Health Facilities Begin Implementing New Universal Symbols to Ease Navigation

    • September 12, 2010

To help underserved populations and patients with limited English proficiency skills navigate health care facilities, Hablamos Juntos and the Society of Environmental Graphic Design (SEGD) announced today the posting of 54 new universal symbols for health at four locations across the country. Facilities implementing the symbols include: Women & Infants Hospital in Providence, R.I.; International Community Health Services in Seattle, Wash.; Children's Mercy Hospital in Kansas City, Mo.; and Grady Health System in Atlanta, Ga.

Navigating through a hospital or health care facility can be a confusing, stressful experience if signage is not easy to understand. However, it can be challenging to identify signage that will work for all patients, including those with limited English reading skills. During trials conducted at the implementing facilities, these new symbols were found useful by patients from extremely diverse linguistic backgrounds, including English, Spanish, Khmer, Vietnamese, Mandarin, Somali and Korean.

"Making our signage easy to understand and eliminating language barriers is one simple way we can improve the health care experience for everyone," said Yolanda Partida, director of Hablamos Juntos, a program administered by University of California, San Francisco, which is dedicated to developing practical tools to overcome language barriers to health care.

Symbol design is important to comprehension. The communicative value of symbols also improves with public use and exposure. In order for a symbol to be considered universal, it must receive an 87 percent or higher comprehension rate—no matter what language a patient speaks—a standard set by the International Organization of Standards (ISO). Most symbols in use today, for example the AIGA/DOT Transportation symbols that have been used for over 40 years have not been tested against ISO standards. Health symbols that conform to these stringent standards can play an integral role in helping patients unfamiliar with English find unfamiliar destinations. They also offer an alternative to current bilingual/trilingual signage that can quickly become useless with unreadable font size.

The symbols were developed by Hablamos Juntos under a grant from the of Robert Wood Johnson Foundation's Pioneer Portfolio, which supports innovators whose bold ideas push beyond conventional thinking to explore solutions at the cutting edge of health and health care. A collaborative of four design schools worked with Hablamos Juntos and SEGD to develop a curriculum to test 155 candidate symbols—which were primarily designed by students—and identify those that were best understood by linguistically diverse subjects. The project staff then worked with designers in the pilot project to identify locations, which together with the new symbols, made it easier for visitors to find their way around the facilities. Schools participating in the project included:

  • Department of Art & Design, College of Liberal Arts at California Polytechnic State University;
  • Digital Design Program, College of Design, Architecture, Art and Planning at the University of Cincinnati;
  • Graphic Design Program in the College of Design at Iowa State University; and
  • School of Visual Communication Design at Kent State University.

"Incredible innovation can result when experts from different fields come together to find solutions," says Paul Tarini, senior program officer with Robert Wood Johnson Foundation's Pioneer Portfolio. "With this project, health care and design experts have come together to create an adoptable solution that will make it easier for people, especially those who often experience the most challenges, to get the care they need.

A workbook that guides facilities through the implementation of universal health care symbols, as well as poster and production-ready art for 54 symbols, are available for free download.



Hablamos Juntos was established in 2001 to develop practical solutions to language barriers to health care. It is located at the UCSF Fresno Medical Education Program, a clinical branch medical education and physician training program of the University of California, San Francisco. UCSF Fresno faculty physicians and medical residents care for the overwhelming majority of the area's underserved populations at partner hospitals and clinics.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. Projects in the Pioneer Portfolio are future-oriented and look beyond conventional thinking to explore solutions at the cutting edge of health and health care. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime.