Chapter 14: Developing the Wayfinding System

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Chapter 14: Developing the Wayfinding System

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Mr. Daigneau notes that the Ambulatory (Mays) Clinic building project created the wayfinding project and also opened discussions about how to construct an efficient bridge system between buildings. He explains that he hired a wayfinding consultant that had worked for Disney and developed a system based on visual cues and sequencing of information. He instructed the consultants to use basic transportation engineering principles to develop signs. He notes that the signs with Gateway Numbers were borrowed from Disney (and were adopted by the Texas Medical Center after MD Anderson erected them). Mr. Daigneau explains how the wayfinding system evolved through the use of focus groups and testing of solutions with patient groups. He also notes that patients were asked to evaluate furniture choices. "We were not building for ourselves," Mr. Daigneau says. Mr. Daigneau next talks about how focus was shifted to the bridge system between buildings when there were some near accidents with physicians crossing Holcombe Boulevard.

Identifier

DaigneauW_01_20131003_C14

Publication Date

10-3-2013

Publisher

The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center Building the Institution; The Administrator; MD Anderson History; MD Anderson Past; Institutional Processes; Discovery and Success; Building/Transforming the Institution; Growth and/or Change; Obstacles, Challenges; Professional Practice; The Professional at Work; Institutional Mission and Values; Understanding the Institution; Patients, Treatment, Survivors; Discovery, Creativity and Innovation

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Tacey A. Rosolowski, Ph.D:

Is now a good time for you to tell me about that project? I didn't want to interrupt your story about the different buildings, but I had on my list of other questions wayfinding. Do you want to talk about that now, or would it be better to wait?

William Daigneau, MBA:

Well, once the decision was made to move across the street and there were other decisions going on. Dr. Mendelsohn was very keen on developing a research park on the south campus. So all of these things, while we were working on the Ambulatory Clinic Building and under negotiations and development design for the Mitchell Building, which was the basic science expansion with a major vivarium underneath it" so a lot of these things were going on at the same time, so we were facing a lot of critical issues. We had master planned the" but now we had two entrances for patients. Well, how are we going to" ? And then we've got to tie these facilities together somehow. A bridge system. How would we do a bridge system here? We studied different routes for a bridge system, some wrapping around Garage 2, going into the front of Alkek. Some, which is the one that we finally adopted, which went along the back of the Mays Clinic, connected Faculty Center, and went across the street to the front of Clark. So all these issues were coming up. How do we move patients about? Once they're in here, how do they tell where they're at, where they're going, which entrance are they coming in? So all these questions started to emerge, and that initiated the wayfinding project" a whole team devoted to that. They worked on nothing but the wayfinding project. Hired a consultant. Looked at ones that had worked for Disney.

Tacey A. Rosolowski, Ph.D:

Oh, really?

William Daigneau, MBA:

Well, some of us had been to Disneyland. If you think about it, big park, right? They had these gates that you go in, where to park. You have line-of-sight on some things. There's the monorail station. That's where I need to walk to. So you have visual cues. You have information that goes from very general to very specific. So there were a lot of principles in Disney World that were now" though I never use that term because I figure" you know" comparing us to Disney World is not like the right thing to do here, but some of the same issues and moving large volumes of people around. So we looked for consultants, and we finally" I can't remember the name of the firm, but we picked them" they had good experience in those types of things" of all things, amusement parks, and sports facilities.

Tacey A. Rosolowski, Ph.D:

So what were some of the solutions that they came up with for the particular problems and challenges of Anderson?

William Daigneau, MBA:

Well, basically they were picked because of" early in my career, when I worked for the city of Peoria, I had taken some courses in transportation engineering, and one of the things was signage" you know" how signs are created on highways. They tell which exit to get off, how much information you need to know. Route numbers, street names" all of that is part of transportation engineering. Now, we've all been around the country, and we've seen experiences of good transportation engineering and bad transportation engineering. So it's like everything else. You can go to a restaurant and get a good steak and another restaurant, a bad steak. It's the same with engineers. But there were some principles that made a lot of sense to me in traffic engineering. Well, I applied those same principles in terms of guidance to the consultants, what we were going to try to achieve, and that was" one thing I'd learned was from the general to the specific. In other words, at some point in the journey you get the person into the right area. Once you get them into the right area, you supply them with more information to get them headed in the right direction. And then once you have them headed in the right direction, you give them more information about their destination. But you don't load up this enormous sign that says, For the breast clinic" da, da, da, da." You can't put that on a sign. It makes no sense to them. They can't absorb the information. They don't have time to read it. You don't put signs up" Dr. Mendelsohn likes signs at the top of the building, so we agreed we'd put MD Anderson up there and the benefactor's name. But down at street level, which is where you and I are looking, you put Breast Center. (laughs) Not So-and-So Breast Center, just Breast Center. That's all they need to know. Okay, I must be getting close. So keep the signage very simple. Go from the general to the specific. Create routes that are identifiable. Create recognizable cues along the way as to, Well, they told me to expect to see a fountain. Is a fountain there? Yeah, there's the fountain. I must be on the right way."

