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Record W4407845006 · doi:10.1093/geroni/igaf020

Door Decals for Wayfinding and Redirection: A Quality Improvement Project Involving the Use of Clinical Real-Time Location Systems for Evaluation of Environmental Design Changes

2025· article· en· W4407845006 on OpenAlexaff
Leia C Shum, Twinkle Arora, Yasser Karam, Amy Cockburn, Shehroz S. Khan, Andrea Iaboni

Bibliographic record

VenueInnovation in Aging · 2025
Typearticle
Languageen
FieldEnvironmental Science
TopicUrban Green Space and Health
Canadian institutionsUniversity of TorontoToronto Rehabilitation InstituteUniversity Health Network
Fundersnot available
KeywordsQuality (philosophy)Computer scienceEnvironmental qualityEnvironmental resource managementSystems engineeringProcess managementEnvironmental scienceEngineering

Abstract

fetched live from OpenAlex

Background and Objectives: Environmental design modifications are important non-pharmacological interventions for people with dementia in older adult residential care, but their effects are difficult to measure objectively. In this paper, we present the assessment of the impact of door decals installed on patient rooms, offices, and exit doors on patient movements as an example of the uses of location data in evaluating environmental design interventions. Research Design and Methods: We undertook a quality improvement project in an inpatient specialized dementia unit using de-identified data from a clinical location monitoring system from 79 individuals with dementia admitted over time to 15 patient rooms to measure patient movements. In the first phase, decals were applied to 1 office and 6 patient room doors, and doors with and without decals were compared. In the second phase, patient movements were compared before and after a decal was applied to the remaining exit, office, and 9 patient doors. Main outcomes of interest were the number of daily approaches to concealed doors and daily approaches and entrances to patients' own and others' rooms. Results: Using location data, we identified a significant reduction in the number of approaches to and dwell time at office doors and exits. No differences were found in patient movements in relation to their own or others' rooms in either phase, although patients assigned a room with a decal tended to approach others' rooms with decals less often than those with a plain door. Discussion and Implications: Door decals successfully reduced patient contact with staff-only doors and exits but did not have a large impact on patient movement with respect to wayfinding. Location tracking systems provide an important opportunity to evaluate the impact of design interventions in situ in specific older adult care contexts.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.009
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.421
Threshold uncertainty score0.305

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0090.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.247
GPT teacher head0.428
Teacher spread0.181 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2025
Admission routes1
Has abstractyes

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