Hospitals Address Patients’ Emotional Needs Through Art and Design.
You are tired, weak and in pain. Your family surrounds you and looks almost as oppressed by the elephant in the room: cancer. Your life now revolves around trips to the hospital for chemotherapy, radiation, scans and doctor discussions. Due to physical, mental and emotional exhaustion, you sit in a wheelchair as a family member steers you into elevators and halls that have become a melancholy maze memorized in your mind.
This was the reality for my family and me after my mother was diagnosed with cancer in November 2005. To add insult to injury, she had to go to a place she always dreaded in order to get treatment and surgery: a hospital.
Sometimes I got temporarily lost in the mural of small fish swimming along the Seattle suburban hospital’s walls that lead to treatment rooms. When she spoke privately with her doctor, I distracted myself—consciously and subconsciously—with the bright children’s paintings in the hall. Flowers and suns painted with broad brushstrokes were so simple—a welcome, lively diversion from the complicated issues of illness.
I am not alone in dealing with an ill loved one, and in visiting City of Hope and Huntington Hospital, I know I am also not alone in contemplating art and design’s role in hospitals.
“There are times when you do chemo and are sick and as soon as you enter that driveway you are too busy looking at the wonderful flowers and everything, and it takes your mind away from how you are feeling,” says six-time breast cancer survivor Michelle Gearhart-Pash, who first started City of Hope treatment in 1988.
A work of art in themselves, the gardens have something to offer everyone, from many varieties of roses to a Japanese garden and sculpture garden with large contemporary pieces. Gearhart-Pash also enjoys children’s art on the third ﬂoor of the outpatient building, the Geri and Richard Brawerman Center for Ambulatory Care.
“That just puts a smile on your face,” she says. “I believe atmosphere helps in your healing. I couldn’t imagine myself in a gloomy room doing chemo. … At City of Hope, the rooms were always cheerful.”
While art and color scheme may have become more of a focus over the years, City of Hope’s art roots began when Reuben Kadish and Phillip Goldstein—who later became world-renowned abstract expressionist painter Philip Guston—painted a fresco-style mural in 1935, titled “Progress of Life,” in what is now the visitor center and gallery.
The outpatient Brawerman Center has an eclectic mix of art on the walls, ranging from the realistic to the abstract. Most outpatient art is donated and original lithographs include a light-hearted Claes Oldenberg depiction of a palm tree and a Roy Lichtenstein of pale green blinds that resemble bamboo outside a nearby window.
Opened in fall 2007, City of Hope’s Sheri and Les Biller Patient and Family Resource Center provides educational materials, support groups, computer access and classes in a relaxing atmosphere of neutral earth tones accented by bright nature photographs on stretched canvases. The photos are particularly uplifting and meaningful since artist and former patient Barry Dukoff created them.
“He was treated here for cancer and was so grateful, that he wanted to give something back, not only to us but to patients and families,” says Natalie Schnaitmann, M.S.W. and director of operations for the department of supportive care medicine. “He knows from having experienced it how valuable artwork and beauty can be, so he had a number of pieces to donate.”
Schnaitmann and others in the resource center then discussed which prints would work best in the setting. “We wanted to pick things that were transporting, bright, vibrant and energetic but also beautiful and soothing,” says Schnaitmann. “I know as a therapist, social worker and now director of programs that patients’ lives are chaotic so you don’t want clutter, loudness or abstract art they have to ﬁgure out. You want soft, gentle, open spaces.”
That mission was accomplished in Dukoff’s richly colored photos that include close-ups of greenish-blue, lime green and red plants.
The recently formed patient and family advisory council, which includes Gearhart-Pash and husband Bob Pash, made the ﬁnal selections. “We all wanted art that was soothing to the eye, calming and colorful,” says Gearhart-Pash.
