Monthly Archives: November 2011

Pae White

California artist Pae White’s new show at LA gallery 1301PE brought her work to my attention, surprisingly, for the first time. Her colorful, witty, and joyful work would suit a healthcare environment flawlessly. From the website of Sue Crockford Gallery, her gallery in New Zeland:

Drawn from an abundance of art historical and pop cultural sources, Pae White’s cascading mobiles evoke everything from schools of fish, flocks of birds, and teeming ponds, to Impressionist paintings with their myriad marks. White describes this body of work as “an exploration of movement contained.” Like “a waterfall on pause” the works are “a flurry of color and gentle movement, suspended for contemplation.”

Chandelier (Installation view), 2008, Painted terra cotta, Each 75 x 48 in

Untitled (metal foil), 2009, Tapestry, 115 x 324 in

(via contemporary art daily)

Trees inside

Naturemaker trees at Beaumont Hospital, Royal Oak, MI

Naturemaker trees at Cardon Children's Medical Center, Mesa, AZ

I’m not usually fond of faux nature, but I actually rather like the look of these steel trees by Naturemaker. When real trees are impractical due to size, scale, or environmental concerns, these man-made replicas seems to provide a clever and tasteful alternative that are “87 percent botanically accurate.” The company has completed projects in retail, hospitality, and healthcare environments and the trees all feel ever so slightly…corporate. Founder “artist/sculptor/ecologist/inventor/entrepreneur” Bennett Abrams, passed away in 2004. Partner and co-founder Gary Hanick remains president today. Prices for trees range from $25,000 for a 16 foot tall Oak or Maple tree to $500,000 for a 50 foot Banyan or Olive tree.

If it were up to me, the trees would be white, or shimmery silver and gold, to abstract the experience and try to create an even more original, special space. Something along the lines of Ugo Rondinone’s beautiful aluminum cast trees that Creative Time commissioned for Central Park in New York. Just, slightly less…haunting.

Cast aluminum tree by contemporary Swiss artist Ugo Rondinone

Cast aluminum trees in Central Park by contemporary Swiss artist Ugo Rondinone

Tom Otterness and SF General Hosptial

Here’s a puzzle: how can the following commission for hospital art in San Fransisco turn wildly controversial?

A large bronze Mother with Children sculpture by acclaimed artist Tom Otterness. The charming sculpture, which features Otterness’ signature cartoon-like figures, celebrates the joy of a new baby and the role that hospitals play in providing health services in the community. For the pedestrian walkway to the entrance, Otterness designed a suite of playful small bronze heart-shaped characters engaged in activities such as talking on a cell phone to daydreaming.

Proposed Sculpture for SF General Hospital (via SFAC)

The answer: one 1977 video depicting Mr. Otterness shooting and killing a dog he had adopted. The film, titled “Shot Dog Film” is not a secret. It’s existence has occasionally appeared in one press outlet or another since 2008 and even as early as 1997. Yet there has been a recent surge of press coverage generating outrage that a dog killer was awarded two high profile commissions in San Fransisco. Every time I see one of his hundred friendly bronze blob figures in the New York subway system I must admit, for a split second, I imagine said friendly bronze blob shooting a puppy.  It is this almost inevitable association, now that “Shot Dog Film”‘s gory scenario has been etched in the collective memory of media-reading San Fransicanites, which will cost Otterness the $750,000 contract for art in the new Central Subway, offered to him by the San Fransisco Arts Commission in July 2010. What it will not cost him, is a parallel contract for a sculpture at San Fransisco General Hospital. This is largely due to the fact the city has already paid him $365,750 of $700,000 for the bronze hospital sculpture, titled “Mother with Children.” Terminating the contract would be mean loosing a over a quarter of a million dollars. According to Artinfo “Kate Patterson, spokeswoman for the Arts Commission, said the judging panel was not aware of the 1977 film’s existence when they selected Otterness. The artist told ABC7 that he hopes ‘San Franciscans can forgive him for something he did more than 30 years ago.'”” Otterness puts things a little more blunty, or at least did when the NY Observer questioned him about the video earlier this year:

“What the f do I do with this?” he said. He grew visibly upset. “Certainly the scene it was part of-it was in the context of the times and the scene I was in.” He began again. “It is something I’ve grown to understand that nothing really excuses that kind of action. I had a very convoluted logic as to what effect I meant to have with that video. Whatever I had in mind, it was really inexcusable to take a life in service of that.”

