Active and productive art in healthcare settings
Art has been an integral part of healthcare facilities for many years, with art in public areas welcoming people to the facility, and corridor walls hung with paintings to brighten the environment. This “curatorial” approach is however falling out of favour with client teams. Increasingly art is not being incorporated as merely decorative, it is being used to create change and improvement in patient wellbeing and health, and enrich the lives of staff and visitors; it can be active. From discussions with several health boards and design teams, the key considerations and opportunities highlighted include staff and patient engagement, how the art can be actively used, how it affects the users of the building and how it can be used directly to improve health and support change.
When considering an arts strategy, it is important to consider how the patients, staff and visitors will engage with the art. Whilst installations in public areas may make the facility seem more welcoming in principle, they may not be involved or noticeable within the everyday running or experience of the facility. Similar pieces, if placed strategically, could be used to change the atmosphere of an area, and hence the behaviour and mood of its occupants, aid wayfinding, or be used as a device to create or support a specific activity. In the West Centre in Drumchapel, Glasgow, a centre for children and families, the art is placed in public areas, but used as curiosities that can be discovered over time, clinical staff can reward child patients with the discovery of a new piece or experience.
The West Centre – Working harp set into main stairwell by Tim Taylor.
Art has many forms, and these can all be utilised to serve different needs. They all also can generate activity in different ways. A key step is to consider how they are viewed or explored and then consider in which space or situation this could be utilised best. For example the traditional “picture” based art is best appreciated being looked at, full on, for some time. This suggests its use in areas where people stop and wait, where they can feel bored, or restricted; such as in bedrooms, treatment areas or waiting areas. This does not have to just mean traditional pictures, it could include text to read, intricate sculptures to examine or moving pieces such as video footage of local natural environments using web cams.
The West Centre - Aeroplane in waiting room which overlooks the flight path to the airport. Tim Taylor
In corridors, where people move quickly and are exploring unfamiliar surroundings, art should be adapted for this speed and focus level. It can also be involved in signage and wayfinding, either though highlighting areas that then become recognisable and act as markers, or directly through the incorporation of signage. In Kentish Town Health Centre, a primary care facility in London, the walls are painted with large brightly coloured motifs representing the various specialities housed in the facility. These enliven the main waiting area and route, which are then visible from upper levels, orienting building users. The building’s signage uses a similar painted approach with large symbols and clear bold text to simplify wayfinding integrated into the overall art scheme. Interestingly, the facility does have areas with more conventional framed works in the corridors, but this is used to house the informational posters and flyers that could otherwise clutter the walls and weaken the overall scheme and effect.
Kentish Town Health Centre - signage
Art can also be used to provoke discussion and communication. In the new Midpark Hospital for Acute Mental Health, NHS Dumfries and Galloway created the “perspective project”, where staff and patients were invited to select their favourite locations in the local area, which were then photographed and the images placed in meeting areas in the hospital. These areas and images can now provide a focus for conversations between visitor and patients when these can otherwise sometimes be difficult.
Midpark Hospital – art placed in meeting areas.
In the West Centre, while the building is designed to accommodate the adults, the art has deliberately engaged with the building’s younger users, to reduce nerves and provide entertainment. The emphasis throughout was to make the building interesting for children, providing opportunities for discovery and interaction, without appearing simplistic or patronising. Peepholes at lower (child) levels reveal sculptures within the walls where tiny model people climb or explore the electrics or plumbing. Other installations are directly interactive, including a musical instrument set into a stairway handrail and a ship display that changes with the pressing of different buttons. The art provides an opportunity for the children (and adults) to take ownership and play in a building type where usually they may feel intimidated and controlled.
The West Centre – hidden peephole art scenes. Tim Taylor. (image credit Jo Hanley)
Art has been found to be very helpful in dementia care, stimulating patient’s memories and sense of identity, as well as keeping them active mentally. Memory boxes, where cherished photographs, small items and letters can be displayed by a patient’s door, are used to trigger memories and to make them feel at home with a level of ownership of the space, whilst acting as visual interest for the other patients. In Midpark Hospital the wider art scheme explores the strength and healing benefits of the relationship with nature, including images of plants and flowers, and using a video display in a light box mimicking the moving shadows of foliage on a sunny wall to lead users through a darker area in the main circulation. In settings such as this where people live in the facility for longer, and spend more time walking around, the use of art in corridors may be indicated to provide situation and interest over repeated viewings, as well as orienting potentially confused residents within the new environment.
As well as looking at or experiencing art, patients can be involved in its creation. This can give them ownership of a space or new building, alleviate boredom and enable creativity. In Midpark Hospital, the art strategy focussed on inclusion, working with the patients, staff, visitors and community groups to both explore the art options for the new hospital and also carry out some of the projects such as the production of cyanotypes of plants (using sunlight and photography paper). In Kentish Town Health Centre, one of the waiting areas is used as an art gallery, with pictures created and donated by patients and locals.
Midpark Hospital - cyanotypes
The use of art in healthcare facilities should not be considered as a final stage or fit out issue as it can then be overlooked, lost through funding problems or not integrated fully into the design of the whole environment. For best effect, art can be incorporated into the building itself and the external environment. In the West Centre, the external fencing, waiting area screens and reception desk have been designed as art based built elements, replacing, rather than adding to, other planned spend. If tackled early enough, art’s production can be used to ease the transition for patients and staff into new facilities. Art is an opportunity to improve the health and wellbeing of all the building users and improve the performance of the facility through wayfinding and a positive environment.
The West Centre – exterior fencing, by Tassy Thompson. (image credit Keith Turner Photography)
For more information on the West Centre and its art strategy see the Pulse page, and the NHS GG&C page.
For more information on Kentish Town Health Centre see the Pulse page and the architects' website.
For more information on Midpark Hospital see the Healing Spaces overview
Willis, Jane, Improving the patient experience: The art of good health – a practical handbook, NHS Estates, contains advice on managing art collections in the hospital environment. Part of this publication relating to the Private Finance Initiative is reproduced here by kind permission of NHS Estates.
For an example of the possible steps and stages of setting up an art strategy, see the art and wellbeing section of NHS Greater Glasgow and Clyde Design Action Plan.