Helford Clinical Research Hospital, an inpatient building where patients spend the most time, displays “calming, serene images,” says City of Hope art committee member and senior director of advertising and branding communications Vicky Hoffman. Those images include paintings of purple irises and lily pads and collages of leaves and other natural materials. Since Helford’s patients’ immune systems are usually compromised, Hoffman says the hospital is cautious about including art that may contain toxic materials like varnishes. Patients also have some choice about their room’s atmosphere—some art is hung with magnets, which makes it easy to change based on personal tastes.
“City of Hope,” Hoffman adds, “is about treating the whole person.” Indeed, the hospital’s credo, “There is no proﬁt in curing the body, if in the process, we destroy the soul,” inﬂuences the attention to resources, care and atmosphere. Rooms face the mountains and ﬂoor-to-ceiling windows consume Helford’s lounge areas, nearly diminishing any barrier to the outside.
While City of Hope greets patients and visitors with more of a rural, somewhat understated exterior, Huntington Hospital could easily be mistaken for a luxury hotel. A palm-lined driveway leads to a valet station outside the two-towered light pink main building, which features a large lobby, arched ceilings and well-upholstered furniture. Continuity and the city of Pasadena’s design review process dictated that the West Tower, completed in December 2007, and the 1990s-built East Tower have identical exteriors. The towers comprise the majority of inpatient rooms, along with the older Valentine building, which has undergone small renovations over time.
“All the decisions we made dealt with patient satisfaction and experience, how nurses interact with patients and what makes their job easier, because one of the real satisﬁers of patients is that their nurse is there to help them,” says HDR Architecture senior project manager Tom Onnen, who was the architect of record for the West Tower. “One thing leads into another and it’s about ﬁnding balance between good spaces for nurses [while] having really nice spaces for patients.”
Carpeted corridors in the East and West Towers are a refreshing departure from stereotypical white hospital tile. “We used a lot of materials that were more homey, like ﬂooring that looks like wood so it has more of the feeling of being at home as opposed to institutional,” says Onnen. West Tower rooms also have a hotel-like feel, from the light faux wood ﬂoors and cream and tan walls to the thoughtful visitor amenities.
Instead of hours in an uncomfortable chair by a patient’s bedside, visitors can recline on a built-in daybed beside a window. Each room has a small corner desk, rolling desk chair, free Wi-Fi and a ﬂat-screen TV. “That’s a big trend, incorporating the family in the care of the patient, whereas in the old days you just wanted them out,” says Huntington Hospital Executive Director of Children’s Services Gloria Sanchez-Rico.
West Tower hall photos, for instance, transport patients to beautiful settings like pristine beaches. “You are looking for something non-threatening and realistic because when people are under the inﬂuence of medication or anesthetic, any type of shadows or patterns can become misinterpreted and scary to them,” says HDR nurse consultant and Vice President Cyndi McCullough.
The East Tower has a pod concept where each ﬂoor of 32 beds is broken into eight-bed pods with a nurse station at each pod. The West Tower has a more traditional racetrack layout with the rooms on the outside and a small nurse station for each. “Sometimes one nurse had patients in multiple pods and it became difﬁcult to manage, so in the West Tower we took the concepts that worked well, like an offstage central corridor where the nurses and staff can be out of sight and earshot of visitors and patients, do work inside and then come out to deliver care,” says Onnen.
An “offstage” central corridor away from “onstage” public areas draws from the “Disney concept” that inﬂuenced Onnen and Sanchez-Rico. “In the Disney concept, the core stuff happens inside and you see the pretty stuff out front,” Sanchez-Rico explains.
Huntington’s West Tower patients seem affected by the design because “patient satisfaction scores have gone through the sky,” says Sanchez-Rico. “It is almost like they believe they are getting better care because they are in a better environment. Our patients in the old tower are not getting any worse care—the care and standard is the same—but West Tower patients are giving higher scores than those in the older buildings, though not necessarily the East Tower.”
A hospital will obviously never truly be like a hotel or art museum since people visit these places for distinctly different reasons. However, it is at least comforting to know that some hospitals and architects take more than just physical care into account. They put themselves in the often-overwhelmed shoes of a patient and his or her loved ones and challenge the typically detached hospital atmosphere to create a safe haven for body, mind and spirit.