Color Coding the “Labyrinth”: How Staff Perceived a Two-Part Intervention to Improve Wayfinding in an Adult Emergency Department

Michael Madson, Kelsie Goodwin

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objectives, purpose, or aim: We report a two-part wayfinding intervention, considering four quality criteria (visibility, usability, efficiency and overall effectiveness) from staff perspectives. Background: Few studies to date have explored wayfinding in the Emergency Department (ED). Yet, as ED usage continues to grow, effective wayfinding in these high-stress, fast-paced environments is likely to become increasingly important. At an adult ED located in the U.S. Southeast, wayfinding has been a persistent problem. We subsequently developed a two-part wayfinding intervention: colored routes to key destinations in the ED and corresponding visitor badges. Methods: Quality criteria were formulated using the Donabedian model: visibility (structure), usability (process), efficiency (process), and overall effectiveness (outcome). Assessments consisted of staff surveys, which were distributed from March to early April 2019. Results: The strong ratings across quality criteria, added to affirmative comments from staff, provide evidence that the color coding system made a positive impact on wayfinding. Conclusions: While the results should be generalized with caution, the two-part intervention may be highly portable to other contexts. Future studies might examine the effect of colored routes alone. They might illuminate relations between structure, process, and outcomes as they relate to the assessment of wayfinding. They might also expand wayfinding quality criteria. Ultimately, such studies should improve not only the productivity but also the accessibility and user experience of the ED.

Original languageEnglish (US)
Pages (from-to)429-441
Number of pages13
JournalHealth Environments Research and Design Journal
Issue number4
StatePublished - Oct 2021


  • Emergency Department
  • color coding
  • quality improvement
  • staff
  • surveys
  • visitors
  • wayfinding

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Public Health, Environmental and Occupational Health


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