This commission is one piece of an approximately $7 million Art Enrichment fund to enhance a new nine-story, 448,000-square-foot inpatient care facility. I’ve been following the project for a while now and feel badly writing about it in the context of all this controversy because, in all actuality, it’s an impressive and unusual initiative to put a major, high profile, public arts scheme inside of a new public hospital build.  Otterness is just one of 13 artists commissioned as part of a much, much larger scheme implemented by the San Fransisco Arts Commission, the non-profit organization charged with selecting and managing art for San Fransisco’s civic spaces. I encourage you to look over all the commissioned works at the Art’s Council website here – I’m excited to see this all realized and installed! For this commission:

Arts Commission staff worked with the 13 selected artists, who represent diverse artistic and ethnic backgrounds, to develop proposals for artwork that would be appropriate for this type of setting. The guidelines provided to the artists drew upon several studies that measure the impact of art on the clinical and behavioral outcomes of patients in hospital settings. The studies indicated that patients who are exposed to art, especially works that incorporate natural imagery, experience improved health outcomes. Art has also been proven to have a positive impact on the pleasure and well-being of staff and visitors. A hospital arts committee composed of representatives from each area that will receive public art also participated in the selection process, directly contributing their knowledge and sensibility about patient care.

Below are the beginning sketches illustrating the very early phrases of a few of the works that other artists are making for the hospital.

Phoenix Children’s Hospital

The new tower at the Phoenix Children’s Hospital successfully avoids the typical hospital typology in favor of…an aesthetic I’m going to call the 1990s cruise ship aesthetic! The architects explain their aim was to evoke a “blooming desert flower.” No matter the associations, it’s a magical, spirited, and unique space designed by the firm HKS, a Dallas based powerhouse for medical architecture. Each floor has an animal that ‘sponsors’ it and a unique color scheme – enhancing wayfinding and adding to the playful atmosphere. Just how do these floors stack up? The lower level =  labs, a pharmacy, information technology, and storage for equipment. First floor = imaging, patient registry, outpatient pharmacy, a kitchen/restaurant, a 24-hour café, and administrative offices. The second floor =  ambulatory clinics. The third floor =  support functions, family spaces, and a rooftop garden. The fourth floor = inpatient procedures. The fifth floor and above are patient rooms. The patient rooms are each arranged with two groups of 24 single occupancy rooms. The elevator lobbies that people encounter as they move between floors each feature exterior views, a bronze animal sculpture, and a digital photographic wallcovering of a plant or nature scene. Like this:

A wonderful virtual tour is available on the Hospital’s website here. The project was featured on the March 2011 cover of Healthcare Design Magazine. In the accompanying article,  Sandra Miller, the HKS Interior Designer overseeing the interiors explains:

One of our directives was to avoid looking childish, which is one of the major challenges in a pediatric facility. The children treated here range in age from newborns to 20 years old, so it doesn’t make sense to only target the 5-to-8 year olds.  We established the look of the tower through color and artwork, and incorporating interactive positive distractions within the building

Art plays an important role in the concept. There are magnetic marker boards and each patient has an area on the wall outside of their room to display his or her own artwork, allowing them to personalize their own space. Miller explains that “the goal was to make each patient room like their own individual ‘front door’ into their world.” The hospital’s Center for Cancer and Blood Disorders also runs a website that allows shoppers to purchase original artwork or note cards featuring art by patients, with all funds going towards the hospital. You can see the spaces for patient artwork in the background here:

The dramatic lighting scheme throughout the building was overseen by lighting designer Scott Older with Philips Color Kinetics. The lighting is truly transformative in the above images, all taken after dark and perhaps ran through a photoshop filter or two. During the day the hospital looks a bit more…like a hospital, as you can see in this video from Phoenix news chanel abc 15:

(All Images HOK via modxdesign)

 

 

 

Pearson Lloyd and Violence in the A&E

There were 57,830 physical assaults on NHS staff in England in 2010-11, and given the NHS’s initiative to design features that minimize violence in the A&E, it’s safe to assume that a disproportionate percent of these assaults took place in A&E departments (A&E, or accident and emergency, is the British version of American ER). The BBC writes that the design counsel and the NHS worked with psychologists to identify six profiles explaining why patients might become violent and nine factors that could trigger violence – such as inhospitable environments. Design firm Pearson Lloyd won a commission to create inexpensive elements that don’t physically create a barrier between staff and patients, but reduce violent incidents. It will be tested for a year at select hospitals. As we noticed yesterday in my post about the patient experience at the A&E, and as is restated by the Design Council:

Patients and other service users arriving at A&E by means other than an ambulance may have significant difficulties in navigating the physical space, and can become lost even before arriving in the A&E department. Once there, they are exposed to a complex system that they may not understand and is frequently not explained to them.

