Art as Therapy

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How photography gave users of Stonefield House a sense of belonging in their new facilities.

Nightingale Associates is passionate about designing buildings that not only cater for the individual needs of its users, but also improve their general wellbeing. It is imperative that a building can fulfil its function and also makes its occupants feel comfortable in their surroundings. Art-therapy is a fantastic way of expressing oneself creatively and helping an individual’s personal development. In their latest project, Nightingale Associates have combined art-therapy with interior design to create a contemporary new mental health/rehabilitation ward for St George’s Hospital, Stafford, called Stonefield House.

A winning image showing just how creative therapy can be

The stigma surrounding mental health and rehabilitation units is not unfounded. Historically, units were very clinical and unwelcoming, with limited facilities and schemes to help patients enjoy their time in recovery. However, times have changed; hospitals and numerous charities in the UK now provide the funding to make facilities more comfortable for patients, and offer more opportunities to improve the quality of life and rehabilitation for those who need it. Nightingale Associates have been working with both NHS and private hospitals for 20 years to improve the design of hospitals to cater for patients’ special needs.

Working with the trust, Nightingale’s decided to incorporate the artistic talents of Stonefield’s users into the design to create an inviting and personalised environment. Users were encouraged to take part in a photographic competition which would be turned into wall-art for display in communal areas.
Over the course of four sessions, the users were taught how to use the cameras and were permitted to enter the building during its construction to capture interesting shots of the building process. Under the guidance of staff and occupational therapists’, they selected 12 of their favourite images to be turned into art. The images have been printed in monochrome, with certain features picked out in colour to fit in with the interior design. The striking images give a real sense of the users’ perspectives and will be mounted in the room from where they were taken to give a sense of ‘before and after’.

View from Stonefield House overlooking construction site

By letting patients go behind the scenes and actively selecting the wall-art not only helps them to feel at ease with the new facilities, but also helps to create a more comfortable and homely environment. The use of photography in this way is known as “Therapeutic Photography” – photography conducted by individuals for artistic and creative exploration. It differs from “Phototherapy” which is the use of photographs within the framework of formal therapy, for example, during counselling.

To continue this artistic venture, when the LSU (Low Secure Unit) reopens in October 2010, users will be able to take part in a weekly art group, which will be self-funded. Installing an art activity programme for users is a great way for them to get to know each other in an informal and sociable setting. Many of the users stay in the facility any time from a few days, up to 2-3 years, so there is a regular client group to work with. The majority of Stonefield users are male and are aged between 18 and 80; therefore trying to design a building and find activities to suit everyone is problematic. However, because art is generally thought of as a universal pastime, people of all ages can enjoy it. Using photography is especially stimulating to male users as it is considered as a particularly masculine-friendly art form and was a fun way to launch the scheme.

Users had the opportunity to capture the construction team at work

In general, artistic therapy is a worthwhile practice that can be applied to our daily lives. Developing your own artistry (in any medium, whether through photography, sculpting, drawing or painting) allows individuals to express themselves in a positive way, helping to relieve stress and increase self-esteem. And if anything, art helps people to escape from day-to-day life and focus their attention on one task, which is a difficult thing to do when juggling priorities and having so many distractions in life.

The Stonefield House ward, part of the Michael Flanagan building, along with a £30 million redevelopment project for Shelton Hospital, is Nightingale’s seventh project for their client, South Staffordshire and Shropshire Healthcare NHS Foundation Trust. The £3.2 million ward was built as part of a two-phase project in which an existing building is being re-used as the main hub of the scheme. The colourful new ward has a contemporary feel, with wood floors, bright furniture and large windows to make the most of the natural light.

A room with a view

In pursuit of good design and innovation, Nightingale Associates hope to enter this project for the 2011 BBH (Building Better Healthcare) Awards for Best Use of Visual Art in Healthcare as well as Best Interior and Best Sustainable Design categories. Thanks to a strong relationship with the Trust and their commitment to good mental health design, Nightingale Associates was shortlisted for Best Interiors in Mental Health in 2008, and were also highly commended in the Product Design category for the Norbury Lounge Chair.

