Our work for Children’s Emergency (A&E) for Evelina London is the focus of a new article, written by Jo Makinowski in the July 2017 issue of Healthcare Design & Management magazine. Below is a transcription of the article, recreated with permission from HD&M magazine. 

The art of interior design

How art and interior design have helped to transform services at a London hospital

A rebuild of the paediatric emergency unit at the Evelina London Children’s Hospital showcases a new approach to art and interior design which is helping to demystify healthcare delivery for young people.

Working with consultants from Art In Site; the hospital ditched the traditional fantasy world usually created to act as a distraction for young people waiting for treatment.

Instead, they opted for a series of characters who appear in narratives aimed at guiding patients through the process and explaining the journey.

A fantasy world

Speaking to hdm, Art In Site’s Martin Jones explained: “Children do need to be distracted when they are in hospital, but usually people create a fantasy world – a jungle or a beach – where they can lose themselves.

“But, when we spoke to staff, we quickly moved away from those themes and agreed that superimposing them into another world was not the best solution.

“There’s something counterproductive about that as then they have the treatment and it is even more scary.”

John Criddle, a paediatric A&E doctor, was involved in the project and supported this new approach. 

He was involved in the design of the project, along with patients, their families, nursing staff and doctors and paediatric clinical psychologists.

He said: “I have worked in A&E for a long time and I know how stressful it can be for children and their families.

“When we got the opportunity to rebuild the department it gave us great potential for trying something new that would help to reduce stress.”

The hospital secured funding from the Guy’s and St Thomas’ Charity and set about creating an environment that would help with the delivery of healthcare, not just act as a distraction.

Explaining procedures

Criddle said: “A lot of what we do in the department is carrying out medical procedures, like manipulating joints, putting in drips, or administering medication.

“It is important to have a distraction so you can do this with minimum stress. But it is also very important that the young people know what is happening so they don’t feel scared and so the procedures can be carried out more easily.

“With this project we wanted to remove some of the fear and provide a narrative to what is happening.”

This is delivered through a gang of characters based on real-life children presenting to A&E with some of the most-common conditions and ailments seen among young people. 

They appear in narratives played out on the walls and in an interactive app.

The project was predicated on two major sources of knowledge – an ethnographic study, Reducing violence and aggression in A&E by the Design Council; and an environmental psychological study carried out by Art In Site associate, Dr Mercedes Freedman.

Children can play on the specially-designed app, provided on a tablet in the A&E waiting area. It enables them to indulge their curiosity about the environment and allay any anxieties about upcoming treatments. 

They can play games based on doctors’ lists of the top causes of coming to A&E, and how to avoid them; access advice on accident prevention and personal health; explore their surroundings in a virtual tour; meet doctors; learn about clinical equipment and clinical interactions through interactive narratives; and explore links to the wider healthcare context, for example services such as mental health and sexual health.

It also provides parents with notes on what to do next and clinicians with explanatory tools. One game, for example, visualises bones in the body, helping to explain to children where, why, and how breaks occur.

Shapes and colours 

Children and doctors feature in the app as friendly illustrations, based on real-life observations.

The characters, designed by Japanese artist, Kiriko Kubo, fully integrate with the environment - popping out from doorways, moving across walls, creeping onto ceilings above beds, manifesting as a large-scale window vinyl, and appearing on stickers handed out to children. 

They also function as wayfinding aids and provide friendly information via speech bubbles.

The rebuild included the creation of Bodypaint, an ambitious digital interactive installation at the entrance to the department, which facilitates play in a controlled and safe manner.

Projected onto a large wall, the piece uses dynamic colours and shapes, which move and transform in response to body movements, providing relief from anxiety in the form of exercise, stimulation, and distraction in a safe, controlled manner. 

Raising awareness 

And ‘info slices’ are used to inform children and their families in simple language what is happening at various points in the journey. 

The scheme has been designed using colours that blend in with the interior design of the main children’s hospital, helping to link the two buildings.

Criddle said: “Before the rebuild there used to be an old TV on the wall in the waiting room playing something no one was watching. 

“But I was standing there yesterday and, since the introduction of Bodypaint, the TV was switched to radio, playing chilled music, and a child was in front of the wall, moving around and dancing and creating this beautiful sequence of colours on the walls. 

“The whole waiting room seemed calmed by this.

“Traditional art projects are fun until the fantasy breaks and I am really pleased that we did not go down that route.

“This represents a much-more-mature approach to designing this type of environment.”

Jones added: “It is about making the children aware of their own bodies and what is happening.

“The characters are all lifelike and it has not been done in a Disney-esque way… We are really thrilled with the results.”

Credit: Jo Makinowski