. The experimental results show that the proposed robust floor determination algorithm outperformed the other floor algorithms and can achieve the highest percentage of floor determination accuracy in all scenarios tested. Specifically, the proposed algorithm can achieve greater than 95% correct floor determination under the scenario in which 40% of RNs failed.
Background
Wayfinding in hospitals is a complex problem since patients, who are likely to be under stress, may have to navigate their way to multiple locations in the course of a single visit. While good wayfinding design can reduce stress, poor wayfinding not only can increase anxiety on an individual basis but also generate additional costs for the hospital itself due to: lost time among staff members because of the necessity of directing patients rather than concentrating on their designated task; the cost of missed appointments or delayed meetings; and additional security staff to ensure that patients don’t go to restricted areas.
Objectives
We focused on whether a questionnaire, whose development involved collecting data using the subjective experiences of wayfinders with diverse needs and abilities, could provide, compared to current methods, added value in uncovering wayfinding problems in hospitals.
Methods
The methodology we developed involved four steps: 1) creating an initial questionnaire based on the literature; 2) customizing the questionnaire to a hospital environment; 3) validating and verifying the questionnaire; and 4) evaluating the questionnaire’s added value at nine other hospitals.
Results
The questionnaire’s generality and added value were demonstrated since many types of wayfinding problems were uncovered at the nine hospitals that other methods had overlooked or regarded as relatively unimportant.
Conclusion
The research emphasizes the centrality and uniqueness of the wayfinder and not that of the institute in determining what people need. Our findings can contribute to understanding wayfinding issues in hospitals and to sensitize designers to the needs and knowledge levels of wayfinders when designing hospitals.
Gulshan & Nanji Orthopaedic and Plastics Center at the North York General Hospital is the second busiest site after the emergency department serving more than 26,000 patients annually. Increase in patient flow, overworked staff, and recent renovations to the hospital have resulted in patients experiencing long wait times, and thusly patient dissatisfaction and stress. Several factors contribute to patient dissatisfaction and stress: i) poor and unfriendly signage; ii) inconsistent utilization of the numbering system; and iii) difficulty navigating to and from the imaging center.
A multidisciplinary QI team was assembled to improve the patient experience. We developed a questionnaire to assess patient stress levels at the baseline. Overall, more than half of the patients (54.8%) strongly agreed or agreed to having a stressful waiting experience. Subsequently, based on patient feedback and staff perspectives, we implemented two PDSA cycles. For PDSA 1, we placed a floor graphic (i.e. black tape) to assist patients in navigating from the clinic to the imaging centre and back. For PDSA 2, we involved creating a single 21”×32” patient-friendly sign at the entrance to welcome patients, with clear instructions outlining registration procedures. Surveys were re-administered to assess patient stress levels. A combination of both interventions caused a statistically significant reduction in patient stress levels based on the Kruskal-Wallis and Mann-Whitney U Tests.
The present project highlighted the importance of involving stakeholders as well as frontline staff when undertaking quality improvement projects as a way to identify bottlenecks as well as establish sustainable solutions. Additionally, the team recognized the importance of incorporating empirical based solutions and involving experts in the field to optimize results. The present project successfully implemented strategies to improve patient satisfaction and reduce stress in a high flow community clinic. These endpoints were achieved by incorporating patient friendly signage, as well as improving patient flow directors.
Indoor position estimation has become an attractive research topic due to growing interest in location-aware services. Nevertheless, satisfying solutions have not been found with the considerations of both accuracy and system complexity. From the perspective of lightweight mobile devices, they are extremely important characteristics, because both the processor power and energy availability are limited. Hence, an indoor localization system with high computational complexity can cause complete battery drain within a few hours. In our research, we use a data mining technique named boosting to develop a localization system based on multiple weighted decision trees to predict the device location, since it has high accuracy and low computational complexity. The localization system is built using a dataset from sensor fusion, which combines the strength of radio signals from different wireless local area network access points and device orientation information from a digital compass built-in mobile device, so that extra sensors are unnecessary. Experimental results indicate that the proposed system leads to substantial improvements on computational complexity over the widely-used traditional fingerprinting methods, and it has a better accuracy than they have.