The photographic artwork was created with the assistance of Brighton based company, alonglines.

Re-thinking space in healthcare estates

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Clean, lean, safe and green are this year’s themes for the Healthcare Estates annual IHEEM conference where Nightingale is presenting a paper.

Richard Mazuch, director of Design Research and Innovation, will be talking about ‘Re-thinking space – Innovative approaches for inpatient accommodation’.

The last 12 months have seen unprecedented changes in our political and economic situation, making the challenges facing healthcare estates bigger than ever before. The paper will describe three innovative approaches developed by Nightingale Associates for the provision of Inpatient accommodation for both existing and new build healthcare settings.

Re-use and refurbishment within the existing estate

BedPod

Developing a lean estate is now more important than ever. Trusts have to find more affordable ways of upgrading their existing accommodation.

Nightingale Associates, with partners SAS International and Billings Jackson Design, have developed the BedPod as part of the Design Council ‘Design for Patient Dignity’ programme funded by the Department of Health. To provide same-sex accommodation, the current solution involves major ward or hospital refurbishment at significant capital cost, downtime and loss of beds. By utilising existing space within wards, the BedPod provides same-sex accommodation at a fraction of the cost.

The BedPod offers a uniquely flexible solution for providing Inpatient bed space. Developed for minor or major works and as a temporary or permanent measure, the BedPod is a prefabricated, modular product that offers simplified procurement, minimal disruption and no loss of beds. Manufactured to the highest quality, its modularity enables choice in initial specification and facilitates replacement and upgrade over time to minimise obsolescence.

Moreover the BedPod aims to create a sense of patient empowerment, offering increased control and improving patient dignity. It is also designed to improve the healing environment by increasing sensory engagement and helping to control the spread of infection.

Providing the right Inpatient accommodation is about understanding the context and applying the right solution. This approach provides the Estate Manager with flexible solutions that respond to reoccurring issues, whilst making the most of any investment.

100% Single room accommodation

Ysbyty Aneurin Bevan, aerial sketch perspective

As the debate continues as to whether single bed accommodation is the future of the NHS, Nightingale Associates (with their Supply Chain Partner, BAM) are about to complete the first purpose designed 100% Single Room hospital in Wales. The 96 bed hospital in Ebbw Vale for The Aneurin Bevan NHS Trust, delivered via the Designed for Life: Building for Wales Framework, will be receiving patients by October 2010. The proposed ward layouts were developed in close consultation with the Trust team, patient groups and stakeholders to ensure cost effectiveness, staff efficiency, optimal observation, patient control, as well as patient privacy and dignity. Best practice, current guidance and full scale mock-ups have been utilised during the design development process.

Multi-bed bay accommodation

Cruciform ward layout

Nightingale Associate’s experience in the healthcare market underlines that providing 100% single room accommodation is often unaffordable or inappropriate for the intended purpose or patient group. To address this problem, Nightingale’s havedeveloped the cruciform ward to provide a cost effective, staff efficient and patient centred alternative to current multi-bed bay models.

The cruciform ward layout is configured to emphasise individual bed heads for each patient, thereby creating a sense of personal space and controlling the spread of infection. The innovative layout provides for the integration of en-suite sanitary accommodation as well as areas for informal seating and/or patient dining. The ward can be deployed with varying percentages of single room accommodation. The cruciform ward has been successfully developed for the recently completed Phase V, Princess Elizabeth Hospital, Guernsey and the new Peterborough City Hospital due for completion in the autumn 2010.

Healthcare Estates is the largest and most influential institution in the UK. The conference is taking place in Manchester Central from 5^th-6^th October 2010.

Arts in health: Choosing art for healing environments

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As the new Peterborough City Hospital approaches practical completion this Summer, the Trust’s art steering group, including Nightingale Associates representatives, has chosen two artists to provide artwork for selected areas of the new-build.

