Case Study – Meaningful public participation

The new Children’s Unit at Salisbury District Hospital replaced buildings dating back to World War II. Outpatient, Inpatient, Day Assessment and Therapy services moved into a refurbished two storey section of the main SDH North hospital building in July 2011. In order to lift the Unit environment from acceptable to exceptional, the refurbishment included art commissions funded through the Stars Appeal Caring 4 Kids campaign. Many local people and businesses worked hard to raise the donations to create a state of the art Unit that is child and family friendly.

An essential part of the design process was to connect with children, staff and the public to get a better understanding of what was needed for this Unit. Following the initial online survey in June 2008, the steering group and artists, led by ArtCare, committed to putting meaningful public participation at the core of the design process. The steering group, governing the commission’s process included staff, parent and patient representatives. This ensured the balance of quality design and practicality to create an environment that is both functional and fabulous.

Themes based on the natural environment were chosen to help reduce the clinical atmosphere of a hospital building and were agreed by public vote. For Level 3, Outpatients and Therapy departments, the theme is ‘Waterworld’ and for Level 4, Inpatients and Day Assessment Unit, the theme is ‘Treetops’. The art commissions were an integral part of the overall interior scheme from the outset, ensuring the chosen themes were fully incorporated into the design of the Unit. The result is an innovative, robust and quality environment with focal points that distract and delight patients, families and staff.

Throughout the design process, ArtCare delivered creative workshops with 1100+ children to source inspiration for the new Children’s Unit. Ideas and artworks from this workshop programme were used directly in finished installations such as printed Digiclad™ panels (unique wall cladding) in consulting rooms and bedrooms, and indirectly as research materials for commissioned artists. The artists themselves also worked with children during their design process.

The teen waiting room was co-designed by local teenagers who took over an empty shop to build a full-scale model from cardboard of their ideal waiting area. Boex, the designers, then used their model to create the final design for the space. School pupils prepared reclaimed pallets to created the ‘wooden’ Digiclad™ beach huts along the main Outpatients corridor. Over two years, photography AS level students at Burgate Sixth Form Centre worked on a ‘live’ brief to produce images for use in the Unit. Their photos enliven Inpatient’s corridors, are sampled in the bedroom panels and even the bedside TV is customised with their images as backgrounds.

I love this room because I helped design it!

The engagement in meaningful public participation built on links between the hospital and the local community. Children learnt new skills and more about the life of the hospital, that it’s not just a place to get well. The creative workshops were mutually beneficial, integrating with the national curriculum and school topics. Public participation meant children, parents, staff and the public being really involved – literally making their mark. The result is a new Unit with a unique identity, which is child and family friendly. Playfulness is present throughout, from flooring and seating to lighting and ceiling tiles, creating a distraction and interaction whether in therapy, treatment or as an inpatient. In short, the new Children’s Unit was designed with children for children.

More about the artworks

Fish tank

Starfish bench

Playdeck glass

Download ‘Waterworld and treetops’ (pdf) – ArtCare’s colourful project record that reveals more about the artworks in the Children’s Unit and the participation of local children in the design process.

The Benson Care Suite, a dedicated maternity bereavement suite, was officially opened in April by Sir Christopher and Lady Benson, who funded the suite with a generous donation to the Stars Appeal.

Maternity staff are able to provide mothers with one to one care, away from distractions, and to offer the time and support parents need to start the grieving process. Families have the chance to make the short time they have with their babies as personal and special as possible.

ArtCare’s Penny Robbins, who designed the decor for the new suite using feedback from parents and staff said, “The themes and colours were carefully chosen to create a sensitive environment that is private, calm and comfortable. The photographic images of nature in the rooms allow peaceful reflection and poems, printed on acrylic panels in the corridor, give expression to some of the difficult emotions felt by families at this time.”

Parents using the Neonatal Unit can stay close to their babies in extended and refurbished accommodation. Funded by the hospital’s Stars Appeal the Joan Stainer Family Accommodation Unit comprises of four en-suite double bedrooms, a playroom, lounge, kitchen, quiet room and multi-purpose education room.

Parents and staff working with ArtCare’s Penny Robbins chose the colours for the unit and themes for the artworks. In the parent’s words they wanted the new unit to be ‘welcoming, calming, friendly and relaxing’ and so each of the bedrooms is furnished with solid oak furniture and has a large panoramic landscape image on one wall. The rooms are designed to feel as homely as possible – all have an en-suite shower and different types of lighting. The playroom has been designed with the needs of siblings in mind and has a range of toys and books and a games kiosk. The parent’s lounge provides a calmer space for relaxing. Both of these rooms lead onto a decked area and adjoining garden. These spaces give families time together to bond and support each other.

The blossom and butterfly silhouette design on the window of the quiet room provides a focal point on entering the new unit as well as privacy for users of the room. The design is also repeated windows and door signs throughout the parent accommodation creating a sense of identity for the unit.

Case study – Dementia friendly environment

‘Oh my goodness, it’s amazing!’ were the words of the first two patients to be admitted to the refurbished Redlynch Ward early in 2014. Other recurring words used by patients to describe the new environment, which was the first at Salisbury District Hospital to integrate dementia friendly features, were just as positive – ‘spacious’, ‘cheerful’, ‘colourful’ and ‘wow’.

