Navigating One’s Way Around Byzantine Hospitals

Not many people know that my wife (Gina the Gorgeous) is a serial inventor. Wherever we are and whatever we’re doing, she will recognize something lacking or see something existing that could be improved immeasurably. Wishing to share the joy of her discovery, she will describe her new idea to me in exquisite (some might say “painstaking”) detail.

Once Gina has grabbed the conversational ball and is on a roll, she brooks no interruption, as I know to my cost. I am allowed only to grunt appreciatively at appropriate junctures in her oratory expositions. Thus, it is unfortunate that everything Gina has invented thus far has already been conceived and created by someone else.

“Yes,” I will say when it’s my turn to talk (which is an increasingly rare event these days), “that’s a wonderful idea. It’s called a traffic light. There’s one over there.” Well, I may be exaggerating just a tad with respect to this particular example, but I’m sure you get the essence of the concept I’m endeavoring to express.

Lest you feel I’m being unkind, I should note that I recently found myself in a “shoe on the other foot” situation, because I also ended up spending a lot of time inventing a solution to a problem for which there was already a solution, if you see what I mean. It was like déjà vu all over again (as opposed to jamais vu, which is when something you know to be familiar feels unreal or novel in some way).

This all came about a few days ago when Gina and I drove up to Nashville to accompany her mother to one of the larger hospitals for some tests. As we left the grande dame’s abode, we entered the address provided on the appointment letter into my car’s GPS.

The address on the letter was in the form [doctor’s name][office number] [street number] [street name] [city] [zip code], so no problems there. The GPS took us directly to our destination. We could see the number in huge digits on the front of the building. Unfortunately, copious signage indicated there was no stopping and no place to disembark passengers. On the bright side of things, since the numbers on the building were so large, I was able to observe them for a long time in my rearview mirror as we continued down the street with a little tear rolling down my cheek.

Just to add to the fun and frivolity, there is (what appears to be) never-ending roadwork going on in that part of Nashville. Each time we visit, it’s a brand-new experience. Had we been able to enter the desired building, it would have been a simple exercise to take an elevator to the specified floor. As it was, after circling (it might be more correct to say “spiraling around”) the area a few times, with the occasional “Detour” sign thrown in for good measure, we found a multistory parking garage associated with the hospital.

This is probably a good time to note that this particular hospital is composed of more buildings and parking garages than I’ve been able to count. Each garage is associated with a hospital building (I only wish we could have found the one attached to the building in which we wished to be), and all the buildings are linked by skyway bridges. Just for giggles and grins, these bridges are at different levels to each other, so progressing from building A through building B to get to building C brings to mind an eldritch game of three-dimensional chess, with your humble narrator as one of the pawns.

When we entered the building attached to our parking garage, we asked a passing nurse for directional advice. She replied that this was her first day on the job and she was lost herself. When we eventually stumbled across an information desk, its occupant was similarly uninformed. The situation was in no way helped by the fact that, once you have entered the hospital labyrinth, they stop using street numbers, and instead refer to the buildings by names like “Cuthbert’s Tower” and “Ermintrude’s Folly.”

The situation was only exacerbated by the fact that these buildings are populated by miles of featureless corridors. It’s like a maze. Everything looks the same. You don’t know if you are making progress or if you’ve just returned to where you started. It had to be said that this a tad disheartening (thankfully, I’m not bitter).

I like to think that I’m reasonably intelligent and “with it” in the scheme of things. Assuming this to be true, then if I have so much difficulty navigating this sort of facility, what chance do old, sick, confused people have (which are the sort of folks you tend to find in hospitals)? It makes one wonder how many thousands of “people hours” are wasted each week by patients and staff desperately trying to work out how to get to where they want to be.

They don’t call me “Tracker Max” for nothing (in fact, they don’t call me “Tracker Max” at all). Eventually, we staggered dazed and confused into our destination doctor’s office, at which time Gina’s mom was whisked away. When she returned, she informed us that she needed some additional tests in a faraway facility (still located in the same hospital). Happily, she had been provided with a list of step-by-step directions along the lines of, “Turn right when you exit this office. Take the second corridor to the left. Take the first elevator to floor 5. Follow the signs to the Dilbert Memorial Skybridge. Cross the skybridge to Doom and Despondency tower. Take the elevator to floor 2. Follow the first doctor you see with a beard until you pass the anxiety clinic, then take the third elevator on the right to floor 8. Next…”

All joking aside, this was pretty much the way it was. We meandered our way down myriad corridors, rode multiple elevators, crossed two skybridges, and traversed three buildings to reach our destination. The point here is that these directions were (a) magnificently accurate and detailed and (b) had obviously been handcrafted to convey patients from this specific doctor’s office to that specific test facility.

I fully expect that, in the not-so-distant future, navigating any large building, including hospitals, will be aided by the artificial intelligence (AI)-powered augmented reality (AR) glasses we will doubtless all be wearing. However, that will be a solution for tomorrow. What I want is an answer for the here and now.

This led me to think. Wouldn’t it be a good idea to have computer terminals mounted on the walls at each of the hospital’s entrances. Each terminal would already know its own location. All a visitor would have to do would be to enter the doctor’s name and office number, and the terminal could print out a list of detailed step-by-step instructions to get them from here to there. Similarly, since each doctor’s office is already knee deep in computers, should any additional tests or whatever be required, each patient could be presented with customized directions to any other location in the complex.

I must admit that I got a little carried away by all of this. I started to think about ideas like downloading hospital maps into smart phones. Possibly adding wireless beacons throughout the facility, and so on and so forth. I also recognize the problems involved, like keeping the database up to date with old doctors leaving, new doctors joining, offices moving and…

I was well on the way to applying for a patent and planning my retirement on the profits I anticipated making before it struck me that it might be a good idea to have a quick Google while no one was looking to see if there was anything like this out there. Almost immediately, I discovered there are indeed existing options, like the Hospital Digital Wayfinding Solutions from CenTrak, for example.

“Oh dear,” I said to myself (or words to that effect). Now I know how Gina feels. Of course, my next question was, “If such solutions exist, why aren’t hospitals using them to make everyone’s lives easier.” And, of course, I immediately answered myself, “It’s the fact that they would have to spend money, stupid!”

It’s sad to think that we have the technology but—despite the fact that we spend so much on healthcare (US health care spending was $4.3 trillion or $12,914 per person in 2021, according to CMS.gov)—we can’t be bothered to deploy it. It’s also sad to think of the countless thousands of people who are desperately trying to navigate their way through hospitals as you read this column. And what’s really sad is that Gina and I are going to have to do this all over again in three months’ time. By then, experience has taught me that, much like the neo-noir science fiction film Dark City, the roadworks will have changed beyond all recognition in that area of Nashville, the doctor will have moved his office to a new hospital building, and the hospital buildings themselves will have morphed in ways beyond my ability to describe.

I’m too young for all this excitement. What say you? Have you spent any time trying to navigate your way around an unfamiliar building or facility recently? If so, do you have any thoughts you’d care to share?