An Introduction to Regulatory Signage Solutions that Meet ADA Guidelines and EMTALA Standards

Regulatory signs and messages are designed to instruct visitors on what they should or should not do both inside and outside of facilities. Regulatory signs can be found in almost any place, but when considering architectural or built environments, they are commonly associated with stairwells, safety and critical access points, and facility management and maintenance areas. Vehicular or transportation signs also fall into the category of regulatory signs, and common examples include traffic signs (e.g., one way, stop, yield, speed limit). However, for built environments, this information piece will focus on the following regulatory signs:

• ADA-Ready™ Signage, Messages and Symbols
• Emergency Exit, Egress and Luminescent Signage
• EMTALA Signage and Messages

Function, Location and Message Determines What Kind of Regulatory Sign is Needed

There is no all-encompassing standard or rule for governing regulatory signs and messages when it comes to architectural environments. Instead, best practices are established through professional industry experts and local building code requirements. When determining the form, message and location for a regulatory sign, the best place to start is with the most current Department of Justice ADA Guidelines and work with an experienced signage and wayfinding company to determine what solution will work best. Under the section that governs signage, the current ADA guidelines establish the recommended size and placement of messages and symbols on ADA regulatory signs.

For regulatory signs and wayfinding plans to be effective, it is recommended that regulatory signs and messages serve the language needs of at least 75% of the people who visit the facility. One of the best means of breaking through communication barriers is through the use of pictograms or symbols. For healthcare facilities, a series of universal symbols designed to facilitate wayfinding has been created and adopted by the International Standards Organization. There are 28 symbols that were proven to be most effective at conveying the appropriate information to visitors and patients and also conform to ADA guidelines. For more information and to see the list of symbols, visit http://blog.asisignage.com/2010/12/23/ada-signage-universal-design-universal-healthcare-symbols.

ADA-Ready™ Regulatory Signs

While English is the majority language spoken in the U.S., the number of ESL (English as Second Language) people has grown dramatically. In addition, more than 9 million adults in the U.S. are illiterate and rely on pictograms and symbols to find their way. Therefore, the most effective solution is to integrate multilingual messages and pictograms on key information and regulatory signs.

Although there are a number of universally recognized symbols used in ADA signage, there may be symbols that may have different connotations in other cultural and ethnic backgrounds and thus may offend certain users. Therefore, it is recommended to stay with commonly used and established pictograms for ADA-Ready™ regulatory signs.

ADA-Ready™  Regulatory Sign Recommendation:

• Meet the latest ADA Guidelines
• Clearly communicate a regulatory message
• Integrate pictograms whenever possible
• Consult local codes to ensure the regulatory sign and message meets the facility’s needs
• Match the architectural environment/design

Egress and Self-Illuminating Signs

For decades, egress signage and emergency exit regulatory signage was commonly seen as the ubiquitous emergency escape plan by an elevator and the overhead “EXIT” sign at key door ways and stairwells. These are still important regulatory signs for egress, but since 2001 regulations for egress and emergency escape signs and messages integrate a power-failure resistant component: self-illuminating signs through luminescent materials.

These new power-failure resistant regulatory sign codes are most commonly found in new construction for large commercial structures, but many built environments with several floors are choosing to retrofit the egress and emergency escape regulatory signs with self-illuminating signs. In addition, facilities are also choosing to apply self-illuminating strips to stairs along emergency exit routes.

EMTALA Signs and Messages

EMTALA stands for the Emergency Medical Treatment & Labor Act, and it ensures public access to emergency services regardless of ability to pay. Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual’s ability to pay. The EMTALA Operations Manual specifies signage requirements at medical facilities to properly communicate the individual’s right to treatment:

• Specify the rights of individuals with EMCs and women in labor who come to the emergency department for health care services
• Identify participation in the Medicaid program
• The wording must be clear and in simple terms that are understandable by the population served by the hospital
• Signage must be posted in places likely to be noticed by individuals entering the emergency department, as well as those individuals waiting for examination and treatment