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The Challenge
The early days of the COVID-19 pandemic brought unprecedented challenges for hospitals across the nation. Like their peers across the country, leaders at the University of Maryland St. Joseph Medical Center immediately began brainstorming ways to improve the patient experience under such unique circumstances.
Among the ideas that surfaced, art activities were considered. A review of current literature showed that art and the creation of art could be helpful for reducing anxiety, managing pain, and improving emotional wellbeing. As the hospital did not have a licensed art therapist to guide an art program as an alternative therapy, it was decided that a recreational art program for distraction and enjoyment would be the best approach.
Artist Spotlight
Artist Tracie Kiernan, the owner of stepbysteppainting.net, was one of the content producers invited to participate in the initiative. She was excited to create and share a collection of videos for this program.
Ms. Kiernan knew from personal experience how meaningful art activities could be for patients, as she had recently shared painting lessons with a family member that had been terminally ill. “It brought him so much joy,” states Ms. Kiernan. “He said it was a wonderful distraction from everything going on. He painted a lot during his last few months, and his paintings now bring comfort and joy to his family.” Another artist who provided content shared that “I have suffered depression/anxiety myself and art continues to help. I hope it brings joy to patients, the way it does for me.”
The content contributors made helpful recommendations for the painting supplies needed. With an intial investment of $100, Ms. Chahanovich’s team purchased art supplies including paints, brushes, palettes, and canvases. They packaged them into individual kits, labeling them with instructions for accessing the appropriate video tutorial on-demand through the Tigr system. The kits were stocked on a rolling cart, which became known as the HeART cart.
To kick off the initiative, Mr. Nasir began making daily visits on the Cardiac Surgery floor, selected as the pilot location for its larger patient population and longer length of stay. Mr. Nasir spoke with unit staff each day to identify patients who were appropriate for participating in a painting activity. He would round on those patients in the morning to invite them to participate, then return later in the day with the HeART cart. Once each patient had their materials and workspace ready for painting, a tutorial video would play at a scheduled time through the Tigr system. Mr. Nasir would round again upon completion of the video for cleanup and collection of materials, followed by a short interview with each patient about the experience.
The positive impact of the painting activity was observed immediately. Feedback from patients was overwhelmingly favorable, with growing enthusiasm from staff to match. “It didn’t take long before nurses on the unit would get excited to see him approaching with the HeART cart and would have referrals ready for him,” says Ms. Chahanovich.
Ellen Sheridan, MS, MEd, RN, Program Coordinator for the LAUNCH Residency, Mentorship and Clinical Nurse Internship at St. Joseph’s Medical Center, was pleased to see how warmly nurses embraced the initiative. “Volunteers did all the work, so there was nothing extra asked of nurses,” she explains. “When they saw how much of a difference it made for their patients, it was a no brainer.”
The team continued to assess the impact of the program through patient surveys and video viewing data from the Tigr system. While on-demand views of the art tutorial videos increased after the hospital-wide rollout, utilization was not the key measure of success. “We understood that even if only 10% of patients wanted to participate, it would still make a difference to that small group,” states Ms. Chahanovich.
More lessons unfolded as the program reached patients in other units. The team discovered a few common barriers to participation in art activities and came up with creative solutions to address them.
Early in the rollout, lower engagement was noted among patients who were waiting to be pulled from the room for procedures or tests, or who anticipated a shorter length of stay. In response, the team increased the flexibility of the program by adding colored pencils to allow participants to decorate a card for a loved one. Other patients would decline because of their emotional state or fatigue but still gained an awareness of the program so they could request to participate when they felt better.
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As demand for the program grew, St. Joseph’s Medical Center applied for a grant from the Beryl Foundation and received funding for more art supplies and enhancements of the HeART Cart. Ms. Chahanovich and her team revised the scripting to present the painting activities in a clear manner, emphasizing positive feedback from patients who had previously participated. They trained additional volunteers, who also began showing paintings completed by other patients as examples of how a finished work might look. Seeing the paintings served to create excitement among patients and for many, gave them the boost of confidence that they too could be artists too.
More than three years after COVID-19 arrived in the United States, hospital operations have largely returned to normal following the end of the public health emergency declaration. Still, many of the innovations and creative approaches developed to support positive patient experiences during the pandemic have remained in place. The Painting with Patients program at St. Joseph’s Medical Center is one such program that endures beyond the lifting of pandemic restrictions, with continued support from the hospital’s Client Outcomes Manager at Avidex. “She’s been such a great partner in guiding us toward where we needed to go with this project,” says Ms. Sheridan.
“As we continue sharing art activities with patients, we discover new ways to measure success,” states Ms. Chahanovich. “For instance, we tell patients that they can keep their finished paintings, or if they’d prefer, they can donate them back to the hospital to be displayed in common areas. Over time, more and more patients have opted to take their paintings home. One of the most profound statements we hear from patients is that painting ‘made me forget that I was in the hospital.’ But when a painting goes home with a patient, it tells me they created a positive memory during their time in our care. We gave them a patient experience they don’t want to forget.”
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