Even Architects Get Lost in Hospitals

By Karen Zwart Hielema

I’ve spent my career studying buildings, circulation, and how people move through space. You’d think that would give me an advantage when I step into any building—especially something as structured as a hospital.

But a few months ago, when I went in for a routine procedure, all of that confidence disappeared. I was tired, hungry, and more anxious than I wanted to admit. The last thing I needed was to feel disoriented. Yet that’s exactly what happened.

I wandered down long, identical hallways. I stopped at signs that didn’t seem to answer the questions I was asking. Every turn felt like a guess. And in that moment, I wasn’t the architect, the designer, or the professional. I was just another patient, frustrated and a little lost.

That experience stayed with me because it reminded me of something important: wayfinding isn’t just about putting signs on walls. It’s about empathy. It’s about anticipating what someone might feel when they walk into a stressful environment, and guiding them in a way that reduces that stress instead of adding to it.

Good hospital wayfinding doesn’t begin at the door—it begins at home, with the appointment notice that tells you where to go and when. It continues with the entrance experience, where the first sign either reassures you or overwhelms you. And it follows you through each hallway, elevator, and waiting room, shaping the journey so you never feel abandoned.

Hospitals are complicated, emotional places. They carry the weight of vulnerability. But they don’t have to feel like a maze. When architecture, information design, and journey mapping come together, patients and families can feel guided, supported, and understood.

That’s the kind of design work I want to see more of—and the kind of work we do at DEXD. Because sometimes, even architects get lost. But with thoughtful design, patients don’t have to.