This article offers a step-by-step description of how qualitative data analysis software can be used for a qualitative content analysis of newspaper articles. Using NVivo as an example, it illustrates how software tools can facilitate analytical flexibility and how they can enhance transparency and trustworthiness of the qualitative research process. Following a brief discussion of the key characteristics, advantages and limitations of qualitative data analysis software, the article describes a qualitative content analysis of 230 newspaper articles, conducted to determine international media perceptions of New Zealand's environmental performance in connection with climate change and carbon emissions. The article proposes a multi-level coding approach during the analysis of news texts that combines quantitative and qualitative elements, allowing the researcher to move back and forth in coding and between analytical levels. The article concludes that while qualitative data analysis software, such as NVivo, will not do the analysis for the researcher, it can make the analytical process more flexible, transparent and ultimately more trustworthy.
http://nbn-resolving.de/urn:nbn:de:0114-fqs150283
Indoor navigation systems have recently become a popular research field due to the lack of GPS signals indoors. Several indoors navigation systems have already been proposed in order to eliminate deficiencies; however each of them has several technical and usability limitations. In this study, we propose NFC Internal, a Near Field Communication (NFC)-based indoor navigation system, which enables users to navigate through a building or a complex by enabling a simple location update, simply by touching NFC tags those are spread around and orient users to the destination. In this paper, we initially present the system requirements, give the design details and study the viability of NFC Internal with a prototype application and a case study. Moreover, we evaluate the performance of the system and compare it with existing indoor navigation systems. It is seen that NFC Internal has considerable advantages and significant contributions to existing indoor navigation systems in terms of security and privacy, cost, performance, robustness, complexity, user preference and commercial availability.
The performance of time division multiplexing and frequency division multiplexing protocols for light emitting diode light emitting diode (IPS) designs using visible light emitting diode lights is evaluated. The impact of timing synchronisation errors on the localisation accuracy of IPS designs is also determined.
We travel through the environment to reach places that satisfy our needs and wants. Successful travel requires that we know where to go and how to get there; it also requires that we can move along the intended route in the intended direction without having accidents or getting unnecessarily delayed. Taken together, these are requirements of navigation: coordinated and goal-directed movement through the environment. Navigation occurs over a wide spectrum of spatio-temporal scales. We navigate to the other side of the room, to the post office, to visit our relatives in another town, or to vacation half way around the world. In order to navigate effectively, we apply our psychological skills of perception, cognition, and motor behavior, within the contexts of physical and social environments, and with the assistance of technologies of information and transportation. There are consequently a host of human factors issues relevant to navigation. Attention to these issues can result in improvements to the design of technologies, environments, and training procedures that increase the ease, accuracy, efficiency, comfort, and safety of navigation.
The aim of this study was to investigate the antecedents of trust in technology for active users and passive users working with a shared technology. According to the prominence-interpretation theory, to assess the trustworthiness of a technology, a person must first perceive and evaluate elements of the system that includes the technology. An experimental study was conducted with 54 participants who worked in two-person teams in a multi-task environment with a shared technology. Trust in technology was measured using a trust in technology questionnaire and antecedents of trust were elicited using an open-ended question. A list of antecedents of trust in technology was derived using qualitative analysis techniques. The following categories emerged from the antecedent: technology factors, user factors, and task factors. Similarities and differences between active users and passive user responses, in terms of trust in technology were discussed.
Purpose of the Study: The purpose of this study was to describe prevalence of technology use among adults ages 65 and older, particularly for those with disability and activity-limiting symptoms and impairments.
