American Art Resources: Intelligent Design
Const/Architecture
Written by John Zorabedian   
Friday, 29 February 2008
Evidence-Based Design - American Art Resources: Intelligent Design - RedCoat Publishing
Kathy Hathorn’s company is at the forefront of a growing movement in healthcare: evidence-based design. She explains how the right artwork can improve the patient experience.
As evidence mounts that environmental aspects of a patient’s experience in a healthcare setting influence their stress level, many hospitals are using evidence-based design to improve patient experience. Research now shows that even the right choice of art on a wall can put a patient at ease, whereas the wrong choice can increase stress.

Evidence-Based Design - American Art Resources: Intelligent Design - RedCoat Publishing
Kathy Hathorn, CEO and Creative Director
The Houston art consulting firm American Art Resources (AAR) has for 25 years advised hospitals on evidence-based design, commissioning and installing artwork for its clients. Kathy Hathorn, the company’s CEO and creative director, is working to build on the body of research into how patients, as well as caregivers, respond to art.  

“The research supports the idea that when we’re under stress, a different part of the brain is judging our environment,” Hathorn said. “We are not reacting from the thinking part of the brain, we’re reacting from the ancient part of the brain that is purely instinct.”

Some of the most groundbreaking research into healthcare design has been conducted by Robert Ulrich, a fellow at the Center for Health Systems and Design at Texas A&M University and a director of the Center for Health Design, an advocacy and research group promoting evidence-based design.

Ulrich’s work has found that patients prefer realistic art depicting scenes of nature, including open landscapes and calm waterscapes. Abstract art, his research found, is consistently disliked by patients and can increase stress and worsen outcomes.

Hathorn’s company began conducting its own research two years ago, through surveys of patients and staff at hospitals where it has installed artwork and now has a full time PhD on staff to head up research projects.

“We’re probably a couple of years away from having enough data to make an overwhelming argument for evidence-based design,” she said. “But the data has already begun to surface.”

Sacred Heart
The new 1 million-square-foot Sacred Heart Medical Center at Riverbend facility in Springfield, Ore. is the latest example of the successful implementation of evidence-based design. Hathorn and AAR worked with the center’s planners and architects from the outset to create a healing environment complete with evidence-based art.

“Sacred Heart will be the new benchmark,” Hathorn said. “The intention is to create a facility that is not only world class in scope and nature, but is also a healing place steeped in many of the principles of evidence-based design.”

Hathorn commissioned work from local and national artists, relying on AAR’s network of affiliated artists and artisans, to imbue the facility with a sense of its local environment. Signature pieces include the 10-foot by 16-foot bas relief that grace the facility’s iconic clock tower, a 30-foot carved glass window in the hospital chapel, and 500 linear feet of artist-made stair rails. A nationally prominent sculptor who lives in Eugene is creating a monumental bronze that will be located at the entrance of the meadow across from the hospital.

Warren Cather, a renowned glass artist from Winnipeg, Manitoba, traveled to Springfield to complete the window, which depicts an aerial view of the nearby MacKenzie River.

“Our challenge has been how you use a local resource to make sure the principle of an evidence-based art program can be met,” Hathorn said. “Works of this sort take about two years to plan design and install. But we work directly with the architects Anshen+Allen and WAT&G, and they’ve been great partners in developing these pieces.”

Ongoing research
The concept of evidence-based medicine relies on continuously updating practices to reflect new developments in medical research. Evidence-based design works much the same way.
AAR has a team of researchers who conduct surveys of patients and staff to study the best types of artwork for various settings. “The research becomes a tool for choosing artwork for therapeutic environments,” Hathorn said. “But it also spills over into the demographics of a service area of the hospital.”

Different ethnicities have varying cultural interpretations of artwork, as well as symbols in artwork, AAR’s research has shown. AAR’s art-preference pilot study of 50 patients at the Laguna Honda Hospital and Rehabilitation Center, a long-term care facility in San Francisco, found that certain images evoke different emotions depending on the patient’s cultural background.

For example, in Western culture, an image of white lilies is tranquil and relaxing; Asian cultures see white as a symbol of death.

“You have to figure in the cultural, ethnic, and socioeconomic factors as well,” Hathorn said. “The preliminary findings indicate that ethnic background does influence what makes people feel comfortable with art. This type of research has tremendous potential in demonstrating the value that evidence-based art adds to the hospital’s bottom line.”

AAR’s other research has included studies of pediatric patients, artwork as an agent of social interaction with patients and staff, and the effects of artwork on staff members in hospital labs.

Staff members also respond positively to artwork, reducing their stress levels. That, in turn, can lead to lower staff turnover and improved patient care. AAR is in the midst of commissioning and installing artwork at Cedars-Sinai Outpatient Cancer Center in Los Angeles. The facility surveyed patients about their impressions of the previous artwork, which was largely abstract. “Significant numbers of patients could not even identify the artwork that was in the space even though they were frequently in the facility,” Hathorn said. “We are changing it to an evidence-based program, and we are getting a lot of positive feedback from patients already.”

The positive effects of evidence-based design and art on patient experiences spill over into the patient’s impressions of the hospital as well. The potential exists for branding based on an improved patient experience.

“It costs the same amount of money to do an art collection that’s evidence based as one that’s purely decorative,” Hathorn said. “What people are realizing is that an evidence-based art collection can really enhance branding efforts and philanthropy efforts if you can point to something that puts patients first.”

As more hospitals catch on to the potential to improve patient experience with artwork and superior design, Hathorn said the successful ones have backed up their work with due diligence.

“People are really looking to put the science behind it, rather than doing it because it’s a buzzword right now,” she said. “The most forward-thinking healthcare leaders are saying, let’s not just do it blindly, let’s look at the research and do it right.” 
 
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