Reception areas

Ensure that lighting at reception desks illuminates the receptionist and the desk itself. Lighting coming from behind the receptionist, whether from a window or artificial light, turns the person into a silhouette making it harder to see his or her face. This is unhelpful for people with impaired vision as well as making lip-reading very difficult for anyone with hearing loss. Lighting should not cause discomfort either for the receptionist or for anyone interacting with him or her. Lighting is particularly important for a person trying to sign a form at the desk. This means providing adjustable blinds or curtains at windows, as well as good artificial light that is properly angled and shaded. An extra, adjustable desk light at reception desks would be helpful.

Lighting between the entrance and reception areas should be evenly dispersed, with minimum recommended illumination of 150 lux. The lighting level at reception counter top level should be 250 lux.

Matt finishes on surfaces, whether counters, walls or floors, helps to minimise reflection and glare.

Colour contrast between the reception desk and the background makes it easier to find for anyone with impaired vision.

There should be a wheelchair accessible section at reception desks. This will also be of a suitable height for children: 760mm from the floor. Please check with the Irish Wheelchair Association for full specifications. Hearing loops should be fitted at reception desks and information hatches, to enable people who use hearing aids to maximise their hearing ability. Please check with DeafHear for other suggestions.

Signage

Large, clear and tactile signage – including Braille – should be provided. It is especially important to provide directional signs for exits at every decision-making point within the building, so that people with impaired vision can make their way out in the case of an emergency.
Please refer to recommendation for signage.

Accessible information

Information leaflets and forms should be available in clear print, large print, audio, as well as in Braille, on request. Please contact NCBI’s Media Centre for advice about making print accessible to people with impaired vision.

NCBI’s Centre for Inclusive Technology www.cfit.ie also offers advice on ways to make websites accessible.

General accessibility throughout the hospital

Mark glass doors and other large areas of glass to make them visible. Continuous bands of highly visible colour 70mm in width should be provided at two heights: 850mm – 1000mm (which is in the general sight-line of children, wheelchair users and people of short stature) and 1400mm – 1600mm (which is in the general sight-line of adults of average height and taller children). Without this, someone with impaired vision may walk into the glass, as it is difficult or impossible to see. The colour used to mark the glass must contrast strongly with the background as seen through the glass – in both directions.

Provide handrails wherever there are changes in floor level, flights of stairs, ramps or steps. They should be at two heights: 600mm above the pitch line of stairs, and 900mm above the pitch line. Handrails should continue without interruption at landings, and should extend 300mm beyond the final step at the top and at the bottom of the stairs. Handrail ends should continue all the way down to the ground or turn all the way in to a nearby wall. Please refer to Part M of the Building Regulations for information on the best design of handrails. Although Part M is still being revised, the information on handrail design in the current ‘Part M 2000’ is very good and very detailed. It is available from the Government Publications Department, Molesworth St., Dublin 2.

Provide good lighting throughout the hospital, but especially on stairs. When someone leaves a corridor and enters a stairwell, lighting should not deteriorate. Ideally it should improve, as this is a potentially hazardous area; at the very least, lighting should remain at the same level between corridors and stairs. Lights should be angled and shaded in such a way that they illuminate the steps, but do not shine into the eyes of people using the stairs.

Provide effective changes in colour and texture underfoot to give advance warning of stairs. The meaning of each colour/texture change should be consistent throughout the building. Please refer to Ways to use indoor floor surfaces to assist people with sight loss.

Provide contrasting colour on edges of steps – minimum 50mm depth, maximum 70mm, running the entire width of the stairs. Steps should be of even heights and depths – please refer to Part M of the Building Regulations.

Keep circulation paths clear of obstacles, especially at head height – for children, as well as for adults.

Provide rounded or buffered edges on potential obstacles which cannot be removed, or else provide barriers to prevent collisions. Barriers should extend to ground level all around an obstacle, or should have a horizontal rail very near floor level which can be detected by someone with impaired vision using a cane for independent mobility. Otherwise, the cane may swing between the upright posts, under the barrier, and the person with impaired vision will collide with it.

Use colours or tones on handrails, doorframes and door handles which provide strong contrast with the background colour/tone on which they are situated, along corridors and in rooms/wards.

Use colour contrast in toilets:

• between toilet and wall/floor,
• between flush handle and cistern,
• between toilet roll holder and toilet paper and wall,
• between door-latch and door,
• between door and door-frame or wall,
• between soap dispenser and sink/wall,
• between hand-dryer/paper towel dispenser and wall.

Use matt rather than gloss surfaces whenever possible, to minimise glare, and non-slip floor tiles to avoid accidents when floor is wet.

Queueing systems

Where a queuing system is provided (for instance, in an Outpatients Department) it must be suitable for all users. Ticket systems should be made accessible for people with impaired vision. This means careful consideration of the positioning and design of the ticket dispensing machine. An audible component could perhaps be provided. For instance, the person taking a ticket could have the option of pushing a button which would activate an audible announcement of what number ticket he/she has just been given.

When his/her ticket number is called aloud, he/she should also be able to easily locate which hatch to go to. Perhaps the emission of some soft music from whichever hatch is waiting for him/her could be activated. When the person reaches the hatch, the music could be turned off. This is just a suggestion. NCBI’s Access and Awareness Coordinator will be happy to advise further.