Purpose: This article assesses the magnitude and impact of wayfinding problems in US hospitals as perceived by staff. Background: Problematic wayfinding in healthcare facilities is a persistent issue, leading to frustration, stress, fatigue, physical aggression, wasted time, and a negative organizational image. Despite anecdotal evidence, few studies have quantified the impacts of wayfinding problems. Methods: This descriptive cross-sectional study used an online questionnaire to gather data from hospital staff in the United States. The questionnaire targeted (1) wayfinding for hospital staff, (2) wayfinding for hospital visitors, (3) the impact of wayfinding problems on staff, and (4) the importance of addressing wayfinding problems. Data from 301 questionnaires were analyzed using descriptive and nonparametric statistics. Results: Staff found it easy to navigate their own departments but more difficult to navigate other departments. Staff's responses indicated that wayfinding was relatively difficult for visitors. Each staff member spent about 30 min per week on helping others with wayfinding. The five locations in which users needed the most assistance were the cafeteria, restrooms, elevators, exits, and main lobby. Staff commonly escorted people to a point from which they could independently reach their destination. Wayfinding difficulties could distract staff from their main duties and cause frustration. Nearly 44% of the participants experienced incivility from users who had become frustrated by wayfinding problems. Participants rated addressing wayfinding problems as very important. Conclusions: Despite the extensive literature on the environmental factors that influence wayfinding, this study finds that hospital visitors in the United States still struggle with wayfinding, which indicates a potential gap between design research and practice.

The world’s population is aging and, as populations age, they exhibit an increased prevalence of chronic diseases, which can reduce the independence of elderly individuals. The set of initiatives known as aging in place, a common policy response to the aging population, is preferred by both the elderly population and policymakers. Aging in place is a broad and multifaceted topic that involves multiple stakeholders and academic disciplines. A science map of the literature on aging in place can help researchers pinpoint their efforts and help policymakers make informed decisions. Thus, this study maps the scientific landscape of the aging-in-place literature. This review used bibliometric analysis to examine 3240 publications on aging in place indexed in the Web of Science. Using VOSviewer 1.6.20, it conducted various analyses, including a citation analysis and an analysis of the co-occurrence of author-provided keywords. The study identified key research areas, leading countries, institutions, and journals, central publications, and the temporal evolution of themes in the literature. Based on its keyword co-occurrence analysis, the study identified five major research-area clusters: (1) aging-in-place facilitators, (2) age-friendly communities, (3) housing, (4) assistive technologies, and (5) mental health. This study improves the understanding of the various interdisciplinary factors that have influenced the research on aging in place. By making this research more accessible, the study can help researchers and policymakers navigate the extensive information on aging in place and complex relationships more effectively.

Purpose: This study aimed to offer a comprehensive analysis of distinct design strategies identified, evaluated, or discussed in the existing literature that promote environmental flexibility in the context of emergency departments (EDs). Background: EDs are subject to constant changes caused by several factors, including seasonal disease trends, the emergence of new technologies, and surges resulting from local or global disasters, such as mass casualty incidents or pandemics. Thus, integrating flexibility into ED design becomes crucial to effectively addressing these evolving needs. Methods: A systematic search was conducted in four databases: CINAHL, MEDLINE, PubMed, and ScienceDirect, in addition to a hand search. A two-stage review process was employed to determine the final list of included articles based on the inclusion criteria. Included studies were evaluated for quality, and findings were categorized using a hybrid deductive and inductive coding approach. Results: From the initial yield of 900 records, 22 studies met the inclusion criteria and were included in the final full-text review. The identified design strategies were organized into five categories: modifiability ( n = 13 articles), versatility ( n = 8 articles), tolerance ( n = 6 articles), convertibility ( n = 4 articles), and scalability ( n = 7 articles). Specific design strategies under each category are reported in detail. Conclusions: Our findings suggest that most flexibility design solutions are based on anecdotal evidence or descriptive studies, which carry less weight in terms of reliable support for conclusions. Therefore, more studies employing quantitative, relational, or causal designs are recommended.

The performance of healthcare facilities during the COVID-19 pandemic demonstrated that healthcare environments can support or hinder critical aspects of pandemic response, such as infection control, surge capacity, workforce safety, and continuity of care. This study maps the scholarly landscape at the intersection of pandemics, healthcare, and the built environment to clarify how built environment-related concepts are positioned within pandemic-related healthcare research. A total of 5061 records were retrieved from the Web of Science Core Collection and analyzed using VOSviewer (1.6.20). Author keyword co-occurrence analysis was used to examine thematic patterns. The keyword network identified eight major thematic clusters, with subclusters addressing infection control, pandemics and public health, telemedicine and remote care, data technologies and digital infrastructure, healthcare leadership, care quality and safety, healthcare education, occupational stress and resilience, psychological distress, older adult care, pediatric care, health disparities, workplace safety, and waste management. Overall, the findings show that built environment considerations were present across multiple thematic areas but often appeared indirectly within broader clinical, operational, public health, and environmental discussions. Based on these findings, this study discusses future directions for environmental design research, including systems-based approaches, pandemic-readiness assessment, healthcare worker wellbeing and safety, continuity of care, and more explicit integration of design knowledge into pandemic preparedness, response, and recovery.