universal symbols for healthcare environments - Hablamos Juntos

17 Symbols Testing >87
Surgery, Billing Department,
Intensive Care Unit, Family
Practice Clinic, Social Services
Cardiology, Radiology, OB
Clinic, Immunizations, Waiting
Room
Chapel, Ambulance Entrance,
Pharmacy, Laboratory, Medical
Records
Pediatrics, Emergency
11 Symbols Testing

Early on, the design team decided to maintain the look
established by the Department of Transportaton symbols to
maintain consistency when the new symbols would used in
and San Francisco, California. Tests were conducted with
multi-lingual/multi-cultural groups to guage symbol
recognition through matching tests, and site navigation using
conjunction with existing symbols.
various aids, including the symbols and maps.
Existing symbols, along with newly designed symbols
Hablamos Juntos also conducted web-based matching
(approximately 600 total), were collected and evaluated by
the design team. For each referent, five to six symbols were
tests. Both SEGD field tests and HJ’s testing supported the
initial research and conclusions that symbols can be a viable
chosen to be used in the first round of testing.
means to aid communication and navigation within a health
care environment.
The symbols were subjected to comprehensibility estimation
tests using a system developed by Harm Zwaga and adopted
The full set of 28 symbols and their referents are illustrated
by the International Organization for Standardization (ISO).
on the following page. These symbols are being presented to
The referent and its
The Robert Wood Johnson Foundation as part of a complete
definition were placed
in the center of a five
Technical Paper detailing the testing methods, test scores and
recommendations for future symbol design.
or six spoke “wheel”,
with a symbol within
The next step in the process will be to use the symbols
each spoke. The wheel
within signage systems at three pilot sites to review
Hablamos Juntos’ ten grantee sites –
Olympia, Washington; Long Beach, California;
Grand Island, Nebraska; Fort Worth, Texas;
Memphis, Tennessee; Hoover, Alabama; Philadelphia,
was positioned so that
no symbol was in a
perceived “number one”
position. (See Ex. 1)
their effectiveness in everyday, real world, health care
environments.
SEGD and JRC Design will collaborate on a Best Practices
Pennsylvania; Springfield, Virginia; Anderson,
South Carolina; Providence, Rhode Island.
Three rounds of tests
Workbook for using the symbols. This workbook will include
language translations for the referents, the symbols in digital
were conducted for the referents. For each round, the grantee
format, the testing results report and a national/international
locations provided up to ten people (±100 total per round),
meeting specific primary language criteria. Participants from
four language groups were asked to estimate what percentage
of the general population would understand each of the
presented symbols. The results were recorded, the data entry
verified and subsequently analyzed by the testing consultant
on the project team.
Symbols advanced to the next round of testing if they met
a median estimate of >50. Symbols that achieved a median
estimation >87 passed the comprehensibility test and could
be considered “most meaningful” to the population tested.
Ex. 2 Analysis sheet showing testing results provided to the design team.
had at least one symbol that met the >87 score. This
allowed the design team to select symbols that not only
met comprehensibility standards but also best fit a cohesive
looking system. The eleven referents without any symbols
meeting that criteria were reviewed and evaluated by the
design team. Options for the eleven were reviewed against
the seventeen symbols that did pass, in order to determine
which elements within the meaninful symbols seemed to aid
the public’s comprehension. An option for each referent was
then selected and refined to match the overall symbol set.
rollout campaign for educational purposes. These symbols will
be become public domain upon release, thanks to The Robert
Wood Johnson Foundation.
The team’s wish is that additional needed symbols continue
to be tested through these proven methodologies and
accepted into the standards for use, not only in the United
States but throughout the world, as universal public
information symbols in the health care environment.
A complete report of testing procedures with results for each
symbol is available at www.hablamosjuntos.org.
In addition to statistical summaries, the results were
presented on analysis sheets that would allow the team to
view most meaningful symbols and compare their image
content. (See Ex. 2) Seventeen of the twenty-eight referents
Ex. 1 EMERGENCY – Rounds 1, 2, and 3 test wheels.
Additionally, field testing was conducted by SEGD. This
included recognition and navigational testing at four health
care facilities located throughout the country: Somerville,
Massachusetts; Grand Island, Nebraska; Atlanta, Georgia