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Environment of Care News Nov 2009

Oct 19, 2014




ECN-11-09_Layout 1

Apatient lies in his hospital bed,trying to ignore the pain thatradiates from the tumor that

threatens his life. Hes frightened andlonely, and as he waits for the caregiverto administer the pain relief he needs, hefeels isolated from his family and friends.But across from him is a painting thatshows a waterfall surrounded by lushgreen plants and a cascade of colorfulflowers. Dozens of times each day, hiseyes travel to that serene scene, and eachtime it brings him a measure of relief.

This is the world that art can createin health care facilities. A 2002 study1

showed that the interior design featuresin a hospital have a significant effect onhow satisfied patients are with theirhospitalization experience. According tothis study, the hospital environmentincluding the art in patientsroomscan improve the quality ofhealth care.

Almost half of all U.S. hospitalsnow have programs for the display and


Focus on Health Care Facilities Art

1 Art in Health Care

FacilitiesDesigning Sights for

Sore Eyes

4 CASE STUDY: The End of Artfor Arts SakeM.D. AndersonCancer Center at the Universityof Texas Medical Center UsesArt to Help Heal

6 EMS 6 CRITICAL FUNCTIONS:Function 5: Utilities

ManagementAvoiding UtilitiesFailure During a Disaster

Visit the EC News blog at

Continued on page 2

Healing artwork enlivens new space at Providence Regional Medical Center, Everett,Washington, and is an important part of a design and construction project.

Art in Health CareFacilities

Designing Sights for Sore Eyes

use of art in their facilities. In 2003, theSociety for the Arts in Healthcare(SAH) and the National Endowmentfor the Arts (NEA)2 analyzed hospitalsaccredited by The Joint Commission.Their aim was to assess the arts inhealth care. In spite of the costs associ-ated with art programs, SAH and theNEA concluded that hospitals use thearts to create a more uplifting environ-ment in addition to create a welcom-ing atmosphere and build communityrelations.2

The majority of health care art pro-grams dealing with the display of visualart are created and administered by artconsultants, often hired by either thefacilitys architect or interior designer.The hiring process usually involves arequest for proposals issued by a formalart committee. While other characteris-tics can be attractive to hospitals hiringa consultant, the single most importantcredential for selecting an art consultant

seems to be the consultants in-depthexperience in health care. Like design-ing a hospital itself, designing and pro-ducing a comprehensive health care artdisplay program is challenging andcomplex, especially because many facili-ties are including evidence-based designprinciples in their projects.

A History of HealingAccording to a white paper titled

A Guide to Evidence-Based Art, byKathy Hathorn, M.A., CEO and cre-ative director, and Upali Nanda, Ph.D.,American Institute of Architects (AIA)vice president and director of researchat American Art Resources (AAR), Artis an integral component of humanevolution, both as a species and as asociety.3 In fact, as early as 1860, inher famous Notes for Nursing,4 FlorenceNightingale described the patients needfor beauty and made the argument thatthe effect of beauty is not just on themind but on the body as well.

Because of the profound effectthat art can have on healing, it must be

selected very carefully inhealth care settings,says Nanda. Art has astrong impact, not juston patients but also oncaregivers. She notesthat today there is ashift in practice towardsevidence-based design;in other words, basingdesign decisions on thebest available evidenceand committing toresearch on how design,including art, affectsones health care experi-ence.

A significant bodyof evidence on theimpact of art on healthoutcomes, especiallywith respect to natureimages, is already inplace. Research has

Environment of Care News http://www.jcrinc.com2 November 2009

Art in Health Care(continued)Continued from page 1

Executive Editor: Kristine M. Miller, M.F.A.Senior Project Manager: Christine Wyllie, M.A.Associate Director, Editorial Development: Diane BellExecutive Director: Catherine Chopp Hinckley, Ph.D.

Technical Support and Review Provided by Standards Interpretation Group, Division of Accreditation Operations:Patricia Adamski, R.N., M.S., M.B.A., Director; George Mills, M.B.A., F.A.S.H.E., C.H.F.M., C.E.M.,Senior Engineer; Jerry Gervais, C.H.F.M., C.H.S.P.,Associate Director/Engineer; John D. Maurer,C.H.F.M., C.H.S.P., Associate Director/Engineer;Michael Chisholm, C.H.F.M., AssociateDirector/Engineer

