ASSESSMENT OF WAYFINDING SIGNAGE IN A TERTIARY CARE HOSPITAL AND ITS EVALUATION TOWARDS QUALITY IMPROVEMENT

Abstract

Background: Hospital environments are complex, with many departments and service areas that can be confusing for patients and visitors. The wayfinding signage is an important part of the hospital environment that can help individuals find healthcare services and navigate the hospital independently. The quality of the signage may affect patients experiences and satisfaction with hospital wayfinding. Objective: To assess the quality of the existing hospital wayfinding signage and its association with patient satisfaction and identify signage attributes associated with overall satisfaction. Method: A hospital based, cross-sectional study was carried out at Rajendra Institute of Medical Sciences (RIMS), Ranchi between July 2025 and July 2026. The study included 400 adult patients; attendants and visitors were selected by using a non-probability convenience sampling technique. Data were obtained from the study participants through a pre designed, pre-tested, structured questionnaire administered by an interviewer. The questionnaire covered socio demographic characteristics, details related to the hospital visit, navigation experience, evaluation of existing wayfinding signage, and participants’ suggestion. The instrument demonstrated good internal consistency, with a Cronbach’s alpha coefficient of 0869. Data were entered and analysed using Microsoft Excel and Jamovi Statistical Software (version 2.7.37). Appropriate statistical methods were applied, including descriptive statistics, independent samples t-test, one-way ANOVA or Welch’s ANOVA, Pearson’s correlation, multiple linear regression, and Pearson’s chi-square test. Results: The overall mean patient satisfaction score was 23.15 ± 3.71, with an overall mean satisfaction of 3.86 ± 0.62. Among the assessed signage attributes, the language had the highest mean score (4.28 ± 0.59), followed by visibility (4.25 ± 0.61) and readability (4.24 ± 0.66). A significant relationship was found between overall patient satisfaction and the visibility, readability and language of signage (p < 0.001). Analysis using multiple linear regression also showed that the three attributes significantly predicted overall patient satisfaction and explained 73.0% of its variance (R = 0.854; R² = 0.730; adjusted R² = 0.728), with the language showing the strongest standardized effect (β = 0.376), followed by readability (β = 0.274) and visibility (β = 0.265). A strong positive correlation was found between overall patient satisfaction and the signage audit score (r = 0.727, p < 0.001). The patient satisfaction also differed significantly across the poor-, average-, and good-quality signage classifications, with the mean satisfaction scores of 16.6 ± 4.15, 21.4 ± 2.72 and 25.6 ± 2.52, respectively (Welch ANOVA, p < 0.0010). The association between signage quality classification and satisfaction level was also significant (χ² = 216.059, df = 2, p < 0.001). Conclusion: The study established a strong positive correlation between the quality of hospital wayfinding signage and the satisfaction of the patient. The language, readability and visibility were important predictors of satisfaction and the participants in areas classified as having good-quality signage reported substantially higher satisfaction than those exposed to average- or poor-quality signage. The regular assessment, maintenance and improvement of hospital wayfinding signage, especially its language, readability and visibility, may support better patient experience and quality improvement in tertiary care hospitals.