Tacey A. Rosolowski, Ph.D:

It also makes it easier to ask for directions if you're lost. Where's the fountain?

William Daigneau, MBA:

Yeah, exactly. So use visual cues combined with signage combined with routing systems. When you send a patient a letter, send the" you know" from the general to the specific of how to get here. So come to Houston, take one of two routes in, get on Holcombe, look for" and this was the gateway, the beginning of the gateway signs" entrance five" which was borrowed from Disney" entrance five, entrance three, entrance four. Once we get them there, you make a right turn in, or you turn into that entrance, valet, go in the lobby, take the elevators to the left, go up to the fifth floor, and you're there. (laughs) General to specific. And the lobby has this big piece of artwork. You'll know you're in the right lobby. Look for the big tree of life. Do you like art?" No, it was actually part of the wayfinding system." The gazebo" I mean, all these things" the aquarium" everything was part of visual cues. Oh, I must be" here's the tree of life." To reconfirm, reduce anxiety, keep people on the trail.

Tacey A. Rosolowski, Ph.D:

And the process is also doing double duty. Like the Tree of Life, it is a wonderful addition to" I mean, it's functional, but it also adds to the aesthetics.

William Daigneau, MBA:

And we didn't know we were going to have the Tree of Life. All we said was we need something big that's recognizable.

Tacey A. Rosolowski, Ph.D:

Interesting. So how long did it take to work out those details of way-finding?

William Daigneau, MBA:

Well, they're still being worked on. It's one of those things that you learn" but for example, the gateways" the gate signs. That was adopted by the Texas Medical Center. I mean, we went to them and said, We're going to put up this sign, and we want to put one up in front of Mays. We want to put one up in front of the main complex" actually, two of them" one on MD Anderson and the other on Bertner" that say gate three." Well, if you're going to do that, we'll have to think about it." Well, the next thing we know they're coming back saying, We're going to do that across the medical center." So everybody got MD Anderson's gate system.

Tacey A. Rosolowski, Ph.D:

It's a great solution to the maze down there.

William Daigneau, MBA:

Yeah. It makes it easier. People looking for a little sign" Bertner" do I turn right? Do I turn left? You see the gate signs and you say, Well, I turn into the gate sign. That's where I'm headed." CLIP B: Institutional Mission and Values C: Understanding the Institution C: Patients, Treatment, Survivors C: Discovery, Creativity and Innovation C: Professional Practice B: MD Anderson History A: The Administrator Patients Have Input Into the Wayfinding System

Tacey A. Rosolowski, Ph.D:

Well, there are just millions of details. I remember when I was first coming to MD Anderson and making my way from the parking deck under the Mays clinic all the way across the sky bridge to Pickens Tower, where Research Medical Library is. It was unbelievably confusing, and I so appreciated, when I got into the elevator waiting area to take the elevator up, those little-bitty cards that I could pick one up so I could remember was I in parking level two or three. I mean, I can't even imagine a patient coming in upset, frightened, and having all that going on in their mind, and then they have to worry, Oh my God, I've lost my car." I mean, please, we don't need this. And that's just, I'm sure, one of those millions of details that came out of that wayfinding project.

William Daigneau, MBA:

Everything" and tracked a patient from the airport, coming from Austin, all the way into the complex and what would make sense to them. What where their fail-safes? The kiosks were created. All the maps were created. The instructions to new patients were created. Room signage, naming the clinics to keep it somewhat simple.

Tacey A. Rosolowski, Ph.D:

Now, when you said you tracked patients, was that part of your" ?

