Bff15154783885 59691990bf0aa

Research Overview

Recommendations were given to Texas Children’s Hospital based on a thorough research project presented in excerpt below. The team involved established an alternative reading of the hospital as a “sensory landscape” in which graphics and landmark interventions use color, form, texture, pattern, structure, and sign elements to help travelers intuitively negotiate the scale of the campus. Additional interior elements (landmarks, interventions, thresholds, etc.) that are semi-autonomous to the campus were also recommended in order to aid more instinctive wayfinding.

Texas childrens context 1

City of Houston

To understand wayfinding at Texas Children’s Hospital, one must first understand the macro, mid, and micro complexities of the system. The city of Houston is relatively simple to navigate, relative to your starting point, but the difficulty increases dramatically as you enter the Texas Medical Center.

Texas childrens context 2
Texas childrens context 3

Increasing Density

As demonstrated by the maps above, complexities of navigation and cognitive loads increase as you drawn near the Texas Medical Center. A dense network of hospitals, research institutions, parking structures, pedestrian bridges, and public transit make finding your destination difficult. The system is further obfuscated by several competing numbering systems for entrances, garages, and buildings.

Ecosystem mapping

Ecosystem Mapping

In addition to environmental conditions, we needed to understand the vast array of relationships between patients and medical staff. Mapping this complex ecosystem allowed researchers and hospital administration to visualize communication channels and identify missed opportunities for a better experience.

Shadowing patients, caregivers, and staff was instrumental in the mapping process, as demonstrated by a few of the contextual photos shown below. A total of 8 shadowing exercises and 4 patient / caregiver visits were completed.

41bd0d54783885 596919901b75e
B558d254783885 596f8469e63fb
Efa8e654783885 596919901bc27
Dbea3254783885 596f8469e68b3

Color with Purpose

The use of color on campus had become inconsistent over time, creating confusion for guests. We imagined new, system-wide color guidelines and created a phased rollout plan in cooperation with the TCH interiors group.









Texas Childrens Omni Map Design

Missing Link

A “global” map that shows users how to get from their current position to their final destination was a crucial but missing wayfinding tool. Our team synthesized complex garage, building, elevator, and pedestrian bridge data into a simple campus map, showing the relationship between all towers, underground parking garages, and connecting sky-bridges.

Texas childrens design omni map with nurse 2b6339c6e7000c47e69f9dcc8a0881b2 1

Hierarchy and Predictability

The map modules strategically placed at elevator bays give a snapshot of immediate and campus-wide context while using color to underscore wayfinding. The system clearly shows the relationship between all campus elevators, buildings, and parking structures. This makes it easy for users to find their way even if their destination is in a different building than where they parked.

Texas childrens overall design system
Texas childrens omni map design system
Texas childrens wayfinding signage system
Texas childrens wayfinding signage system detail1
Texas childrens wayfinding signage system detail2

Design System

A modular system for campus wayfinding signs saved the hospital time and money, and allowed for ease of updating. We intentionally designed the fixtures to fit within an existing structure and on an existing chassis for a solution that was at once impactful and economical. The design system was translated and repurposed into an exterior environmental graphics program (not shown).


An extensive research, strategy, and design effort provided valuable patient and organizational insights to executive leadership, aiding in future decision making, that would ultimately help recapture Medicare & Medicaid reimbursements that had been jeopardized due to poor performance on HCAHPS measures related to wayfinding. The research was awarded an SEGD Global Design Award for its focus on human-centered design.


  • Qualitative and Quantitative Research
  • Contextual Analysis
  • Stakeholder Interviews
  • Patient / Caregiver Shadowing
  • Staff Shadowing
  • User Testing / Focus Groups
  • Findings Documentation
  • Design Recommendations / Prototypes
  • Wayfinding Strategy
  • Environmental Graphic Design


  • Texas Children’s Hospital, Client
  • Lauren Serota, Research Consultant
  • Formation, Research and Wayfinding Consultant
  • Fournir, Design Consultant


SEGD / Society for Environmental Graphic Design / Global Design Award / Human Centered Design / 2017


A portion of the research and design project was completed as an independent consultant. A portion of the design effort was completed while on staff as Design Director of Formation in Houston, Texas. For specific details and team member roles, please contact us or view the project and research team at Formation.


Environmental Design
Healthcare Design