In Florence Nightingale’s Notes on Nursing, she pointed out that beauty, sunlight, color, and noise can affect healing. Over 150 years later, research supports her claims. An article in the Journal of Burn Care Rehabilitation showed that murals decreased the intensity of pain and anxiety in burn patients. And research from the University of California at Davis showed that highly stressed patients awaiting surgery on gurneys had lower blood pressure when calm nature scenes were affixed to the ceiling.

Today, every wall should be seen as another opportunity to direct a patient’s attention to something uplifting or engaging. While research has sussed out some best practices, art—whether painted or hung—should be specifically tailored to the health of the community it serves. The following criteria will help you figure out what’s right for your clinic:

The artwork should be appealing—enough to hold a patient’s attention for more than a passing glance. Bonus: Actual engagement.

Each piece of art should appeal to the community it serves. Ex: For a children’s hospital, a magic eye puzzle, labyrinth on the floor, or illustrated history of the facility will draw the attention of both patients and their families.

Nature scenes have been shown to reduce stress by lowering blood pressure, heart rate, muscle tension, and electrical activity in the brain in less than five minutes. According to a study by Roger Ulrich, a professor of architecture at the center for healthcare building research at Chalmers University of Technology in Sweden, the best nature images show “calm or slowly moving water, verdant foliage, flowers, foreground spatial openness, park-like or Savannah-like properties (scattered trees, grassy undershot), and birds or other unthreatening wildlife.”

Art should promote a sense of calm or enjoyment. Abstract art in medical environments has been show to draw negative reactions from already stressed patients.

By installing iPad stations in public areas, clinics and hospitals can offer patients and their families some enjoyment while they wait for a health care provider. Using the Apple Store as inspiration, the Children’s Hospital of Pittsburgh set up a series of tables at different heights adorned with iPads for visitors. iPads have a cross-generational appeal, and at the Children’s Hospital of Pittsburgh, they’re always full.

1. If your clinic has visitors of all ages, set up tables of different heights—some that cater to children and others designed for adults.
2. Secure the iPad and mount it to the table with solid steel construction and welds.
3. Take safety precautions. Make sure all wiring is internal and not accessible by guests. Disable the Internet to avoid unwanted images or inappropriate behavior.
4. Load entertaining content appropriate for the clinic’s visitors.

In most waiting rooms, chairs are arranged side by side along walls or in tight rows like on an airplane. Especially in hospitals, this configuration inhibits interaction in a space where family and friends typically congregate.

Where do we relax after a long day of work? In the living room. Switch out office furniture and generic decorations with adornments that would be pleasing and comfortable for the clinic’s clientele.

Research has shown that postoperative patients with a window overlooking a park complained less, didn’t need as much pain medication, and were discharged earlier than patients with windows with a view of a brick wall.

Patients turn to their phones as a distraction or as a way to stay connected. Access has become increasingly important. Offering charging stations in public areas allows patients to stay connected without having to hunt around for a plug.

Exam room furnishings should bridge the gap between patient and provider, not reinforce it. A 2009 study showed that patients got a better view of their medical record when they sat at a semi-circle table with their physician, equidistant from the computer screen displaying their electronic medical record.

Using a silent paging system similar to the ones used in big chain restaurants (think: Cheesecake Factory), clinics and hospitals can give patients the option of leaving until the care provider is ready to see them.

1. Check the patient in.
2. If the wait is over 5 minutes, give the patient an estimate of the wait time and hand them a pager. The patient is free to grab a coffee, take a walk, or sit somewhere else.
3. When a care provider is ready, the patient is paged and the visit begins.

When seating is flexible and movement is encouraged, patients and providers can tailor the waiting room, exam room, or patient room to support better communication.

In some cases, overnight hospital stays mean overnight guests, too. Instead of making the experience uncomfortable for visitors by relegating them to a hard chair, offer guests a comfortable sleeping space within patient rooms. More sleep for everyone at night can reduce anxiety during the day.

When patients have their own rooms during hospital stays, as opposed to sharing a room with other patients, they routinely report better communication with nurses and physicians—not to mention more privacy and a more positive outlook on their hospital experience.

In patient rooms where family members will be present, evidence-based design guidelines recommend a clear floor area the allows 30 square feet per family member. These rooms should be outfitted with comfortable furnishings that strive for a home-like atmosphere.

Roger Ulrich, a professor of architecture at the center for healthcare building research at Chalmers University of Technology in Sweden has found that patients need pain medication almost 25 percent less often when exposed to morning sunshine. In another study, students exposed to greenery—even graphically represented—were less stressed during standardized tests.

In a report from the Center for Health Design, Roger Ulrich, a professor of architecture at the center for healthcare building research at Chalmers University of Technology in Sweden, found that the number and positioning of signs in hospitals is important. Patients and visitors navigate the hospital faster, are less hesitant, ask for directions less often, and report lower levels of stress when there are more directional signs present. The study’s recommendation: “directional signs should be placed at or before every major intersection, at major destinations, and where a single environmental cue or a series of such cues (e.g. change in flooring material) convey the message that the individual is moving from one area into another. If there are no key decision points along a route, signs should be placed approximately every 150 feet to 250 feet.”

Hospitals and clinics are packed with hulking equipment, run through with cords, littered with stand-alone medical devices, and plastered with signage and other notices. It’s a lot of visual distraction for patients trying to keep their anxiety in check. At the Children’s Hospital of Pittsburgh, all the signage is electronic, and nothing informational is posted on the walls in order to achieve a clean and organized environment.

1. Start by clearing hallways, exam rooms, and patient rooms of all the equipment that doesn’t need to be displayed.
2. Clear the walls of paper notices and needlessly layered signage.
3. Make sure wayfinding signs are displayed often and are consistent in style and message.

When patients and families have a hard time navigating their way around a clinic or hospital, it costs the facility money. A study from 1990 looked at how many hours it costs a hospital to just get visitors where they needed to go. The answer was 4,500. That’s two full time jobs-worth of staff hours spent by employees not stationed at the information. Moreover, when signs aren’t clear, it can increase stress in patients and visitors.

• Wayfinding should be an integrated system made up of several coordinated elements: signs and numbers should be clear and easy to see; verbal directions should be clear and consistent; mailed, printed, and electronic information needs to be consistent and easily understood.
• When wayfinding is appropriately integrated, it includes the following four components: administrative and procedural levels, external building cues, local information, global structure. 

Studies have shown that an abundance of bright light, both natural and artificial, has significant benefits for patients. Lots of light during the day can improve circadian rhythms, depression, and agitation. Compared with patients in dimly lit rooms, patients exposed to lots of light are discharged faster.

Where do we relax after a long day of work? In the living room. Switch out office furniture and generic decorations with adornments that would be pleasing and comfortable for the clinic’s clientele.

Research has shown that postoperative patients with a window overlooking a park complained less, didn’t need as much pain medication, and were discharged earlier than patients with windows with a view of a brick wall.