According to an article in Design Week, the new scheme to provide clear, prominent guidance and relevant information to patients and caretakers includes:

A new approach to greeting patients on arrival; a system of environmental signage, called ‘slices’, which gives clear, location-specific information; a personal ‘process map’ explaining what patients can expect from the treatment process; and screens to provide live, dynamic information about how many cases are being handled.

This information will be delivered via a series of narrow vertical information “slices” that can easily an inexpensively be placed in existing A&E facilities, creating an instantly recognisable point for information and communication throughout the department. These sliced could even be placed on ceilings to provide information to patients on stretchers. The Design Council explains:

The visual language was deliberately developed to reference a journey map, with each step represented as a ‘stop’. The stop names can be read from a distance, and the overall process can be quickly understood. If the reader moves closer, they can read the explanatory text and learn more about each step.

Both the BBC and Design Week links include videos about the project that I’m not able to imbed into the post but that are well worth watching. Below is a video from the Design Council explaining the initiative to reduce violence in the A&E.

Kentish Town Health Centre

I’ve posted a number of word-heavy blog posts recently. Here are some beautiful images of one of my all time favorite healthcare buildings, the Kentish Town Health Centre in London. It opened in 2008, and was designed by Allford Hall Monaghan Morris.

It’s such a gorgeous building. According to World News Architecture it houses a large GP practice, a dentist, paediatric, dental and children’s services, breast screening and diagnostic imaging, plus office space, staff facilities, library and meeting rooms all designed around an internal street. From the architects’ publication on the project:

The vision was to create a wonderful building where not only medicine but health and art came together for the community. Ideas of transparency and  connectivity were embraced by the architects  and the whole team worked collaboratively to create a building that expresses the new, holistic approach to healthcare. KTHC creates a bold civic presence that responds to its environment.

Here is a wonderful 4 minute video wherein the architect, Paul Monaghan, explains the project with images of the building itself interspersed.

when researcher becomes patient

Healthcare spaces can be exceptionally challenging to understand from the user’s perspective, with their emotionally nuanced and personal experience entirely outside of most people’s day to day lives. I came across two personal blog posts from designers and researchers who went from theorists, to patients.

Photo: Salma Patel

Salma Patel is a British doctoral researcher interested in digital engagement and participation in healthcare. The above photograph was taken by her on an unexpected visit last summer to Addenbrooke’s A&E department in Cambridge. In this blog post titled “Experiencing the link between environment design & patient experience” she chronicles her interactions with the built environment. She begins the narrative:

As we approached the hospital it wasn’t clear where we supposed to park. There was a sign directing people towards the main car park but there was no sign for A&E parking point or drop off. We continued through the emergency route as it was late at night. As we came in front of the A&E department we realised that the parking bays were disabled only – and though they were all empty, my husband being the ethical man he is, decided not to park there. Ahead of me, I could see some parking spots, but again as there were no signs we were unaware if we were allowed to park there. My husband decided we should just go to the main car park. He had no idea which way to turn.

Luckily, it was a quick stay and Salma is fine. I find it worthwhile to click through and read this visual narrative of the a&e experience from a patient who has an eye turned very specifically to the design of the facility.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Crystal Richards, is a member of the healthcare team of the Pertkins+Will Seattle office with five years of healthcare experience. She is also a Lukemia survivor. Richards and Perkins + Will colleagues Missy Kutner and Susan Lee wrote an affecting post for the Contract Magazine blog. Richards begins:

I had just finished creating a walk-through animation of a new ambulatory surgery center the day before I got the call. Sure, I understood how to lay out a healthcare facility, how circulation through a hospital worked, where the “family zones” needed to be drawn on the plan, but I was about to get an unsolicited insider’s perspective that would change my life.

She then provides powerful insights surrounding her own emotional experience as a patient. Kutner and Lee relate these personal experiences to existing design elements sometimes put in place to ease the stay of long-term patients, including windows and skylights, bringing the outdoors in and extending patient areas into common spaces, providing social spaces and exercise equipment, creating “family zones” in patient rooms and and workspaces for caregivers in common spaces. The post provides a uniquely personal piece in an field that tends to be analytic and evidence based.

On lab coats and scrubs

When you imagine a doctor’s office or a hospital, what is one of the most prominent visual elements of the whole experience? Here’s a hint: though not technically part of the “built environment” this element is very much part of the “designed environment.” The answer: it’s the uniforms doctors and nurses wear as they care for you. The ubiquitous white lab coats and baggy pastel scrub pants that take people who, walking down the street are just people like you, and set off a visual cue that these people could be wielding needles and frightening diagnoses;  a fact that makes the average patient’s heart race.

