St. Thomas’, Emergency Department (Adults)

Guy’s and St Thomas’ NHS Trust

Reducing Violence & Aggression

One of the biggest issues facing A&E departments in recent years is violence and aggression, coming from patients, directed at staff in the form of verbal of physical abuse. A major 2013 study by the design council identified that one of the major factors is poor information design, which leaves patients feeling confused, disorientated, and angry, eventually leading to aggressive behaviours.

Our art strategy for the new A&E aims to help patients navigate their way through a complex environment and set of procedures, making the patient experience less frustrating, and thereby reducing aggression towards staff.

User-friendly graphics

We created a set of graphics to make wayfinding intuitive and give each department and stage in the journey a sense of arrival.

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These illustrations demarcate the space according to icons and colours, printed on vibrant Trovex material.

A real-time animation

The graphics also feature in a colourful animation, which plays on screens in waiting areas and the relatives’ rooms. It shows a vista of Westminster Bridge that changes in real time according to the time, tide, weather and season. The St Thomas’ community has contributed short, zen-like quotes about their favourite times of day and night, which pop up to match the conditions in the animation.

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This also offers something that the typical Emergency distraction points (e.g. TVs, news papers) cannot: a mindful, meditative way to focus the mind in times of boredom, stress and anxiety, and an overall calming atmosphere across the Emergency Dept.

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Majors & Resuscitation

Further along the patient journey are two departments - majors, resuscitation – dealing with patients who are in a critical condition. The healing presence of art continues here in the form of large-scale portals demarcating the entrance to both departments.

Explaining Emergency film

More recently, we produced a documentary film – “Explaining Emergency” featuring informative graphics and interviews with staff, who explain treatment protocols, waiting times, the patient journey, and how the service operates overall. This plays in waiting areas, helping to address the key concerns on patients’ minds – “why is that person being seen first?” “where am I in the queue?” – thereby helping to calm worries and prevent irritation, anger, and violence. Showcasing the expertise and dedication of staff, and the daily challenges they face, this film encourages a mutual empathy between front line staff and patients.

2019 Lecture series

We’ve been busy sharing our experiences and insights in a lecture on the project. Enjoy this video of the lecture, which was delivered at the Royal College of Physicians, London, in June 2019, as part of the European Healthcare Design Congress 2019.

This artwork has been supported by Guy’s and St Thomas’ Charity, which helps create a world-class environment for patients, staff and visitors at Guy’s and St Thomas’ NHS Foundation Trust. Find out more at


“The bold design across the public and private areas has madea phenomenal difference to people‘s experience of A&E […] I am sure the artwork is responsible for the reduced violence and aggression we are seeing.”

- Dr Simon Eccles, Chief Clinical Information Officer for Health and Care

“The zoned colour scheme helps patients to orientate themselves within the department – and makes it easier for them to tell friends and relatives where they are.”

- Dr Katherine Henderson, Consultant, Adult’s Emergency

“The clarity of colours, consistency of design, and excellent information slices help staff and patients understand the different areas within the department.”

- Dr Katherine Henderson, Consultant, Adult’s Emergency

“Sitting waiting for news about a sick relative is a difficult experience and people do not want to read a paper or even chat. The calm moving image is really helping patients and relatives to focus on something more appropriately peaceful and neutral.”

- Dr Katherine Henderson

Date 2013 - 2019

Sector Healthcare

Service Hospital, Emergency Department (A&E)

Commissioned by Guy’s & St Thomas’ NHS Trust

Artists Art in Site, Vahram Muratyan

Users Adult patients

Awards Winner, German Design Awards 2020