The costs of confusion are significant
When we think of hospital inefficiencies, we often think of understaffing, obsolete equipment or administrative bottlenecks. But there is a hidden and costly problem that affects almost every hospital: poor signage.
A confusing signage system (unclear or inconsistent signs, maps and directions) not only causes frustration, but also costs hospitals hundreds of thousands of dollars per year in lost productivity, inefficiencies and wasted staff time.
In a 1990 landmark study, researcher Zimring (1) analyzed the financial and human costs of poor signaling at Emory University Hospital. His findings were enlightening:
- Annual cost of poor signage: over $220,000 per year
- Loss of staff time due to giving instructions: more than 4,500 hours per year
- Cost per hospital bed per year: $448
- The amount spent annually on signaling problems was greater than the cost to fix them
But this was in 1990; 35 years ago!
” Perhaps most important are the human costs that result from a poor signaling system. How much is it worth the tears of the old lady trying futilely to find her way back from the cafeteria? How much is it worth the time of the cardiac patient’s wife who spends half an hour trying to find her car so she can get a quick bite to eat away from the hospital? “
– Engagement Ring (1990)
Let us adjust the 1990 Zimring study costs to 2025 price levels, taking into account inflation over the 35-year period. To update the 1990 costs to 2025, we use Consumer Price Index (CPI) data. The CPI measures the average change over time in the prices consumers pay for goods and services. According to the U.S. Bureau of Labor Statistics, the CPI in 1990 was 130.7 and is projected to be approximately 315.6 in 2025. This represents a cumulative inflation rate of approximately 141.5% over the period.
Total annual cost due to poor signage:
- Total 1990: $220,556
- 2025 adjusted total: $220,556 × (315.6 / 130.7) ≈ $556,000
Cost per hospital bed:
- Cost 1990: $448
- Adjusted cost 2025: $448 × (315.6 / 130.7) ≈ $1100
Adjusting for inflation, the annual costs associated with poor signage at Emory University Hospital would be approximately $556,000 in 2025.
How poor signage is costing hospitals money: breaking down the numbers
Let’s look at these costs and see why hospitals should take signage seriously, as an investment, rather than as a minor inconvenience.
Hospitals pay for poor signage in a number of ways:
Staff time spent instructing: $166,000 per year (2025 price level)
In hospitals with poor signage and unclear maps, staff are constantly stopped and asked for directions. This may seem trivial, but when you add up the time spent, it becomes a significant financial loss.
- More than 4,500 hours of work are wasted every year
- Equivalent to +2 full-time employees dedicated exclusively to giving instructions
- 30.7% of the total cost of signage
Instead of focusing on patient care or administrative work, hospital staff lose productivity by orienting lost visitors. This is especially problematic for nurses and physicians, who are already under pressure to manage patient workloads.
Information desk staff: $308,000 per year (2025 price level)
Hospitals should have information desks available 24 hours a day, 7 days a week to assist lost patients and visitors.
- 58% of the total cost of signage
- Salaries of personnel working at information desks
- Security personnel assisting visitors after hours.
While some level of assistance is always necessary, much of this cost could be reduced if signaling systems were more intuitive and user-friendly.
Delay due to navigation problems: $58,000 per year (2025 price level)
Confusion in signage not only affects visitors: it also causes delays for hospital staff.
- New employees arrive late for staff orientation due to navigation problems
- Staff arriving late for meetings, patient appointments and surgeries.
- Delayed services disrupt hospital workflows and reduce efficiency
This cost category was calculated conservatively, focusing only on delays in orientation. If delays in meetings, medical rounds and patient visits were included, the financial impact would be even greater.
Signage maintenance and replacement: over $24,000 per year (2025 price level)
Hospitals with poor signage often resort to workarounds, such as:
- Printing of temporary posters on paper
- Replace obsolete signs gradually
- Ordering new posters from different suppliers without consistency
At Emory University Hospital, annual spending on signage problems exceeded the cost of redesigning the entire system. The hospital planned a one-time investment of $150,000 in a new signage system, less than they spent each year just to fix the confusion.
Hidden costs: stress, frustration and reputation
Beyond the direct financial impact, poor signage impairs the hospital experience for patients, visitors and staff.
- Increased stress in patients and visitors: lost and confused people feel anxious, especially in a medical environment where emotions are already running high.
- Lost time for caregivers: family members waste valuable time searching for patient rooms instead of being present with their loved ones.
- Lower hospital reputation: a confusing environment hurts patient satisfaction ratings, which can affect hospital funding and rankings.
Zimring’s study highlighted heartbreaking examples, such as an older woman crying in frustration after getting lost on her way back from the cafeteria. These moments add up and influence people’s perceptions of the hospital.
The solution: investing in better signage pays off
Hospitals need not accept that signage confusion is an unavoidable problem. Many institutions have dramatically reduced costs and improved patient experience by investing in:
- Clear and consistent signage: standardization of terminology and location of signs helps users to understand instructions easily.
- Logical numbering and department names: avoiding confusing labels (e.g., “Radiology”, “X-Ray” and “Imaging Department” used interchangeably) prevents unnecessary confusion.
- Technology integration: digital signage tools, such as smartphone signage solutions, can further enhance the visitor experience.
The bottom line? Every dollar or euro spent on improved signage saves hospitals money in the long run. A one-time investment in a better system can eliminate the recurring annual cost of staff inefficiencies, confusion and wasted time.
Final thoughts: How much does confusion cost your hospital?
If a hospital spends hundreds of thousands of dollars or euros each year on inefficiencies in signage, it’s time to rethink priorities.
Imagine what that money could be used for:
- Recruitment of additional nurses and physicians
- Modernization of medical equipment
- Expansion of patient services
Signage is not just about signage: it is also about efficiency, patient care and financial accountability. The cost of doing nothing is high. The cost of fixing it is an investment.
Does your hospital have a clear and intuitive signage system, or is the confusion costing you more than you think?