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IMPROVING WAYFINDING IN HOSPITALS FOR THE DESIGN OF TRAUMA SPECIALIST HOSPITAL, BAUCHI
ABSTRACT
The purpose of this study was to establish ways of improving wayfinding in hospitals in Nigeria in response to the rise in trauma cases from insecurity in the country. The approach was explored in North East Nigeria to generate appropriate responses to wayfinding needs during emergencies. North East Nigeria is a geo political zone that has been vulnerable to various scales of terrorist attacks in the country. Two surveys were conducted in four hospitals to explore both existing wayfinding features and relationship between physical features, coded information and social practices in hospitals in North East Nigeria. Results from the first survey, visual survey and interviews, reveal extensive incorporation of wayfinding features with little or no guidelines, resulting to poor design, confusing signs and high dependency on social practices. The second, a questionnaire survey provided data analyzed for means (M) and Relative Agreement Index (RAI) under the three-wayfinding concept of physical features, coded information and social practices. Results reveal that hospital users in the study area employ physical features (M 3.22) and social practices (M 2.58) followed by coded information (M 2.55) for wayfinding in the study area, this implies that users will find it tasking to find their way through complex hospitals in the event of trauma and/or other emergency related cases by relying on poorly designed wayfinding guides. The implication is that architects and other construction professionals need to differentiate finishes, structures and landscape elements, project clear building entrances and sidewalk as well as design colour guides on walls not floor to improve wayfinding in the study area.
TABLE OF CONTENTS
DECLARATION ………………………………………………………………………………………………. i
CERTIFICATION …………………………………………………………………………………………… ii
ACKNOWLEDGEMENT ……………………………………………………………………………….. iii
ABSTRACT ……………………………………………………………………………………………………. iv
TABLE OF CONTENTS ………………………………………………………………………………….. v
LIST OF FIGURES …………………………………………………………………………………………. ix
LIST OF TABLES …………………………………………………………………………………………… xi
LIST OF PLATES ………………………………………………………………………………………….. xii
LIST OF APPENDICES ………………………………………………………………………………… xivABBREVIATIONS…………………………………………………………………………………………. xv
1.0 INTRODUCTION ……………………………………………………………………………………. 1
1.1 Background of study ………………………………………………………………………………… 1
1.2 Statement of the problem …………………………………………………………………………. 2
1.3 Aim and objectives …………………………………………………………………………………… 3
1.4 Scope of the study …………………………………………………………………………………….. 3
1.5 Research questions …………………………………………………………………………………… 3
1.6 Justification of study ………………………………………………………………………………… 4
2.0 LITERATURE REVIEW ………………………………………………………………………… 5
2.1 Wayfinding …………………………………………………………………………………………… 5
2.2 HISTORICAL DEVELOPMENT IN WAYFINDING ……………………………………………………… 6
2.2.1 Pre Passini Era (PrePE) ………………………………………………………………………………. 6
2.2.2 Passini era (PE) …………………………………………………………………………………………. 7
2.2.3 Post Passini Era (PoPE) ……………………………………………………………………………… 8
2.3 The Importance of Good Wayfinding …………………………………………………………. 10
2.4 FACTORS AFFECTING WAYFINDING …………………………………………………………………. 13
2.4.1 Environmental Information ……………………………………………………………………….. 14
2.4.2 Signage System ………………………………………………………………………………………. 18
2.4.3 Individual Characteristics …………………………………………………………………………. 20
2.5 Wayfinding in Emergency Conditions …………………………………………………….. 22
2.6 Wayfinding Design Principles/guidelines ………………………………………………… 22
2.7 HOSPITALS ………………………………………………………………………………………………… 30
2.7.1 Types of Hospital …………………………………………………………………………………….. 30
2.7.2 Trauma Specialist Hospital ……………………………………………………………………….. 32
2.8 Summary of Literature Review ………………………………………………………………. 36
3.0 RESEARCH METHODOLOGY ……………………………………………………………. 38
3.1 RESEARCH DESIGN …………………………………………………………………………………….. 38
3.1.1 Case Study Approach ……………………………………………………………………………….. 39
3.1.2 Unique Adequacy Approach ……………………………………………………………………… 39
3.2 Population of Study ………………………………………………………………………………… 41
3.3 Sampling ……………………………………………………………………………………………….. 42
3.4 Instruments for Data Collection ……………………………………………………………… 44
3.5 Procedure for Administration of Instruments …………………………………………. 44
3.6 Data Presentations and Analysis …………………………………………………………….. 45
4.0 CASE STUDY ……………………………………………………………………………………….. 46
4.1 Introduction …………………………………………………………………………………………… 46
4.2 WEAK FORM …………………………………………………………………………………………….. 46
4.2.1 Federal Teaching Hospital Gombe (FTHG) ………………………………………………… 47
4.2.2 STATE SPECIALIST HOSPITAL (SSH) GOMBE ………………………………………………………. 48
4.2.3 Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi …. 49
4.2.4 Federal Medical Centre (FMC), Azare, Bauchi State ……………………………………. 50
4.2.5 Key Findings …………………………………………………………………………………………… 51
4.3 STRONG FORM ………………………………………………………………………………………….. 66
4.3.1 Section A of the Questionnaire (Demographics) ………………………………………….. 67
4.3.2 Section B of the Questionnaire ………………………………………………………………….. 71
4.3.3 Summary ………………………………………………………………………………………………… 75
5.0 RESULTS AND DISCUSSION OF FINDINGS ………………………………………. 77
5.1 Introduction …………………………………………………………………………………………… 77
5.2 Findings from first survey (weak form) …………………………………………………… 77
5.3 Results and Discussion of findings from second survey (Strong form) ………. 79
5.4 Summary of key findings ………………………………………………………………………… 81
6.0 DESIGN PRELIMINARIES …………………………………………………………………… 84
6.1 Site Location (Bauchi State) ……………………………………………………………………. 84
6.2 Selected Sites ………………………………………………………………………………………….. 85
6.3 Site Selection criteria and features ………………………………………………………….. 88
6.4 Site Location ………………………………………………………………………………………….. 90
6.5 Site Analysis …………………………………………………………………………………………… 91
6.6 SITE CLIMATE ……………………………………………………………………………………………. 92
