Posted by Yvonne on 12.11.2009

Source: Guys and St Thomas NHS Foundation Trust

ID/Lab’s hospital terminology and pictogram comprehension research in 2008 showed the confusion that can occur when using ‘medical or process jargon’ on signage. At first glance the results of the terminology testing provide few surprises:

Terms such as Podiatry (10%) were not understood nearly as well as Foot Clinic (42%). The lowest scores given for Allied Health (0%) and Ambulatory (0%). Both these terms are meaningless to patients and visitors, regardless of their proficiency in the English language.

The study involved users from the top five most common languages spoken by the hospitals users, representing 75% of the hospitals CALD (Cultural and Linguistic Diversity) users.

As Rob Waller on his Simpleton blog points out: Wayfinding projects are not just about showing people the way – they are often about making the way easier to show. Guy’s and St Thomas’ Hospital last year renamed many of their buildings to provide a set of names that makes more sense for patients. For example, people used to have trouble finding New Guy’s House, because it was not particularly new. This means that they’ve had to change not only signs and maps, but appointment letters too.

Department names are also changing:

  • ‘Paediatrics’ = ‘Children’s services’
  • ‘Ophthalmology’ = ‘Eye department’.
  • ‘Renal unit’ = ‘Kidney unit’
  • ‘Surgical appliances’ = ‘Patient appliances’.

Hurray for simplification!

FJ de Kermadec


Thanks for your thoughtful reply, Michel! I definitely agree with you that wayfinding goes beyond signage, and I applaud your efforts to bring consistency to the hospital. I especially like the idea of renaming buildings, having new addresses assigned to them and ensuring the layout is clearer to understand. Overall, I am definitely not criticising your drive for simplicity and your global approach to wayfinding—on the contrary. I am not convinced that replacing proper names with simpler ones is the right move in the long term—but I do understand your argument for it—, and it is only a matter of personal perspective, certainly not a criticism of your efforts at large. Keep up the interesting work!

Michel Verheem


Hi FJ, You are right in saying that the solution to simple navigation is not to dumb down names of departments and services. Especially in a hospital environment, simple wayfinding requires a holistic approach; spoken word (staff training), written information (e.g. website, appointment letter, information brochures), signage (e.g. information, directional, landmarks) and the built environment should work together to make the user find their right destination - and the way out again. The 'dumbing down' of the terminology being used is to make the information accessible for a larger proportion of the users. ID/Lab's terminology research shows that people with limited English proficiency find simpler terms easier to understand and remember. For people with a visual or cognitive disability, the dumbed down version of the medical terminology allows them to easier separate between terms that often look very similar (e.g. Orthoptics, Orthopedics, Orthodontics, Opthalmology, Oncology). As part of the wayshowing strategy, the terms to be used for each department, building, specialism, etcetera, that will be used in wayshowing and patient information should be agreed and used consistently by all. If staff giving spoken directions refer to a destination by one name, appointment letters refer to it by another and then signs use a different term, people will have real difficulty finding a destination. Staff must be made aware of the potential wayfinding problems people will have if terms used in appointment letters and spoken directions do not relate to the wayfinding information at the site, including signs, directories and maps. Unfortunately, wayshowing is too often seen as a signage exercise, with no or little regard to all the other stimuli and information that the wayfinder requires before and during their journey. Hope this clears it up!

FJ de Kermadec


While helping patients navigate around the hospital is a highly commendable and highly useful project, I remain unconvinced that the solution is to dumb down names and departments. Certainly, emergency services should be accessible quickly by outside patients and, therefore, announced in the simplest language possible, with an abundance of red and pictograms. However, shouldn't patients who are being cared for by a podiatrist reasonably find their way to the podiatry department? If they don't, or do not know who is in charge of them, then maybe the key lies in training staff and doctors so that patients are provided with the right words to understand where they are being treated, and by whom. Children’s services could mean social services, and patient appliances could mean television rental. The signs may no longer be obscure, but they have become fuzzy.