"Designing for Health" is a monthly, web-exclusive series from healthcare interior  design leaders at Perkins+Will that focuses on the issues, trends, challenges, and research involved in crafting today's healing environments. This month's topic:

Maximizing the Impact of Art in Architecture

By Carolyn BaRoss

One may encounter this statement expressed in ordinary letters, mounted within a typical floor directory at The Standard hotel in downtown LA: "you are a victim of the rules you live by." This and other "truisms" by artist Jenny Holzer are installed on each floor. It's a memorable discovery of an unusual installation.

In evaluating art for the healthcare environment, evidence-based research demonstrates stress-reducing effects of certain positive distractions; mostly through access to nature. (Ulrich, 1991.) A small number of studies have also found that nature scenes in representational art are preferred by more patients over chaotic, abstract art. (Ulrich & Gilpin, 2003.)

Considering this research, can the "rules" be stretched when defining art programs for healthcare—without restrictions defined by conventional expectations for imagery or format—to lead to positive effects? Independent art curator Nancy Rosen states, "It's good to free ourselves from what's already been done and think more broadly about the potential role of art and artists."

One example may be a project under construction for The Johns Hopkins Hospital in Baltimore. Through a collaborative process for a new 1.6-million-sq.-ft. clinical building, the design team worked with artist, client, donor representatives and art curator to achieve an installation with transformative results: an ever-changing, polychromatic study of light and pattern in the façade that enlivens and defines the identities of the adult and children's towers. 

Because the original building concept had a polychromatic façade, Rosen thought to intertwine a commissioned work with the architectural form, and introduced artist Spencer Finch to the project. She states, "The institution and the architects were committed to the idea of using color on the building's façade. Working with Finch, this goal became an opportunity to think about light, color and reflection, and how these elements could become integral, rather than applied." 

 Finch drew inspiration from ideas found in Monet's paintings and the effects of reflected light on water. Color selection and refinement were developed through observations of the light on site, at different times of the day.  Rosen continues, "Spencer's concept also had to do with softening the character of the glass, which can often appear to be impenetrable and intimidating. The results have been almost a melting, or dissolving, achieved through a double layer of a hand-drawn frit pattern applied to building's curtain wall. Starting with an Impressionist landscape, Finch reinterpreted and reconsidered the role of color, light and reflection to transform the envelope of the building into something people would find accessible and beautiful."

The façade installation was achieved in collaboration with Perkins+Will architects Ralph Johnson, Jerry Johnson, Ed Witkowski, Hopkins facilities director Michael Iati, and consulting architect Allen Kolkowitz. Its implementation utilizes conventional construction technologies including custom frit patterned, low-iron glass, which is etched on each of two separate faces, and 4-sided structurally glazed curtain wall with shadow boxes to maximize the perception of depth. Curtain wall details include painted metal panels in 26 colors, installed behind the patterned glass veil. Mockups were used to test concepts and systems, and became informative to the design process.

Finch's work has a powerful presence. Through the course of the day, colors transition from silvery to intense; the frits become softly illuminated and their shadows play across surfaces inside. The effect influenced all disciplines including site, interiors, and lighting design.

Inspired by the art, Susan Weiler of The Olin Partnership designed landscape colors and textures to evolve with the seasons and move in the breezes. The entry plaza and gardens work at the pedestrian level and also when viewed from above.

Public spaces are organized around expansive views to the site. Sunny, light and modern, the adult tower lobby faces onto a meditative garden. From outside to in, materials and details work in concert with and support the art. Color palettes throughout feature accents of pure artist's color set against a light-reflective background. They were developed to complement and not mimic the artwork.

Regarding the process, Rosen explains, "With lots of different building types, including hospitals, the expectations can be cliché, what's been done. We were trying to bypass those and think about the role of art and artists. I hope what we are doing with this building is to elevate the experience about being a patient or visitor in the hospital. There is no formula. So much depends on chemistry and judgment of the teams and configurations that are collaborative in spirit, but not to say that other outcomes are disappointing. Successes of these collaborations depend on the individuals and opportunities they see for collaboration and working side by side with different disciplines. In my own experience, and I have lots of similar experiences, some architectural teams are open and not threatened, some can feel very proprietary. I am not passing judgment, but sometimes the final outcome is better than what any individual can do on their own."

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Carolyn BaRoss, LEED AP, is a principal at Perkins+Will and the healthcare interior design director and interior discipline leader for the New York office. With a specific focus on design in healthcare, she creates interior solutions that flow seamlessly with architectural concepts. She brings a highly collaborative approach, resulting in thoughtful, functional, aesthetic and humane environments. She is leading the interior design of the new clinical building at The Johns Hopkins Hospital. She can be reached at carolyn.baross@perkinswill.com.

Credits for this article and research information:
"The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity" Roger Ulrich*, Xiaobo Quan, Center for Health Systems and Design, College of Architecture, Texas A&M University.  Craig Zimring*, Ajali Joseph, Ruchi Choudhary, College of Architecture, Georgia Institute of Technology.

*co-principal investigators and corresponding authors.  Report to The Center for Health Design for the "Designing the 21st Century Hospital Project."



Past installments of "Designing for Health" are available here:

• The Benefits of Healthcare Learning Environments
• Making Hospitals More Hospitable for Children and Their Families
• A Seat at the Table
• Healthcare Facilities Want You to Take Notice
• A Prescription to go Paperless
• Peace and Quiet
• Research Informing Design
• Shifting Culture, Shifting Service Lines: Is Tiger Woods the New "Grandmother"?