Using The Arts to Reduce Disorientation, Anxiety, Aggression, & Violence at St Thomas’ New Emergency Dept.

Violence and aggression costs the NHS £69m a year – much of which is concentrated in Emergency depts. This paper describes the implementation of a refurbishment project at the new Emergency dept. at St Thomas’ Hospital that blends illustration, interior design, animation, and documentary film to bring a greater sense of orientation and calm, thereby reducing aggressive and violent behaviours – all for a small fraction of the build cost.

Methodology and Results

After conducting an environmental psychological study the research team spent 2 weeks on site, observing and speaking to users, building up a full 24hr picture of the service. Workshops and feedback sessions were held with staff, patients, leading first to strategic principles, and then to design prototypes.

The project incorporates 4 features that improve on the predecessor service:

i) Colour and illustrative wayfinding: each department has been given a distinct visual identity in the form of a colour and set of illustrations of the surrounding locality (eg. landmarks, weather, river-boats, buildings). Printed large-format to signal department areas and entrances clearly, these help to transform a complex, non-linear journey into a stimulating and intuitive experience, thereby improving patient flow.

ii) Strategically placed bodies of text, which inform patients at the point of need – written in collaboration with communications experts and frontline staff in improved, jargon-free language.

iii) A documentary film – “Explaining Emergency”, featuring informative graphics and interviews with staff, who discuss treatments, waiting times, the patient journey. This plays in waiting areas, helping to address the often unanswered questions on patients’ minds – eg. “why is that person being seen first”?

iv) A “Moving Image” piece, which plays in all waiting areas & relatives rooms, featuring Westminster Bridge, brought to life through a captivating assemblage of animated boats, landmarks, cars, clouds, reflections, people, birds and more. All elements in the animation are controlled by meteorological data (temperature, tide, weather, sun position). This artwork therefore paints a portrait of the surrounding area as it is “right now”, providing a (cost-effective) way to watch the splendor and peacefulness of the Thames from the waiting room chair.