Data from the 2011 National Health and Aging Trends Study, a nationally representative sample of community-dwelling Medicare beneficiaries (N = 7,609), were analyzed. Analysis consisted of technology use (use of e-mail/text messages and the internet) by sociodemographic and health characteristics and prevalence ratios for technology usage by disability status.
Forty percent of older adults used e-mail or text messaging and 42.7% used the internet. Higher prevalence of technology use was associated with younger age, male sex, white race, higher education level, and being married (all p values <.001). After adjustment for sociodemographic and health characteristics, technology use decreased significantly with greater limitations in physical capacity and greater disability. Vision impairment and memory limitations were also associated with lower likelihood of technology use.
Technology usage in U.S. older adults varied significantly by sociodemographic and health status. Prevalence of technology use differed by the type of disability and activity-limiting impairments. The internet, e-mail, and text messaging might be viable mediums for health promotion and communication, particularly for younger cohorts of older adults and those with certain types of impairment and less severe disability.
The aim of the study was to generate design criteria in order to encourage and facilitate wayfinding for advanced Alzheimer’s patients. Two sources of data were used: interviews with the staff of a typical urban nursing home, and a wayfinding experience with its residents. The results show that even patients with severe cognitive deterioration are able to reach certain destinations. Wayfinding decisions have to be based on environmental information that is readily accessible, so that the patient can proceed from decision point to decision point. Monotony of architectural composition and the lack of reference points render wayfinding difficult. The elevators are seen to be a major anxiety-causing barrier. Visual access to the main destinations increases their use and facilitates wayfinding. Signage has an important function, creating redundancy in wayfinding communication and compensating for the loss of memory and spatial understanding. Floor patterns and dark lines or surfaces can disorient the patients and cause anxiety.
This study used a desktop virtual environmental simulation of 18 large-scale residential environments to test effects of plan layout complexity, physical differentiation, and gender on acquired spatial knowledge. One hundred sixty people (95 males and 65 females) were assigned at random to the different conditions. After a learning phase, participants were asked to (a) estimate the direction from the start point to a destination, (b) navigate to the destination, and (c) select the layout of the environment and sketch the route they took. Higher scores for acquired spatial knowledge emerged for simple over complex environments, for moderate or high differentiation over no differentiation, and for landmark or road differentiation over no such differentiation. For direction and navigation errors males performed marginally better than females, and for navigation errors younger respondents performed better. The results suggest that designs with physical differentiation and fewer choices at nodes will help people learn their way around.
Recently, indoor positioning systems (IPSs) have been designed to provide location information of persons and devices. The position information enables location-based protocols for user applications. Personal networks (PNs) are designed to meet the users' needs and interconnect users' devices equipped with different communications technologies in various places to form one network. Location-aware services need to be developed in PNs to offer flexible and adaptive personal services and improve the quality of lives. This paper gives a comprehensive survey of numerous IPSs, which include both commercial products and research-oriented solutions. Evaluation criteria are proposed for assessing these systems, namely security and privacy, cost, performance, robustness, complexity, user preferences, commercial availability, and limitations.We compare the existing IPSs and outline the trade-offs among these systems from the viewpoint of a user in a PN.
A number of issues can affect sample size in qualitative research; however, the guiding principle should be the concept of saturation. This has been explored in detail by a number of authors but is still hotly debated, and some say little understood. A sample of PhD studies using qualitative approaches, and qualitative interviews as the method of data collection was taken from theses.com and contents analysed for their sample sizes. Five hundred and sixty studies were identified that fitted the inclusion criteria. Results showed that the mean sample size was 31; however, the distribution was non-random, with a statistically significant proportion of studies, presenting sample sizes that were multiples of ten. These results are discussed in relation to saturation. They suggest a pre-meditated approach that is not wholly congruent with the principles of qualitative research.
