Journey mapping has grown in popularity in healthcare planning because it can serve as a versatile tool to understand how and what provokes emotions along specific touch points during a visit to a healthcare facility. The purpose of journey mapping is to capture these touch points along with emotions that were felt, whether that is positive or negative, in an experience continuum format.

What makes journey mapping so valuable in architecture is that it can be adapted to gathering insight from any user type (patients, visitors, providers, caregivers, staff, etc.) and can be used in real time, such as in focus groups. The power of this tool is that it builds empathy between the users and facilitators. Users feel empowered that people are asking questions and listening to their responses. Likewise, facilitators from the project team feel enlightened to know how design can influence human experiences.

The outcome of mapping experiences is that common emotional patterns can be identified. Interpreting maps from multiple users of systems is known as relational-centered design.

Let’s look at a case example of a more recent, practice-based application of journey mapping with staff and patients/families. UPMC is building two new bed towers on its Shadyside and Presbyterian campuses. Before going to the drawing boards, leadership at UPMC wanted to learn more about the patient/family experience and staff well-being. Particularly, they wanted to know how people, space, process, and technology influence journeys to, through, and from the campus.

To gain this insight, HGA conducted separate staff journey mapping and patient/family journey mapping sessions.

The objective of the staff investigation was to capture experiences related to overall well-being as it relates to process, technology, and space. To do this, a mixed-method approach was devised that involved focus groups and walking interviews. An intent was to ensure there was a well-represented sample made up of an even distribution of staff roles from each of UPMC’s campuses, including environmental services, catering, volunteers, nursing staff, residents, physicians, faculty, and more.

 Journey mapping was one of three activities used during the focus groups (the other two activities were open questions and imagery critique). For the journey mapping activity, a large poster board was hung on a wall, with broad phases regarding staff’s typical journey (traveling to work, being at work, and leaving work) written on it. Participants were asked to add sticky notes detailing their personal experiences (positive or negative) during each phase.

The data gathered was quantified and categorized into themes to find relationships and pain points. As design moves forward, these findings will be triangulated with insights from other focus group activities and walking interviews (which will be highlighted in a future blog). Overall findings will be shared with the leadership and the project team to brainstorm design interventions.

For the patient journey, we worked to identify the emotional highs and lows during a typical six-phase journey (pre-diagnosis, diagnosis, entry, treatment, recovery, and transition). The key user of our research were patients, and their families, organized around seven key service lines: HVI, Transplant, Oncology & Immunology, Orthopedics, Neurosurgery, Emergency Department, and General Surgery/Trauma. We wanted to understand shared perception of a patient’s journey between staff/providers and patients/families.

Two emotional journey maps were gathered through crowd-collected approaches. First, through an 80-person UPMC staff workshop (providers, PAs, RNs, administrators, etc.), staff created a patient persona and mapped their observed and perceived patient/family journey, highlighting actions, behaviors, and emotions at touchpoints throughout the continuum of care.

We then held seven focus groups of 10 to 18 patients/families per service line, all representing a range of experiences in addition to diverse demographics on age, gender, and race. Each patient/family first completed an individual emotional journey map to prepare their contribution towards a collective service line journey map during the last section of the focus group.

In comparing staff’s perception of patients’ journeys to that of actual patient journeys, we learned that there was a disconnect of where we, as designers, could narrow focus on how best to build empathy and strengthen people-to-people relationships through process, space, and/or technology.

In showing our analysis during a second work session, UPMC staff had an impactful “ah-ha” moment as they built empathy for patients and their families when viewing the compared journey maps. Instead of showing just showing what they were doing to improve process and workflow, we focused on the emotion and why. The results were themed, and we worked with UPMC staff to identify ideal design responses around micro-interactions, hospitality in healthcare, family-centered care, and supporting a new normal during and after treatment.

Not only did emotional journey mapping build rapport and empathy between staff, patients, and families, it served as a framework for UPMC staff/providers to be ambassadors to the voice and needs of patients and their families.

Adaheid Mestad, design anthropologist with HGA, contributed this this blog. Kara Freihoefer, PhD, CID, EDAC, LEED ID+C is a design researcher at HGA (Milwaukee). She can be reached at