Nightingale Associates discussing the project. Stills taken from the planning film by Living Projects.

Dan Savage and Linda Schwab have been selected to provide wall and glazing treatments throughout Peterborough’s new City Hospital, which has been designed by Nightingale Associates under contractor, Brookfield Construction (UK) Ltd.

Incorporating art into the healing environments is more than hanging aesthetic pictures on the walls; for Peterborough & Stamford Hospitals NHS Foundation Trust it’s been a two-year long programme, providing the opportunity to create an appealing healthcare environment as well as building identity for individual departments and aiding wayfinding.

The artist selection process has come to fruition following two years of planning. Dan Savage will provide wall and glazing treatments in the children’s out-patient department, adolescent in-patient, emergency centre, bereavement suite centre and NICU.

Dan Savage will provide wall and glazing treatments in the children’s out-patient department, adolescent in-patient, emergency centre, bereavement suite centre and NICU.

Linda Schwab will provide artwork for haematology and oncology unit, waiting area, children’s waiting day treatment unit, children’s waiting area in the head and neck unit and glazing in the faith centre. 

Linda Schwab will provide artwork for haematology and oncology unit, waiting area, children’s waiting day treatment unit.

The locations identified by Nightingale Associates’ architects and the Trust as priority areas for artistic embellishment were chosen according to the service they provide – or particular needs for patients, staff and visitors.

Nightingale Associates’ Interior Design Lead, Elizabeth Petrovitch, believes the effect of artwork upon children’s recovery cannot be underestimated.

Nightingale Associates’ Interior Design Lead, Elizabeth Petrovitch, said: “The children’s departments feature high in the priority art areas as the effect of artwork and bright colour themes upon children’s recovery cannot be underestimated.”

Freelance arts consultant, Emma Larkinson, has been employed by the Trust. She has helped put together a longlist of artists. She is also a member of the arts steering group including Trust representatives, Nightingale Associates, contractor representatives and user groups members. But it wasn’t as simple as picking the best three artists by a demographic vote; other factors had to be considered.

“There are always challenges for artists working in public contexts,” says Emma, “Within healthcare there are limitations that come with restricted use of materials.  In addition there are often strongly held identities for wards and groups of staff and patients, which means there is often a directional design brief. The best artists are those that are able to identify the opportunity for a creative response that results in a unique environment that people can relate to.’

The art needed to respond to the building’s natural lighting and design features. It needed to be engaging, potentially educational, flexible and able to respond to different environments within the hospital – as well as meeting the relevant technical specifications and infection control methods.

The new hospital offers new facilities but also a refreshed visual language for the healthcare environment.  Wayfinding and orientation are a key area of the patient experience and this has been addressed by the wayfinding and interior design strategy.  A positive contribution to a locally relevant design language has been made by Nightingale Associates in their design of wayfinding symbols.

Wayfinding symbols designed by Nightingale Associates.

Not only do these art projects contribute to the patient experience, they have also provided the opportunity for staff to engage with arts practitioners in order to express and explore key areas of interest through art commissions – resulting in more unique work environments. 

Wayfinding symbols designed by Nightingale Associates reflect buildings of local importance.

While visual arts form the backbone of the arts strategy, the new hospital’s relationship with the community it serves through the building’s art and other activities has been explored.  Students from a local school  are creating paintings for particularly areas, temporary exhibitions and installations will be incorporated through partnerships with the local museum and art gallery and even hospital staff are creating artwork for the staff spaces.

There will also be a local photography competition based around wayfinding themes and an arts film by Richard Mullane at ‘Living Projects’  using local landscapes and communities. 

“A well considered piece of art can instill feelings of hope, comfort, reflection and joy. It is a window out of the highly functional world of the hospital, a break from the thoughts and feelings associated with a hospital visit,” adds Elizabeth.

The art is planned to be installed by the end of the year but the art programme will continue through the Trust after the handover in Autumn.