William Daigneau, MBA:

We had focus groups of patients, not only asking them what the problems were but tried out things with them. Actually" I didn't mention this" we had focus groups on every design of every building. The users would create groups. We talked to patients. What's your frustration? We had employee groups. We extensively used focus groups to test out ideas as well as" not only discover problems but to test out ideas. We tried out furniture. We put furniture out in the lobbies and asked people to try it out and rate it" if you like it, don't like it. We're not building for ourselves. The end result is" you know" I always remind our people that these are not our buildings. We're not building for ourselves. We're building for our patients, our faculty, and our staff. Either they find these facilities easy to use, reliable, comfortable, or they don't. We don't want the latter. We want the former, so we need to involve them, make sure we test every" some architect says, Oh, I've done this fifty places." Yeah? Well, you haven't done it at Anderson. Until you show us" and that's one thing that Dr. Mendelsohn" you didn't go into Dr. Mendelsohn without data. If he was convinced you had done your research" and I'll give you an example of that. We built Faculty Center, right? Had the bridge system in place. Nobody was using the bridge. The docs, especially the surgeons, were walking right across Holcombe at grade level, not using any of the crosswalks. Shortest distance" the front door of Faculty Center to the front door of Alkek, that's the path they were taking because they were in a hurry. Time is important to them. I'm getting there as fast as I can. I'm not going to use that bridge. I'll have to walk all through Clark Clinic to get over to Alkek. I'm not doing that. I'm walking right across the street." Well, we had a few close calls. So next step"

Tacey A. Rosolowski, Ph.D:

Yeah, I read about some of those near accidents on Holcombe, dangerous.

William Daigneau, MBA:

put police officers out there. We had a flashing sign" pedestrian" police officers out there slowing traffic down. The final straw was when this woman almost ran over one of our police officers. Let alone the faculty member, ran over" so I said, We're just waiting for a major fatality here. It's not a matter of if we're going to get one; it's a matter of when we finally get one." Because again, even if these people don't speed a lot, they're distracted, they're looking for directions, they're looking around, and all of a sudden they've run over somebody. So I went back to Dr. Mendelsohn and said, Dr. Mendelsohn, we've got to close off the ability to walk across the street. Either people have to use one of the signalized intersections or use the bridge system. We have a bridge system in place. Let's use it." He said, I mean, I'm from New York City. I walk across the street all the time. People do that." I said, Okay." Next meeting" I had the research done on at-grade pedestrian deaths in Houston. (laughs) The recommendation of traffic specialists, law enforcement, overwhelmingly was even with a flashing signal, the safety of crossing between two intersections doubles the chance of pedestrian injury. I mean, there's the numbers. Okay, we'll tell the faculty." But it had to be supported by data.

Tacey A. Rosolowski, Ph.D:

So how did you actually get people to stop?

William Daigneau, MBA:

Put in a fence. When you go back to Houston, look. There's a fence that runs along the median so you can't cross. Now it's been alleviated. Once Mays was basically completed, the new bridge was completed. So now there were two bridges on either side of Faculty Center to cross the street. So even among some of our longer-term faculty who remember those days, it became a nonissue because now it was so convenient to go across the second bridge. So we solved the problem eventually, removed any reason why you wouldn't want to use the bridge" air conditioned, fast, solved the problem. So the second bridge solved that problem. But yeah, that's" big fence goes there. And again, administration trying to interfere with" well, administration trying to interfere with you keeping your life. (laughs) So a lot of that" you know" focus groups, research, data" everything we did was" nobody walked into our door and said, Well, this is the best thing since" " Oh, yeah?" Baylor, when we built the new vivarium, put in an automated cage wash system. So my question was, of the consultant who recommended this to us, what happens if it breaks down? Now, if you remember, when Denver International Airport was built, they had an automated bag handling system. The thing never worked.

Tacey A. Rosolowski, Ph.D:

I remember newspaper articles about that.

William Daigneau, MBA:

So they had to go back to a manual, throw-the-bags-around, labeling, all that stuff. So with that in my mind, I asked the consultant, So what happens if this thing doesn't work?" Oh, it will work. It's guaranteed by the manufacturer." No. Let's say the manufacturer comes back to us and says, ÷It doesn't work. We just can't do anything about it,' what's our fallback position?" Well, you don't need one." No, no, no." (laughs)

Tacey A. Rosolowski, Ph.D:

That's a weird answer.

William Daigneau, MBA:

Yeah. It works. It works. Baylor bought it." I said, We're not Baylor. Baylor may have chosen to jump off the bridge. We're not going along with them." So we didn't put it in. As it turned out, Baylor spent a lot of money on their system, trying to get it to operate.

Chapter 14: Developing the Wayfinding System

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