“The appreciation of art and the response to art is heavily based on human perception,” said Upali Nanda, who is principal and director of research for the architecture firm HKS, Inc. and a professor of architecture at the University of Michigan.

Art, she says, can be used for making a space memorable, for positive distraction, for inspiring awe, and for wayfinding—knowing where you are in a building or an environment, where your destination is, and how to get there.

To determine how art might be best used in a healthcare setting, Nanda and her colleagues have drawn on a concept developed by Austrian art historian Alois Riegl at the turn of the 20th century called “viewer’s share.” Riegl recognized that a work of art is incomplete without the perceptual and emotional involvement of the viewer. In a museum, Nanda said, we are cognitively much more prepared to do our share of the beholder’s work. We may even be disappointed if the art we encounter in that context doesn’t challenge us.

In hospitals, however, patients are in varying levels of vulnerability. According to recent research, familiar and non-threatening images of nature tend to be the most calming. But it’s not one size fits all, Nanda said. “Anchor yourself in the human perception.” Think of who is receiving the art and what their experiences might be.

 

“Our intention is to offer patients and their families a place of respite and a place of beauty where they can feel hope in uncertainty,” said Chrys Yates, program director of the Center for Humanities in Medicine at the Mayo Clinic in Jacksonville, Florida.

Viewing artwork provides a “meaningful distraction,” according to Bruce Scherting, director of Project Art at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. It allows people to explore their environment, make discoveries, and spend time focusing on things that are not directly connected to their medical care, he said.

One patient described to Scherting how, during medical treatments, she and her husband would walk the Iowa Hospitals’s corridors visiting favorite pieces of art. It was sort of like coming to the hospital to “visit old friends,” they told him.

Joanne Cohen, the Cleveland Clinic Art Program’s executive director and curator, said its art collection is a resource for the community. “We treat some of the sickest, most acute patients from all over the world,” she said. “We are just trying to come up with ways to ameliorate their experience.”

Helping patients and caregivers navigate Cleveland Clinic’s buildings—some 38 million square feet of space—is another practical purpose for visual art in hospitals, said Cohen, echoing Nanda. Those who may be stressed or late for an appointment use pieces of art as landmarks to find their way around the buildings.

 

Hospitals often acquire art through a combination of philanthropic giving and percent-for-art laws, like the one on the books in New York City, which requires eligible city-funded construction projects to spend one percent of their budgets on public artwork. Unlike other public buildings, hospitals are built with a mission to serve patients, and as a result of their commitment to patient care, how hospitals’ arts programs care for their collections also differs from other public organizations, such as museums.

“As a hospital, our standards are probably more akin to a lot of corporate art collections,” said Cohen. While she and her staff see themselves as stewards of the art, they don’t have the same flexibility as a museum, where works can be rotated to allow for regular conservation. With millions of square feet of wall space to fill, “our goal is to have all our art on view,” she said.

Iowa’s Scherting concurred with Cohen: “We don’t have control of the environment like a museum has control of their environment.”

Scherting sees hospitals’ art collections as working collections. “It’s out there working every day,” he said. Compared to what he experienced working in museums, the conservation issues faced by art in hospitals can be difficult for him to wrap his head around, he said. “But I have to appreciate the role that the work is playing in this particular environment.”

For others, though, the particulars of the hospital environment pose risks to the artworks displayed there.

“If you look at it from a conservation point of view, it’s really problematic because you’re putting them into an environment that is just not good for art in so many ways,” said Margaret Holben Ellis, president of the American Institute for Conservation in Washington, D.C. “For me, going into a hospital and seeing a work of art that has conservation problems is like seeing a sick patient.”

Given that so many pieces of art in hospitals have become culturally significant, the topic needs careful unpacking, she said. “I think conservators would welcome a dialogue to address this issue.”

Ellis added that the first step for any collecting institution is to establish collection-care policies that include taking a holistic view of environmental conditions such as temperature, humidity, transport, lighting, and air pollution. Insurance and other economic concerns should also be taken into account. Many pieces in hospitals’ collections have become more valuable over the years, which probably is a driving force when it comes to decision making, Ellis said. But conservators do not make value judgments about works of art, she added. “I think the hospital administration has to make a policy decision about those works.”

Dang said she is working with members of NYC Health + Hospitals’s art advisory council—a group that includes medical staff, hospital administrators, and community members—to determine which pieces ought to be sold, placed in storage, or conserved. Her priority is to raise funds to conserve and maintain her hospitals’s art collection. She is also focused on implementing the audio tours, which will provide opportunities for patients and staff to slow down and reduce their stress levels.

She added: “Artwork actually helps bring the humanity back into the hospital.”