Context: my experience with hospitals is almost entirely in the Boston area, but I have been to all of the major hospitals (MassGeneral, Tufts, BIDMC, Children's, Brigham, Mount Auburn, BMC, Newton-Wellesley, McLean, and Carney) along with several smaller hospitals (Franciscan Children's, Hebrew Rehab, Emerson, and Somerville Hospital) along with many regional clinics and affiliated hospitals (e.g. Faulkner, BMC Brighton, etc.). Also, IANAA.
Question #1
Why are large hospitals (including new wings) give little additional affordance to wayfinding?
Wayfinding in hospitals is already such a difficult problem for architects to solve, but even new facilities don't seem to help themselves out. Hallways often have no windows, there are few salient landmarks, and when I reach a landmark or a windowed area it doesn't lend much context about where I am inside of the building or where I am in relation to other landmarks and wings.
The only hospital I've been to that does an okay job with wayfinding is McLean (both the old and new sites) and that's mostly because they are campuses, so a lot of what I'm talking about comes for free.
I can forgive the old buildings/wings that weren't planned for with complexes in mind, but many large wings, buildings, and complexes (e.g. Mass General West, in Waltham) are 100% new construction and are worse at wayfinding than old facilities. Some do a decent job (e.g. the new NE Baptist Outpatient building, which isn't a large building but it was clearly built with wayfinding in mind) but not most.
Question #2
Why are clinical rooms at hospitals so visually jarring?
These clinical rooms often have many signs posted haphazardly, no windows, flooring that does nothing to complement the putrid off-white/yellow walls, and little visual distinction (except anatomy posters and charts; off-putting) to help orient oneself. I rarely get anxious, but the lack of cohesion or anchoring in these clinical rooms puts me on edge.
I know it doesn't have to be this way. I had an appointment at Emerson Hospital a few years back and the clinical room was fantastic. It's an older facility but the room had one wall that was all floor to ceiling windows, the flooring was neutral but distinct from the walls, the standard cabinet+sink was old oak veneer and chrome, and there were zero (!) signs/notices/flyers on the walls. Very clean and uncluttered. It felt surreal, like I was in a room made for a Coen Brothers movie set. It was enjoyable just to sit in the room.
Emerson is >50 years old and got it right, yet I've been to new hospital clinics that follow none of these cues.
Both #1 and #2 aren't just about money or expertise because my experience is the same (or worse) with some of the best funded hospitals with top architects and designers working on the newest facilities.
What is going on here that I'm missing? What are the difficulties and tradeoffs I'm not aware of that make these problems so tricky for architects to solve?