From the top, images show Nightingale ’s Matthias Peretz, Elizabeth Petrovitch and Emma White discussing the project. Stills taken from the planning film by Living Projects; Dan Savage’s artwork; Linda Schwab’s artwork; wayfinding symbols designed by Nightingale Associates 

How can building design improve dementia care provisions?

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It causes changes in mood, judgement, personality, and makes it difficult to communicate or cope with day to day tasks. And it usually gets worse over time. By 2020, it is estimated over a million of us will suffer from such symptoms – caused by dementia.  

Dementia can start as early as 40. With about one in every 20 people over-65 suffering from it, by the age of 80 about one in five are affected. Yet care provisions and older adult facilities have been identified in the Draft of the Health Building Notes as largely unfit for purpose. Clearly, building design must respond to the demand for quality dementia provisions and care facilities.  

Can Gerry Robinson Fix Dementia Care Homes? - asked BBC One recently.

Care and treatment for sufferers of dementia should be at the heart of the general election campaign, the Alzheimer’s Society charity told the BBC. As the press continues to reveal the flaws in elderly care – specifically in relation to dementia care – how is building design working to improve provisions and facilitate a better healthcare service for older people? 

Building Better Healthcare Awards 2009: Winners announced

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Nightingale Associates scooped the Patient Environment Class Award for Best Interior Design of the Centre of Neuromuscular Diseases at UCLH at this year’s Building Better Healthcare (BBH) Awards.

The annual BBH Awards celebrate excellence, innovation and professionalism in the healthcare built environment, looking specifically at building design, the patient environment, people, products and estates and facilities management.

The winning project, the Centre for Neuromuscular Diseases at UCLH, was extensively refurbished earlier this year to provide a stimulating and modern environment in which to conduct specialist scientific research. The centre, which is located in an early twentieth-century central London building, has a ‘contemporary fitting in the classical shell’ design theme, displaying a unique mix of modern architectural design concepts with many carefully-restored original features.

Sensory design in schools | Primary Capital Action Conference 2009

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Oranges were given out at the Primary Capital Action 09 event to demonstrate the power of the senses. Image used courtesy of OrangeSmell via Flickr CC.

We know that children are best prepared to learn when they are active and alert. The challenge for teachers and designers is to create school environments that enhance this emotional and intellectual receptiveness. While a new building may offer the opportunity to design up-to-date learning environments, this is not always an option; the Government’s cash injection of £3bn will not help all the UK’s primary schools. So how do you transform life-expired buildings into inspiring spaces on modest budgets?

The recent Cambridge Primary Review final report has suggested that school building design should provide better facilities for specialist teaching, outdoor learning and libraries. But there are other ways of revolutionising primary school learning through building design. At this year’s Primary Capital Action event, Nightingale Associates took centre stage to explain the theory of sensory learning and introduce a potentially ground-breaking primary school experiment.

100% Design: Contemporary Interiors and Architectural Event

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Nightingale Associates popped down to this year’s 100% Design event at Earl’s Court to learn more about the latest innovations on display. Here are some of the exhibitors who caught our attention:

Perception of Colour

Artists, Rob and Nicky Carter, are investigating the public’s perception of colour by inviting exhibition visitors to choose the shade they believe to represent the seven different colours.

2700 Pantone swatches have been laid out for 1000 members of the public to select colours from the whole Pantone range that, in their mind, best represent the seven spectral colours: Pink, Red, Orange, Yellow, Green, Blue and Purple.

Exhibition visitors had to choose one shade from the swatches and write its Pantone number on a questionnaire.

The questionnaire answers were then stuck onto seven large wall mounted sheets of aluminium, creating seven large monochromes to evolve over the course of the exhibition. Rob and Nicky Carter said they were unsure about what shape the final artworks would take but were already excited about the results. Particularly about the fact that the red monochrome contained a couple of blues! The perception of colour was clearly differing greatly from person to person.