It’s a big week for thinking about the design of clinicians uniforms. First, the Atlantic published an article on the psychological and clinical advantages and disadvantages of white lab coats. Germs are a very real, very scary challenge and the white lab coat is an important, but not entirely effective, step to help curb their spread. The Atlantic explains that:

A physician wearing a white coat came to symbolize 20th-century medicine, argues Dr. Mark Hochberg, a professor of surgery at NYU’s Langone Medical Center. Before the late 1800s, doctors usually wore black because it was considered formal, he wrote. The shift to white paralleled progress in science and, eventually, the public’s awakening to germ-fighting habits.

But it admits that white lab coats alone will do nothing to slow their spread unless they are worn appropriately and cleaned frequently. Statistically, lab coats are just as guilty as scrubs, and even freshly laundered business casual clothing, when it comes to spreading germs. Perhaps, then, the dawning of this uniform is more related to mental reassurance and institutional ritual than actual germ prevention. The article also quotes an old article as follows:

Dr. Joseph P. Kriss, who in 1975 wrote in the New England Journal of Medicine:

The physician’s dress should convey to even his most anxious patient a sense of seriousness of purpose that helps to provide reassurance and confidence that his or her complaints will be dealt with competently. True, the white coat is only a symbol of this attitude, but it has also the additional practical virtues of being identifiable, easily laundered, and more easily changed than street clothes if accidentally soiled…. Casual or slovenly dress is likely to convey, rightly or wrongly, casual or inattentive professional handling of their problem….

It’s an interesting, quick, and important read and I recommend clicking over and skimming it.

Meanwhile, students at Pratt have been “designing for a difference” and re-thinking the cut of scrubs for “Haven Hospice Specialty Care Unit, Visiting Nurse Service of New York’s 25-bed in-patient hospice facility in midtown Manhattan.” The Huffington Post wrote about the project yesterday and explained that:

Currently, Haven’s staff wear a combination of street clothes and uniforms from a big corporate supplier — not the right fit, we thought, for a workplace focused on attending to the human spirit in addition to the human body. The winning design, by 20-year-old Hannah Ross, is an organic cotton tunic t-shirt and knit pants, topped by a buttoned and pocketed smock that’s inspired by a lab coat but looks like a stylish jacket. The uniform will be produced and worn by Haven’s nurses and nurses’ aides.

Ross also felt that:

“I knew my design had to be really far removed from a typical hospital uniform,” says Hannah. “The hospice looks like a hotel, a spa, something really calm and comforting, and I wanted to capture that.”

Even the most sensitively designed healthcare spaces tend to be filled with staff wearing this “typical hospital uniform” which creates a stark ripple in the overall holistic design. I think that as more and more attention is paid to creating comfortable, welcoming, and sanitary environments, an overhaul of providers uniforms is a natural next step to further humanizing the whole experience. Here is the design winner, Hannah Ross’s winning look, along with images of the other designs submitted:

(Images via DNA info)

 



LegacyER

Legacy ER, in Frisco Texas, is a freestanding emergency room that serves as both an urgent care clinic for non-emergency ailments and a fully functioning ER. Traditionally, these kinds of medicines were seldom housed under the same brand in the same roof, but having them integrated ensures you don’t need to decide whether a trip to urgent care or the ER is more appropriate. However, the two different kinds of care happen on two different tracks, with the nursing station in between, so a toddler with a sore throat won’t be right next to someone with a major knife wound.  All of this happens in a sleek 6,200 square food setting designed by Texas firm 5g. From a 2008 press release on the LegacyER website:

The three founders of Legacy ER, Kirk D. Mahon, M.D., Steven E. Martz, M.D., FACEP and Jay R. Woody, M.D., FACEP wanted a building that was more organic in nature and comforting to patients. To provide rooms with privacy, definition was made using opaque walls and translucent glazing panels. The effect is sound proofed rooms without the use of claustrophobic cubicles or draping. Exposed, polished concrete floors and exterior zinc panels further enhance the patient experience by offering a tactile quality, while natural light provides brightness without the harsh, sterile feel that artificial lighting traditionally offers.

There is also a great write-up of the project on Architectural Record’s website. It’s a cutting-edge concept that I think we’ll see more and more of as in-hospital emergency rooms become even more burdened, and the space looks completely appropriate for it’s function. Serene, inviting, and reassuringly sterile. LegacyER has a perfect five star rating on yelp, an extremely rare feat for a medical facility of an urgent or emergency nature.