URN: urn:nbn:de:0114-fqs100387
Studies of the characteristics of therapeutic landscapes have become common in medical geography. However, there is limited analysis of how therapeutic landscapes are produced. Based upon the qualitative theoretical thematic analysis of focus group data, this study examined the spatial work carried out by healthcare practitioners in a paediatric outpatients' department, turning unsatisfactory space into a therapeutic place. The study highlights the spatial strategies employed by staff to mitigate socio-spatial deficiencies in the healthcare environment. Staff perceived the task of making space work as an integral part of their duty of care to patients and an important facet of their professional identity. This study concludes that many of the spatial aspects of health care practice are often taken for granted. However this may hide the crucial role that health professionals have in producing places that heal.
With this work, we propose and validate a new service system in the context of Wayfinding services to improve the SmartCities mechanism: smart mobility, smart people, smart governance and smart living services. Steering and navigation tasks through an environment constitute an essential activity in our daily lives. They have a high degree of practical value in a variety of domains, such as public area design, architectural Wayfinding, geo-positioning and navigation, as well as urban planning and environmental design. At times, people with a visual impairment may also have problems in navigating autonomously and without personal assistance, especially in unknown environments (outdoor and indoor) using a smartphone. There could also be emergency situations in which the receiving of information in real time could be crucial. People with motor disabilities usually need information to avoid environments with obstacles, to arrive at a target or to manage touchscreens in daily activities and different environments. The use of landmarks is therefore vitally important in human navigation. Wayfinding systems must change, given that according to the United Nations (UN) Development Program, people with a disability represent around 10% of the world’s population, which is approximately 650 million people. Additionally, according to the World Health Organization, the world’s population of people 60 years of age and older has doubled since 1980 and is predicted to reach 2 billion by 2050. Most Wayfinding applications in the Smartphone market suffer from at least one of the following problems: the information is not dynamic, the design is not universal or the interface is not adapted to different users and preferences. Accordingly, apps do not currently have a universal design. The GAWA platform provides a universal and accessible solution to manage Wayfinding applications that focuses on people with a disability in outdoor and indoor environments in Smartcities. According to the results, the platform could be used for performing activities in their daily lives.
Nowadays location based techniques are used various fields such as traffic navigation, map services, etc. Because people spend a lot of time in the indoor place, it is important for users and service providers to get exact indoor positioning information. There are many technologies to get indoor location information like Wi-Fi, Bluetooth, Radio Frequency Identification (RFID), etc. In spite of importance of IPS, there is no standard for IPS techniques. In addition because of characteristic of data, security and privacy problems become issue. This paper introduces the IPS techniques and analyzes each IPS techniques in terms of cost, accuracy, etc. Then introduce related security threats.
Accessible tourism is a growing market within the travel industry, but little research has focused on travel barriers for older adults who may be experiencing visual and cognitive decline as part of the normal aging process, illness, or other disabling conditions. Travel barriers, such as difficulty finding one's way throughout an airport, may adversely affect older adults' travel experience, thereby reducing their desire to travel. This review of the literature investigates wayfinding strategies to ensure that older passengers who have planned to travel independently can do so with dignity. These include facility planning and design strategies (e.g., layout, signage) and technological solutions. Although technological approaches, such as smart phone apps, appear to offer the most promising new solutions for enhancing airport navigation, more traditional approaches, such as designing facilities with an intuitive building layout, are still heavily relied upon in the aviation industry. While there are many design guidelines for enhancing wayfinding for older adults, many are not based on scientific investigation.
WiFi based indoor positioning has recently gained more attention due to the advent of the IEEE 802.11v standard, requirements by the FCC for E911 calls, and increased interest in location-based services. While there exist several indoor localization techniques, we find that these techniques tradeoff either accuracy, scalability, pervasiveness or cost -- all of which are important requirements for a truly deployable positioning solution. Wireless signal-strength based approaches suffer from location errors, whereas time-of-flight (ToF) based solutions provide good accuracy but are not scalable. Recent solutions address these issues by augmenting WiFi with either smartphone sensing or mobile crowdsourcing. However, they require tight coupling between WiFi infrastructure and a client device, or they can determine the client's location only if it is mobile. In this paper, we present CUPID2.0 which improved our previously proposed CUPID indoor positioning system to overcome these limitations. We achieve this by addressing the fundamental limitations in Time-of-Flight based localization and combining ToF with signal strength to address scalability. Experiments from 6 cities using 40 different mobile devices, comprising of more than 2.5 million location fixes demonstrate feasibility. CUPID2.0 is currently under production, and we expect CUPID2.0 to ignite the wide adoption of WLAN-based positioning systems and their services.
