Art and Aesthetics

 

Notre Dame Stained Glass

 

Introduction

Art and stress. There's some very interesting research being conducted by Roger Ulrich in the department of architecture at Texas A&M University. His work in the field of art in the healing environment can help us begin to understand what happens to patients as they view art in a state of stress. For example, the images they found provocative and stimulating on a Sunday afternoon trip to the museum can be depressing when they view them in the emotional and psychological confines of a hospital.

Healthcare consumers in the 1990s want to participate more in their health choices. From patient-centered care research, we are seeing empirical data measuring the physiological effects of choice on the patient-choice of mealtimes, family visiting privileges, and access to medical records. Through Roger Ulrich's work, it is also clear that something with such intangible properties as fine art can also have measurable effects on the outcome of an illness or at least on the manner in which the patient is empowered to cope with that illness.

Special patients. Hospice patients, intensive care patients and other gravely ill persons who are dealing with a life-threatening condition can benefit from art that dignifies life. These patients need visual serenity-art for private contemplation-art from which solace and comfort can be drawn-art that reflects the dignity of life, when healing may not include curing. I believe that the empowerment attained through art by these patients has to do with the inner peace that comes through acceptance.

Even with patients whose lives are not measured in days or months, such as patients in a nursing home of a skilled nursing facility, seem to benefit when they are given art that represents what is most meaningful to them in their own emotional and intellectual states. I find, for example, that elderly patients relate very strongly to the same images I often use in OB areas-pictures of children at play, children with their parents. These images represent their most precious memories. This is art dignifying life.

There are other groups of patients who find special meaning in art that celebrates life; the most obvious example is the new mother. Certainly the birth of a child is one of life's greatest experiences. Sensitivity to the art that we choose for such a patient can certainly enhance that experience.

Children are another special patient population for whom art can celebrate life. Appropriate artwork can allay a child's fears, make a child laugh or occupy hours of time. And by all means, if you have the opportunity, it's worth the time to visit the lobby of Children's Medical Center of Dallas to see the trainscape, with eight model trains on over a thousand feet of track. It's the largest permanent model train exhibit in the country, and you only have to watch the kids over there to realize the impact it has on them.

There is one more special patient population whose psychological and emotional needs can be addressed through art: patients with a psychological need to escape. If any of you have ever had an MRI or spent time in radiation oncology or chemotherapy, you know this need all too well. When used as a facilitating agent, art in these high-stress treatment areas can be particularly comforting to patients. Once again, through the art we specify, we can give these patients more psychological control over their environment and thus help them to cope better. All we have to do is to imagine that we are there ourselves.

Artwork's marketing appeal. The past 10 years have brought about great changes in the way health care services are marketed and delivered, and more change is on the way. And because hospitals now have to compete for managed care contracts, most administrators I work with are acutely interested in improving the physical appearance of their facilities.

Patient satisfaction surveys show that public perception of the quality of health care services delivered by a facility is based, to a significant degree, on such judgments. And one of the least expensive and most highly visible improvements a facility can make is the addition of art. By adding carefully chosen artwork even without expensive remodeling, it is possible to create, enhance or perhaps even change the perception of a facility in the minds of patients, families and visitors.

So how does this work? Is it simply aesthetics? No, of course not. In this case, it's a matter of looking at service areas from a demographic standpoint to determine the mind-set of the community. If we want to choose meaningful art, we need to evaluate patients in terms of their cumulative life experiences-their access to cultural opportunities, to education and to travel.

While cancer patients and heart patients share the emotional components of their illnesses, not all patients have had the same cumulative life experiences. That's why we, as specifiers, must be very careful to base our decisions on these shared patient experiences.

As an example, let's look back at one of the special patient populations, but now from a demographics standpoint. Consider the OB patient: in this case, a new mother in rural, economically depressed Appalachia. I'm sure you've all seen posters of Mary Cassatt's work. They're very popular for OB projects with limited budgets. But consider how these images of aristocratic mothers and babies might affect this particular patient. Would she be reassured by these images? Or, for example, if a facility serves an ethnic or racially mixed community, the Mary Cassatt images, once again, would be an insensitive choice for this patient base, regardless of income level.

Getting started. Here are the critical issues that make or break such an undertaking:

Budgeting: With so much riding on the outcome of a project, art for the healing environment shouldn't be an afterthought. We all live in the real world, and let's face it: In healthcare, there are never enough dollars to go around. But if an art program is important to you, put the dollars in the budget and leave them there.

The right consultant: From inception to completion, art programs should be planned, coordinated and implemented by competent professionals who make health care their business. This could be an art consultant to the health care industry. Or it could be an architect or interior designer who specializes in health care-someone who understands all of these sensitive issues. It probably won't be the local frame shop or even a respected corporate art consultant. If these are the resources you choose, be prepared to deal with a learning curve.

So how do you choose this individual? Exactly the same way you would choose an architect or designer: by starting with an RFP from which you can easily judge both academic credentials and experience in the field of healthcare.

Programming: As with architecture and design, this is your opportunity to identify the issues underlying your desire to have an art program at your facility-to address the needs of those special patient populations to develop a vision upon which the collection will be built. Aesthetics can be competently ad-dressed after architecture and design are completed. But going beyond aesthetics to create a healing environment must start at the out-set of a project.

Linking art and architecture. Part of the healing quality of art is the harmony that it contributes to the health care environment-in drawing the eye away from long corridors, from frightening looking equipment, from signage that reminds us all too realistically where we are. And this harmony is created when these two are in sync. Just as carpet, wallcoverings, fabrics and furniture must work with architecture as part of patient-focused design, so must art. To be effective, it can never look like an afterthought or the results of a tug-of-war between opinionated individuals. It must be skillfully incorporated to become part of the patient's positive sensory experience.

All of us have an opportunity to make art a subliminal part of the healing process, and not just an accessory to the interior design of a facility. We can all make it truly the art of healing.