The refurbished ward balances imagination with a practical understanding of the demands of a busy working environment. Colour schemes, furniture, fixtures, flooring, lighting, storage, art and signage work in harmony and were designed to solve practical issues, support staff in providing care and contribute to all patients’ well being, not only those with dementia.

The project team included Redlynch Ward staff, the hospital’s Estates team, Medical Device Management Services, Infection Control, Housekeeping and the architect, together with ArtCare’s Lesley Meaker. The project team realised the designs by building on the latest evidence and best practice, for example the King’s Fund ‘Enhancing the Healing Environment’ Dementia Care programme and listening to the needs of patients and staff. The team recognised that clutter can add to a patient’s confusion and an unwelcoming environment can increase levels of anxiety, whereas space away from the bedside for patients to eat, relax or meet with relatives can encourage socialising, and so alleviate some of their distress.

The improvements to Redlynch ward included bathrooms with accessible wet rooms; creating a social space for use by patients and visitors; high contrast colours used between walls, furniture and handrails with toilet doors all painted blue to improve orientation for patients; doors to staff only areas painted the same colour as the wall to discourage patients from entering these areas by mistake; plain, less clinical looking flooring to create a more homely space; the use of accent colour, themed artworks and signage making it easier for patients to find their way back to the correct bay and creating points of focus whilst in bed; acoustic ceiling tiles to aid noise reduction; adjustable standard and mood lighting allowing patients more control over their environment; a dedicated quiet room for relatives that is welcoming, a smaller reception desk and portable workstations meaning staff are near to patients when writing up their notes which provides them with a reassuring presence.

ArtCare’s Lesley Meaker said, “We really listened to what staff had to say about the running of the ward before we came up with the designs. There were many creative challenges along the way. Some of them are clearly visible in the photos taken before the ward was refurbished. One issue was patients gathering around the nurse base, which led us to create the social space. Another smaller problem was some non-movable sockets that were integrated into a piece of artwork – disguised as vintage radios. I think by looking at the needs of patients with dementia alongside those without we have created a distinctive ward environment that staff feel proud of.”

Funding for this project came from the Department of Health and the hospital’s Charitable Trustees. Pitton Ward was also similarly refurbished as Phase II of the project.

ArtCare helped design the new Radnor Ward environment, working closely in consultation with staff and patient representatives. The new ward needed to be a calm and professional environment that reflected the level of care patients receive, whilst reassuring families and carers who visit the most unwell patients at Salisbury.

Lesley Meaker from ArtCare said, “We had to be more creative with space, light and colour in the design of the ward area. Patients need to feel safe and free from too much visual stimulation, such as clutter or busy artworks that could potentially have a negative effect causing hallucinations. Together with staff we chose to keep patient areas light, airy and spacious with use of spring colours in paint and wall finishes.” Wards have been decorated with the latest anti-bacterial paint and floor finishes, whilst four new side rooms have specialist anti-bacterial wall cladding that is hard wearing, easy to clean and low maintenance for patients being cared for in isolation.

Relatives visiting Intensive Care patients also needed extra space and they now have a refurbished quiet room, which is a more contemplative space allowing relatives to take time away from the bedside. It can also be used for private consultation with staff. There is a separate family room with social area and kitchen facilities.

The most striking change in the area is the welcome in the ward entrance corridor and communal spaces, which have large scale photographic artworks by Martin Cook. Martin is not only a staff member working on the unit as Consultant Anaesthetist but also a talented photographer who captures local landscapes around Odstock and Coombe Bisset valley.

ArtCare’s Penny Calvert supported the Mowat Labs, at King’s College Hospital, with creating a bright, modern interior for their new International Learning Hub. The design brief was clear-cut – the environment needed to reflect the excellence, expertise and world leading research that has developed there over decades, and create a sense of flow between the paediatric ward, labs and the new learning hub, so highlighting the team’s “bench-to-bedside” approach to research work. The finished design seamlessly blends printed Altro Digiclad™ wall panels with bespoke artworks, signage and a matching colour scheme to create a vibrant and distinctive environment.

*Professor Alex Mowat was the UK’s first paediatric Hepatologist.

Penny said, “The abstract designs were based on the medical images used in the diagnosis and assessment of liver disease in children, which the Labs specialise in. Other panels incorporate the Mowat logo, in recognition of the Labs founder* and there is also a timeline marking key developments in the history of Paediatric liver research and the birth of the Mowat Labs.”

The waiting area and entrance to GP Spinal X-ray was transformed to provide a fresh, welcoming environment for the many patients who come through the department each year. Simon Clarke, Lead Radiographer said, “Our GP & Spinal department was drab and tired, with mismatched old chairs, poor patient information, limited signage and no visual identity. The support and funding from The League of Friends was vital in enabling us to make much needed improvements to our department. Following the successful bid, we worked closely with ArtCare who have completed an amazing transformation.”

New furniture, forest-themed artworks, coloured ceiling tiles and bright, clear signage has created a unique identity for the department. Simon added, “We can now provide a welcoming environment to match the high clinical service we supply. It’s also had a very positive effect on staff, as well as patients, who are now saying – it looks amazing!”

Waiting area before refurbishment

GP Spinal X-ray before refurbishment