The aim of this age-simulation field experiment was to assess the influence of route complexity and physical ageing on wayfinding. Seventy-five people (aged 18–28) performed a total of 108 wayfinding tasks (i.e., 42 participants performed two wayfinding tasks and 33 performed one wayfinding task), of which 59 tasks were performed wearing gerontologic ageing suits. Outcome variables were wayfinding performance (i.e., efficiency and walking speed) and physiological outcomes (i.e., heart and respiratory rates). Analysis of covariance showed that persons on more complex routes (i.e., more floor and building changes) walked less efficiently than persons on less complex routes. In addition, simulated elderly participants perform worse in wayfinding than young participants in terms of speed (p < 0.001). Moreover, a linear mixed model showed that simulated elderly persons had higher heart rates and respiratory rates compared to young people during a wayfinding task, suggesting that simulated elderly consumed more energy during this task.
In an indoor environment, there commonly exist a large number of multipaths due to rich scatterers. These multipaths make the indoor positioning problem very challenging. The main reason is that most of the transmitted signals are significantly distorted by the multipaths before arriving at the receiver, which causes inaccuracies in the estimation of the positioning features such as the time of arrival (TOA) and the angle of arrival (AOA). On the other hand, the multipath effect can be very constructive when employed in the time-reversal (TR) radio transmission. By utilizing the uniqueness of the multipath profile at each location, TR can create a resonating effect of focusing the energy of the transmitted signal only onto the intended location, which is known as the spatial focusing effect. In this paper, we propose exploiting such a high-resolution focusing effect in the indoor positioning problem. Specifically, we propose a TR indoor positioning system (TRIPS) by utilizing the location-specific characteristic of multipaths. By doing so, we decompose the ill-posed single-access-point (AP) indoor positioning problem into two well-defined subproblems. The first subproblem is to create a database by mapping the physical geographical location with the logical location in the channel impulse response (CIR) space, whereas the second subproblem is to determine the real physical location by matching the estimated CIR with those in the database. To evaluate the performance of our proposed TRIPS, we build a prototype to conduct real experiments. The experimental results show that, with a single AP working in the 5.4-GHz band under the non-line-of-sight (NLOS) condition, our proposed TRIPS can achieve perfect 10-cm localization accuracy with zero-error rate within a 0.9 m by 1 m area of interest.
To review the range of promising technologies (e.g., smart phones, remote monitoring devices) designed to enhance aging in place; identify challenges for implementation of those technologies; and recommend ways to improve access to technologies in older populations.
A narrative review of research, practice, and policies from multiple fields, including information science, gerontology, engineering, housing and social services, health care and public health.
Despite a wide range of emerging and current technologies, there are significant challenges for implementation, including an uneven evidence base, economic barriers, and educational and ergonomic issues that adversely affect many older adults.
Recommendations for future development and adoption include improving the evidence base through field-testing of "packages" of devices in diverse populations of older adults; development of innovative funding mechanisms involving multidisciplinary teams, older adults, and caregivers; and promotion of safety and security in the use of these technologies in older populations.
© The Author(s) 2014.
Accessibility information is necessary to support the everyday mobility of people with disabilities. As a service to aid the mobility of students with disabilities, some universities and colleges provide maps with accessibility information for their campus on the Web. Other maps, while not focused specifically on students, provide information about indoor accessibility and can be extended by users. In this paper, accessibility requirements published in the literature, the criteria used in existing geo-crowdsourcing services and the data used by campus accessibility maps (which are commonly based on the ADA standards) are used to provide an optimal set of requirements for personalized accessibility map (PAM). PAM is discussed and analysed in detail, a prototype PAM developed for the University of Pittsburgh is described, and challenges and future work are highlighted.
