Fixing the wrong things: A $1.3 billion lesson for designers

Mikael Cho
May 29, 2015 · 7 min read

$1.3 billion.

That’s how much money the province of Quebec spent on its new “superhospital” in Montreal.

Today was my first visit for a routine checkup with my wife.

I’ve always hated going to hospitals. It seemed like no matter which one I went to, sterile smells, sad colors, confusing directions, and long wait times were as guaranteed as death and taxes.

As we walked into the front door of this hospital though, I felt optimistic. You can do a lot with $1.3 billion. And the entire city has been talking about how this hospital is supposed to be a saviour for Montreal’s crumbling public healthcare systems.

We enter.

The front entrance of the new hospital

Through the front doors we were greeted by a man who worked for the hospital and directed us where to go. A nice touch when compared to the typical hospital experience of fending for yourself against criss-crossing hallways, multiple banks of elevators, and confusing signs.

As we walked through the main hallway, the bright colors and lighting made us feel happy. We could tell plenty of thought went into the visual design of the building.

But as we moved further and further past the main entrance, our puppy love started to fade.

Although this nice man pointed us in the right direction, when we got to where he directed us we still had no idea where to go. There were multiple elevators and it wasn’t clear which one would take us where we needed to go.

We gambled on an elevator and took it up. Unfortunately, we ended up in the wrong place. So we went to the closest waiting room and got in line to ask for new directions. When it was our turn, the woman at the front desk said,

You’re in the wrong place. This happens all the time. Because not all the elevators go to all the floors, you need to go back down to the first floor and take the north bank of elevators.

North bank of elevators? We thought we took the north bank of elevators? I felt a familiar feeling and thought to myself,

Oh no, here we go again. I don’t know where to go in a hospital.

So back to the elevators we went to head down to the first floor. When the next elevator door opened, we realized the lights that should have signaled which direction the elevator was headed weren’t marked. They were just two small circles. No arrows.

The left light lit up.

Elevator door lights

We asked the people in the elevator which direction they were going. In a way that sounded like they had been asked on every floor before ours, they said, “up.”

There were multiple elevators in our area. Every time one stopped, someone asked if it was heading up or down.

We could feel everyone’s frustration.

Our confidence in the design of this new “superhospital” was fading. Unclear directions were the first thing. But if something as simple as the arrows on an elevator were not made clear enough to know what’s up and what’s down, we wondered what else could be wrong.

We didn’t have to wonder for long.

When we got to the first floor we saw this:

There were confusing letter-number codes and arrows pointing everywhere.

Some things we didn’t understand.

“What’s C RC.4208?”

Some arrows to the same place pointed in different directions.

“Is ‘C’ straight? Or is ‘C’ to the right?”

Ugh. We had no idea where to go.

We stopped a woman who looked like she worked at the hospital, but as we approached her it was clear she was trying to avoid us (probably so she wouldn’t get trapped giving directions). When we finally asked where we needed to go she said she didn’t know and walked away.

I had a sinking feeling in my gut. She didn’t want to help us. She wanted to move on with her day. It felt just like the type of service we tend to get at the current public hospitals in Montreal. I know there’s people who work in these hospitals that want to help and are great at what they do. My wife’s mom and her sister both worked at Montreal’s main public hospital for over 35 years. They’re nice people and they work with lots of nice people. But more often than not, I seem to run into hospital employees that seem too preoccupied with other things they have to do to care about the people they’re serving. I get they might be overworked or they might be frustrated by poor management or internal processes we don’t see. But that’s not an excuse to be mean with hospital visitors. We guessed $1.3 billion didn’t go toward changing any of this.

After another 10 minutes, we eventually found our way.

When we got to the right waiting room we apologized for being late, and the woman at the desk said,

“Don’t worry, this happens to everyone. Everyone’s getting lost around here.”

She was right. As I sat in the waiting room, every person who walked in was in the wrong place and looking for directions.

In a tired, monotone voice, the other woman at the front desk would say the same thing to each person,

Go down to the main floor, and take the other set of elevators.

People would try to clarify the directions to be sure they were going to the right place. But they would get the same, tired response over and over with no extra details until they gave up.

As we left the hospital, I took a picture of a 40-foot structure featured at the center of the hospital grounds. A symbolic ending to the visit.

13m high x 16m wide Havre sculpture featured at the center of the hospital grounds

While the structure may have been beautiful, it didn’t solve my main frustrations with the hospital experience.

A lesson for designers

All these things might sound like smalls details.

After all, a hospital is a place you go to get the care you need. Everything else is gravy.

But a good hospital. A better hospital. A “superhospital” should be more than just a place that gives you medical care. If you’re spending $1.3 billion to make an exceptional hospital, I would expect the basic, yet common problem of finding where you need to go and being helped by people who seem like they care, to be solved for sure.

As we experienced more and more confusion getting around and dealt with more and more hospital employees who didn’t seem to give a shit about us, we felt disappointed.

The happy feelings we initially got from the pretty colors, artwork, good lighting, and nice smells faded away.

By the time we saw a doctor, we weren’t happy. We were annoyed and wanted to go home.

While a big piece of this $1.3 billion may have been put to good use to buy the best medical devices possible and create the most advanced medical research centre in North America, it also seems to have largely gone toward making this building look pretty instead of fixing the still broken process of walking in a hospital and easily finding where you need to go.

I get that a hospital needs certain things that might get in the way of good design. Things like express elevators that skip floors for urgent care are a must for example. But when you have over a billion dollars and a decade to build a new hospital, I’d expect you can figure out something good that gets past constraints like these.

The hospital’s designers had the opportunity to create not just a prettier building, but a system that would make the entire going-to-the-hospital experience that much better.

Sadly, they didn’t. And I still hate going to the hospital.

As we left, I said to my wife,

“I hope we never do this at Crew.”

I hope we don’t spend time fixing things no one cares about.

We might think our home page could use a new design or that building a new feature would be cool.

But are these the biggest problems for our customers right now?

If we haven’t solved the biggest problems for our customers yet, then these things will solve nothing. They might make our product look good but they’ll be a waste.

When you’re building a product, you’ll have lots of stuff you need and want to do. But before you build, you need to figure out what’s most important for your customers and focus your attention accordingly.

If you don’t, you’ll end up with pretty walls for $1.3 billion.

Got an idea?

Crew Dispatch

Thoughts by the founders and members of

Mikael Cho

Written by

Founder/CEO @unsplash @mikaelcho

Crew Dispatch

Thoughts by the founders and members of

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