6.6.1 Circulation and Safety ………………………………………………………………………………. 93
7.0 DESIGN REPORT …………………………………………………………………………………. 95
7.1 Design Brief …………………………………………………………………………………………… 95
7.2 Concept Development …………………………………………………………………………….. 95
7.3 DESIGN ……………………………………………………………………………………………………. 96
7.3.1 Wayfinding consideration …………………………………………………………………………. 96
8.0 SUMMARY, CONCLUSION AND RECOMMENDATION ………………….. 104
8.1 Summary of Findings …………………………………………………………………………… 104
8.2 Conclusion …………………………………………………………………………………………… 105
8.3 Recommendation ………………………………………………………………………………….. 106
8.4 Contribution to knowledge ……………………………………………………………………. 107
8.5 Areas for further research ……………………………………………………………………. 108
REFERENCES …………………………………………………………………………………………….. 109
APPENDICES ……………………………………………………………………………………………… 117
1.0 INTRODUCTION
1.1 BACKGROUND OF STUDY
Wayfinding systems have been the commonly used strategies to guide people’s orientation and navigation within large and complex institutional and multi-level buildings. It is a problem solving process that operates in space and involves spatial organization and/or information (Passini 2002; Timf, 2005; Bianconi and Andreani, 2011). However, many researchers given the task of improving wayfinding limit the solution to developing attractive signs (Health Facilities Scotland, 2007; Wayfinding, 2005). This results to a large number of such buildings developing over time in a disordered manner, producing complex environments consisting of long and confusing corridor systems with bends, turns and confusing signs (Rooke, 2012), These settings challenge and frustrate users especially in chaotic situations such as stampedes induced by panic during fire, security and other types of emergencies (Hajibabai, Delavar, Malek, and Frank, 2006). Such scenarios have unfortunately become common place in the many parts of the troubled North East region of Nigeria.
Nigeria is also grappling with multi-dimensional security challenges, the worst of which has been terrorism. The emergence of terrorism in Nigeria marks a threshold in the dramatic reign of public insecurity, which has generated widespread anxiety in the country with the North East geo-political zone being the worst hit by the terrorist insurgency (Okoli and Iortyer, 2014). According to the United Nations High Commission for refugees, the crises has displaced over 1.4 million and traumatized 5.4 million people in the north-east Nigeria (Channels Television, 2015). Such large number of traumatized victims may or already have called for Federal Government intervention, considering the fact that the geo-political zone has been the most prone and most vulnerable to various scales of terrorist attacks in the country (Okoli and Iortyer, 2014).
In this regard, hospitals are usually the first destination for victims of trauma and their relatives who throng medical facilities in a panicked state to inquire about the conditions of their loved ones. Anxiety and frustration from such insecurity coupled with long and confusing corridor system with bends, turns and confusing signs worsen their situation. Security and medical personnel add to this frantic scenario when carrying out their duties in aid of traumatized patients.
1.2 STATEMENT OF THE PROBLEM
Challenges associated with wayfinding needs are given low priority by designers, seeing it as a hindrance to good design or a problem to be solved with signage (Carpman and Grant, 2002). While security issues set anxiety and frustration, long and confusing corridor system with bends, turns and confusing signs adds to the problem. These can course stress which may result in feeling helplessness, raised blood pressure, headache, increased physical exertion and fatigue (Heulat, 2007), thus, the need to ease the anxiety and frustration, and reduce the fear of crime and enhance the perception of security in North East Nigeria.
While wayfinding researches on hospitals have been conducted out of Nigeria, very little has been done to address wayfinding issues within hospitals in the country especially in light of insurgent attacks on the populace which often occur around hospitals. Additionally, it is not clear what users require, how they respond or their attitudes towards wayfinding needs in relation to hospital design in Nigeria.
1.3 AIM AND OBJECTIVES
This research therefore aims at establishing ways of improving wayfinding for users in hospitals in Nigeria.
Objectives;
The aim of this research will be achieved through the following objectives:
To explore the concept of wayfinding in hospital design from literature.
To establish how wayfinding features have been incorporated in the design of similar hospitals from case studies.
To empirically determine user requirements for wayfinding in hospital design from interviews and questionnaires in the study area.
To develop a framework from literature and case studies on user wayfinding requirements in hospital design.
To demonstrate findings from the research in the design of the Trauma Specialist
Hospital, Bauchi.
1.4 SCOPE OF THE STUDY
This research is limited to those wayfinding strategies concerned with hospital complexes during emergencies with specific interest in the North-East region of Nigeria. This is considering the fact that the geo-political zone has been the most prone and most vulnerable to various scales of terrorist attacks in the country (Abdulrasheed, Onuselogu, & Obioma, 2015; Winsor, 2015; Segun, 2016; Okoli and Iortyer, 2014).
1.5 RESEARCH QUESTIONS
Which wayfinding features have commonly been incorporated in the design of hospitals in the study area?
Which architectural features address user requirements for wayfinding in hospital design in the study area?
1.6 JUSTIFICATION OF STUDY
With the rise in trauma cases from the insecurity problems in the country, it is important that new proposals for hospitals address the problem of wayfinding.
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