Healthcare facilities are often complex and overwhelming for visitors, and wayfinding in healthcare facilities can be challenging. As there is an increasing number of global citizens who travel to seek medical care in another country, it is critical to make wayfinding easy for visitors who are not familiar with the language in a foreign country. Among many wayfinding aids, symbols are helpful for those visitors who have limited ability to understand written language. This study tested universal healthcare symbols in the United States, South Korea, and Turkey to compare the comprehension of symbols cross-country and identify predictors of the correct comprehension. To explore statistically significant relationships between symbol comprehension and countries, Pearson's Chi-square tests, logistic regression, and ANOVA were conducted. The test results showed that ten symbols among 14 tested have significant relationship with countries. Results of this study demonstrate that symbol comprehension can be varied significantly in different countries.
Although wayfinding and orientation in complex buildings is an important criterion for environmental behavior, research on the subject remains limited and the issue is not considered sufficiently during the design process. This article examines the factors that affect wayfinding behavior of individuals in a shopping mall and explains how their behaviors are influenced by factors such as building configuration, visual accessibility, circulation systems, and signage. The case study conducted in a mall in Turkey draws a sample profile of Turkish society from a wayfinding point of view. The relation between wayfinding behavior and shopping activity is discussed. The results show that people did not find the signage system sufficient. Although they found the mall an easy setting from the wayfinding point of view, they still required better solutions to find specific destinations such as telephone booths, restrooms, or stores located in parts of the building that were not visually accessible.
This article presents a discussion of mixed methods (MM) sampling techniques. MM sampling involves combining well-established qualitative and quantitative techniques in creative ways to answer research questions posed by MM research designs. Several issues germane to MM sampling are presented including the differences between probability and purposive sampling and the probability-mixed-purposive sampling continuum. Four MM sampling prototypes are introduced: basic MM sampling strategies, sequential MM sampling, concurrent MM sampling, and multilevel MM sampling. Examples of each of these techniques are given as illustrations of how researchers actually generate MM samples. Finally, eight guidelines for MM sampling are presented.
In today's complex maze of urban structures, wayfinding is no longer simply a matter of putting up directional signs, it is multi-faceted problem that requires sharp design skills. This text spells out the principles of wayfinding and applies them to architectural design. beginning with spatial, orientation, and perception factors, the book shows how well-designed routes and destinations must integrate a wide range of stimuli - graphic, verbal, auditory, and tactile. Plus, convenient checklists show how to prevent potential wayfinding problems in the design stage and to troubleshoot them in existing structures. Supported by numerous real-life examples and hundreds of lively illustrations, this book is a complete guide to spatial direction and logical orientation in buildings and public spaces - jam-packed with proven techniques for helping people find their way through today's confusing world.
This article uses a limited example to demonstrate that studies of wayfinding and spatial learning can benefit from a more rigorous analytic description of building layout and exploration paths that exhibit their own pattern. In at least one case, search patterns are strongly shaped according to the degree of integration of each space and each choice node of the circulation system within the overall layout. Given this overriding trend, we formulate the idea of a search structure whereby the intelligible properties of layouts interact with navigation rules to produce characteristic patterns of exploration.
Previous research has highlighted that blind and partially sighted people find various factors inhibit their abilities to make journeys. This paper proposes that the lack of accurate, appropriate and usable geographical data is one of the reasons for this and these can be tracked back to core human factors issues such as situational awareness, mental workload and environmental ergonomics. Following a review of applicable literature a hierarchical task analysis was performed to better understand the problems in terms of the complexity of various journey types and to identify the geographical data requirements in order to make successful journeys. The task analysis produced a number of results including highlighting four underlying principles which have an impact on the data requirements during any given journey. Finally the need for accessible and accurate geographical data requirements is introduced as a result of the literature review and the task analysis. These highlight the information required in order to facilitate more accessible travel for blind and partially sighted people by providing geographical information about their surroundings in a relevant, meaningful and usable way.
