Salus journal

Healthy Planet. Healthy People.

Healthcare / Arts and health

European Healthcare Design 2019

Using the arts to reduce anxiety, aggression, and violence at St Thomas’ new emergency department

By Louisa Williams, Martin Jones and Liz O'Sullivan 19 Aug 2019 0

This paper describes a refurbishment project at St Thomas’ Hospital’s new emergency department, which blends illustration, interior design, animation, and documentary film to bring a greater sense of orientation and calm, reducing aggressive and violent behaviours.

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After conducting an environmental psychological study, researchers spent two weeks on site, observing and speaking to users, building up a 24-hour picture of the service. Workshops and feedback sessions were held with staff and patients, leading to strategic principles and design prototypes. The project incorporates four features that improve on the predecessor service: 

  1. Each department has been given a distinct visual identity in the form of a colour and set of illustrations of the locality. Printed in large format to signal department areas and entrances clearly, these help transform a complex journey into a stimulating experience, thereby improving patient flow and creating a focal point for stressed patients/visitors.
  2. Strategically placed bodies of text, which inform patients at the point of need – written with communications experts and frontline staff in clear, jargon-free language. 
  3. A documentary film, Explaining emergency, features informative graphics and interviews with staff. This plays in waiting areas, helping address patients’ often unanswered questions – eg, “why is that person being seen first?” – thereby helping calm worries and promoting better understanding of service processes and staff roles. 
  4. Wayfinding illustrations also feature in a ‘moving image’ piece, which plays in waiting areas and relatives’ rooms. The installation brings Westminster Bridge to life through an assemblage of animated boats, landmarks, cars, clouds, reflections, people, birds and more. Patients and staff contributed more than 2000 lines of poetry, describing everyday encounters and events on the bridge, which appear on the screen in a constantly refreshing four-line stanza. All elements in the animation are controlled by meteorological data, painting a portrait of the surrounding area as it is “right now”.

Conclusions: According to staff, these interventions are contributing to a drop in aggressive and violent behaviours, less confusion for patients and relatives, and calmer moods.