Division of Standards and Survey Methods:John Fishbeck, R.A., Associate Director

Contributing Writers: Catherine Rategan, KathleenVega

Editorial Advisory BoardTracy L. Buchman, D.H.A., C.H.S.P., C.H.C.M.,University of Wisconsin Hospital and Clinics, Madison,WIJen Carlson, M.P.H., M.B.A., Loyola University HealthSystem, Maywood, ILDavid P. Klein, P.E., Department of Veterans Affairs,Washington, DCMichael Kuechenmeister, F.A.S.H.E., C.H.F.M., C.P.E.,West Chester Medical Center, Cincinnati, OHJohn W. McKinney III, Atrium Medical Center,Middletown, OHWilliam R. (Bill) Morgan, S.A.S.H.E., C.H.F.M., St. Alphonsus Regional Medical Center, Boise, IDJim Riggs, M.P.A., C.S.P., University Health Systems,Greenville, NCGeorge A. (Skip) Smith, C.H.F.M., S.A.S.H.E.,Catholic Health Initiatives, Denver, COThomas S. (Scott) VanDerhoof, Major, U.S.A.F., M.S.C.,C.A.A.M.A., Air Force Medical Operations Agency,Office of the Surgeon General, Brooks City-Base, TX

Subscription InformationThe 2009 12-issue subscription rates for the UnitedStates, Canada, and Mexico are $319 for both print andonline and $299 for online only; for the rest of the world,the rates are $410 for both print and online and $299 foronline only. Back issues are $25 each (postage paid). Add$25 for air mail delivery. Orders for 2050 single/backissues receive a 20% discount. Site licenses and multi-year subscriptions are also available. To begin your subscription, call 800/746-6578, fax orders to 218/723-9437, or mail orders to Joint CommissionResources, 16442 Collections Center Drive, Chicago, IL60693. For more information, call 800/746-6578.Environment of Care News (ISSN 1097-9913) is pub-lished monthly by Joint Commission Resources, 1515West 22nd Street, Suite 1300W, Oak Brook, IL 60523.

2009 Joint Commission on Accreditation ofHealthcare Organizations. No part of this publicationmay be reproduced or transmitted in any form or byany means without written permission.

Joint Commission Resources, Inc. (JCR), a not-for-profitaffiliate of The Joint Commission, has been designatedby The Joint Commission to publish publications andmultimedia products. JCR reproduces and distributesthese materials under license from The JointCommission.

E-mail us at [email protected] with your article ideas.Visit us on the Web, at

To contact the Standards Interpretation Group withstandards questions, phone 630/792-5900.

Artwork at Northwestern Memorial Hospital, Chicago

shown that viewing nature imagesthat contain positively reinforcing fea-tures can reduce stress and anxietyamong patients and staff and canlower the patients perception of pain.Research further suggests that natureart (or art with views or representa-tions of nature) will promote restora-tion if it contains the following fea-tures: calm or slowly moving water,verdant foliage, flowers, foregroundspatial openness, park-like or savan-nah-like properties (scattered trees,grassy undershot), and birds or otherunthreatening wildlife.

The same research suggests that,in addition to nature art, humans aregenetically predisposed to notice andbe positively affected by smiling orsympathetic human faces. Accordingto Nanda, while these guidelines arean excellent starting point for artselection, it is important to avoid aone-size-fits-all approach. Carefulconsideration of the specific patientpopulation and the health care settingare warranted before making decisionson health care art.

An Art PreferenceStudy

In 2006 an art preferencestudy5 with inpatients at St.Lukes Episcopal Hospital inHouston, Texas, found thatpatients preferred naturescenes and representativeimages to stylized or abstractarteven when the latter wererated as bestsellers by onlineart vendors and included clas-sics by artists such as VanGogh, Klimt, and Chagall. Infact, patients made a distinc-tion between pictures theywould like to see in theirhomes and those they wantedto see in their inpatient rooms.Not surprisingly, when thissurvey was conducted withinterior design students, popu-lar art rated higher. Also, therewas a low correlation betweenthe students emotionalresponse and their aestheticresponse (or preference) to Environment of Care News 3November 2009

Continued on page 10

The Healing Power of Art Carts

Art carts are now a feature of hospital life in

many health care facilities. Customarily, a hos-

pital employee or a volunteer stacks a rolling

cart with various pieces of art and transports

the art to the rooms of new patients, where

patients are asked to select which art theyd

like to have hung on the walls of their rooms.

This lets patients interact with a caring person

and offers them a sense of control in affecting

their own environment.

When Upali Nanda and her colleague

Kathy Hathorn of American Art Resources con-

ducted a study at St. Lukes Episcopal Hospital

in Houston