Abstract
Signage is a core component of wayfinding systems in healthcare architecture, directly influencing patient experience, safety, staff efficiency, and operational resilience. Hospitals present unique wayfinding challenges because of programmatic complexity, multiple circulation systems, shifting functional adjacencies, and emotionally stressed users. This study synthesizes theoretical foundations and applied studies on wayfinding and signage, links signage performance to hospital service quality, and explores multi-method approaches for signage evaluation in healthcare environments. Key discussions include legibility and imageability, the four-step natural wayfinding process, decision-point dynamics, signage typologies and physical parameters, and contemporary evaluation methods (inventory audits, POE, usability testing, eye tracking, simulation, and spatial syntax). The paper integrates evidence from a broad literature base to demonstrate how targeted signage strategies reduce cognitive load, lower staff interruptions, shorten travel times, and improve patient satisfaction. Recommendations include a standardized, repeatable signage evaluation protocol combining objective and subjective measures, prioritized interventions at decision points, accessibility checks, and embedding patient feedback into iterative POE cycles to sustain wayfinding performance in hospital settings.