This paper focuses on an architecture competition for the silver generation, namely those aged 65 years and older. Twenty-seven Swedish informants were interviewed using an interviewing guide that included a photographic survey. The informants emphasised aesthetic dimensions in architecture for the prolongation of ageing in place and independent living in a residential home. This study highlights the individual adjustment of space, and the integrated location in existing urban settings near nature. Based on the findings, a habitational model for exploring the appropriate space for ageing is formulated. It suggests that architecture through location and spatial features needs to generate positive associations with the users.
Healthcare facilities are increasingly utilizing pictograms rather than text signs to help direct people. The purpose of this study was to analyze a wide variety of standardized healthcare pictograms and the effects of color contrasts and complexity for participants with both normal and impaired vision. Fifty (25 males, 25 females) participants completed a signage recognition questionnaire and identified pictograms while wearing vision simulators to represent specific visual impairment. The study showed that certain color contrasts, complexities and orientations can help or hinder comprehension of signage for people with and without visual impairment. High contrast signage with consistent pictograms involving human figures (not too detailed or too abstract) is most identifiable. Standardization of healthcare signage is recommended to speed up and aid the cognitive thought process in detecting signage and determining meaning. These fundamental signage principles are critical in producing an efficient, universal wayfinding system for healthcare facilities.
The professional claims and struggles involved in the design of non-traditional health care places are rarely problematized in applied health research, perhaps because they tend to fade away once the new design is implemented. This paper offers insights into such professional tensions and their impact on health care delivery by examining the design of two dialysis service delivery models in Quebec, Canada. The satellite units were hosted in two small hospitals and staffed by recently trained nurses. The mobile unit was a bus fitted to accommodate five dialysis stations. It was staffed by experienced nurses and travelled back and forth between a university teaching hospital and two sites. In both projects, nephrologists supervised from a distance via a videoconferencing system. In this paper, we draw mainly from interviews with managers (mostly nurses) and physicians (n=18), and from on-site observations. Nephrologists, medical internists, and managers all supported the goal of providing "closer-to-patient" services. However, they held varying opinions on how to best materialize this goal. By comparing two models involving different clinical and spatial logics, we underscore the ways in which the design of non-traditional health care places opens up space for the re-negotiation of clinical norms. Instead of relatively straightforward conflicts between professions, we observed subtle but inexorable tensions within and beyond professional groups, who sought to measure up to "ideal standards" while acknowledging the contingencies of health care places.
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- J Carpman
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Wayfinding in Hospitals. University of Michigan Hospitals, Patient, & Visitor
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Design that Cares: Planning Health Facilities for Patients and Visitors
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Carpman, J.R., Grant, M.A., 2003. Design that Cares: Planning Health Facilities for
Patients and Visitors, third ed. American Hospital Publishing Inc, Chicago.
Wayfinding for Health Care: Best Practices for Today's Facilities
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Navigation instruction validation tool and indoor wayfinding training system for people with disabilities
- L Ding
Ding, L., 2017. Navigation instruction validation tool and indoor wayfinding training
system for people with disabilities. In: Master of Science in Electrical and Computer
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A Position Paper for the Environmental Standards Council of the Center for Health Design
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Achieving a Lean Wayfinding System in Complex Hospital Environments: Design and Through-Life Management
- C N Rooke
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- P Tzortzopoulos
Rooke, C.N., Koskela, L., Tzortzopoulos, P., 2010. Achieving a Lean Wayfinding System
in Complex Hospital Environments: Design and Through-Life Management. In: IGLC-18 Proceedings of the Conference of Safety, Quality and Environment, pp. 233-242.
Technion, Haifa, Israel.