Happy Arts and Health Month

Must everything have a month of it’s own? Not to be left out of the theme-o-the-month bandwagon, the Society for Arts and Health has branded November worldwide “Arts and Health Month.” This will be the 2nd year November has held the honor. Despite my own reservations about the effectiveness of such campaigns, particularly when there is little new content and few events surrounding them, it’s a noble effort on behalf of the SAH to create a concentrated “buzz” around the field.  The hope is:

Arts + Health Month is an opportunity for organizations and individuals worldwide to promote the integration of the arts—including literary, performing, and visual arts and design—into a wide variety of healthcare and community settings for therapeutic, educational, and expressive purposes.

Ultimately, it will be up to member organizations to promote the month – it seems the ultimate goal of the SAH is to provide tools to encourage individual organizations to reach out to the press using the downloadable press releases and fact sheets from the website. For example:

Communities around the world will celebrate Arts + Health Month with educational seminars, art exhibits, talent showcases, and other awareness programs. In <<Your Community>>, <<Include information about the monthly (or current) events your organization has scheduled for Arts + Health Month. Include dates, times, and locations, or provide a link where all of this information can be located. (example:the Society for the Arts in Healthcare, in partnership with <<Name of Partners>>, is offering a unique platform to share and explore national and international model arts in health programs at the first annual Arts + Health Month Symposium: Approaching Health Creatively. Featuring <<Name and Credentials>>

Unfortunately there is no centralized calendar and overworked non profits without outreach or communications or event planning departments might find it all quite too much of a hassle. As a point of comparison, the American Institute of Architect’s New York chapter just finshed up a fantastic month of programming, under the clever heading of “Archtober: Art and Design Month New York.” It was chock full of events, tours, lectures, and featured an easy to use calendar and prominent links to each of the participating organizations. From the Archtober website:

Archtober presents special tours, lectures, films and exhibitions that focus on the importance of architecture and design in everyday life. The many participating organizations aim to raise awareness of the important role of design in our city and to build a lasting civic and international recognition of the richness of New York’s built environment. Special programming every day of the month and access to sites, and their architects, will bring new audiences to all of the participating organizations — all of whom are committed to New York and promoting design excellence.

Imagine if instead of fact-heavy press releases and isolated events the SAH organized even just one week of opportunities for people to volunteer to creatively engage patients, take tours of hospitals and art collections led jointly by clinicians and arts and health advocates, attend lectures with curators, or take in high-profile concerts in healthcare spaces. THEN people, at least New Yorkers, would be much more easily enticed to understand viscerally the importance of the arts in the healthcare experience and the SAH would be able to create a dynamic, more publicly known, brand with greater advocacy influence. It’s a fledgling awareness month though, with a very specific audience, and a good start with lots of potential to grow into something even more energizing in the near future.

Architecture, Art and Wellbeing Lecture

Tuesday, November 8th you can listen live to the RSA and Maggie’s Centers’ lecture on Architecture, Art and Wellbeing online for free right here. It’ll be at 6pm British time, or 1pm for East Coasters.

“The concept of ‘healing architecture’ has been developing over the last two decades and a large amount of research has been carried out into the impact of architectural design on the success of healthcare environments. Evidence that architects can significantly alter a patients’ experience and quality of life has led to a change in attitude and approach to designing spaces such as the Maggie’s Cancer Caring Centres.

Architect Piers Gough, art critic Richard Cork and consultant Dr Sam Guglani discuss Maggie’s pioneering approach to cancer care, and how this collaborative approach can be replicated and used to influence policy to develop better environments for people in healthcare.”

ixxi

I want this to be a blog that features everything from billion dollar healthcare buildings by the world’s best architects, to cleverly designed devices that make procedures easier, to these absurd but simultaneously sort of brilliant ixxi panels that consist of dozens or hundreds of moisture resistant, tear-proof synthetic paper panels held together with X brackets. This Dutch-designed system could so easily be used to create large scale, high impact wall decor or even to construct inexpensive visual dividers where none previously existed. Hard to imagine they would pass hospital code but in more casual primary care setting they provide a highly customizable, easily shipped, assembled, disassembled, and moved visual kick. They can be made to any size (a gigantic 6.5 by 6.5 mural costs 131 Euros) with any single image OR any collage of tens or hundreds of images. The potential, then, exists for patients to each take responsibility for an individual panel that would make up the overall image. ixxi is a simple, affordable product that could provide a customized, and spirited focus point for a variety of clinical spaces.