The MetroHealth System

visual artprogram

"Constructing a New World" by Jacob Dahlgren, image from vitalarts.org.uk (front and back cover)Bridget Riley’s mural at St. Mary’s in London image from theguardian.com (current page)

Art in medicine is critical as it offers an opportunity for us receive what we all need - to connect as human beings. No matter what, we all need a connection and someone to care about us. Art reminds us of our humanity. – Dr. Akram Boutros,

President and Chief Executive Officer, The MetroHealth System

"Hanging Out Again" by Cornelia Baltes, image from vitalarts.org.uk (top)“Big Dipper” by Joby Williamson, image from vitalarts.org.uk (bottom)

table of contents

introduction1

purpose statement15

hope

healing

community

themes17

policies

art selection guidelines

integration - new facilities

integration - existing facilities

donation policy

framing and hardware recommendations

maintenance

22

8 processfeelings the artwork should inspire

artwork tone

11

12

18

19

20

24

26

32

38

40

42

"Herbal Medley" by Tord Boontje, image from vitalarts.org.uk

introduction

metrohealth visual art plan2

introduction

The MetroHealth System’s President and

CEO Dr. Akram Boutros has stated that

medicine alone doesn’t heal and that

arts are a part of the healing process;

contending that to provide care, you must

have art. This is a bold statement that is

exemplified in how MetroHealth operates. A

healthcare system in which staff meetings

are introduced with dancing to the tune

of Pharrell’s “Happy” song, MetroHealth

understands that while art supports healing,

it also supports so much more – such as

morale, creating a sense of unity, quality of

experience and a shared humanity. For all

people, sick or healthy, there is a universal

need for connection – which arts can build.

MetroHealth is undertaking a major

transformation of its main West 25th Street

campus and expanding and improving

neighborhood facilities. The transformation

aims to promote community engagement,

inclusion and diversity and create a healing

environment that supports a positive patient,

employee and family experience. The

inclusion of a well-managed Arts in Medicine

program helps to deliver on these goals.

installation in the dental ward of the Royal London Hospital

by Stephen Smith of Neasden Control Centre. image from

creativereview.co.uk

introduction 3

metrohealth visual art plan4

introduction

Art can connect a space with its surrounding

community and engage a diverse audience.

A successful Arts in Medicine program

creates environments and experiences that

benefit the patients, families, caregivers and

overall public health. MetroHealth realizes

visual, performing and therapeutic arts can

promote healing, wellness and engagement

among patients, families, caregivers and

the community. For the purposes of this

initiative, MetroHealth has focused its

attention to visual arts, but recognizes that

there are other opportunities to integrate the

arts through additional programs.

introduction 5

detail of temporary installation at the Cleveland Public Library's Eastman Reading Garden by Andréa Keys Connell.

image by LAND studio

"The World Seen" by Fiona Curran, image from vitalarts.org.uk

process

metrohealth visual art plan8

process

A component of MetroHealth’s Arts in

Medicine program, the visual arts program

underwent a process that developed both

the broader visioning and strategy for

the program as well as the policies and

processes that would support the vision.

Using the strategies outlined below,

MetroHealth built a mission and vision that

directly reflects the character, qualities and

aspirations of the heath care system.

precedent programs

As a basis to the development of a unique

visual arts program, MetroHealth examined

existing arts programs within other health

care systems, hotels, schools and public

spaces. Paying particular attention to

themes, message, mood, design and

experience, MetroHealth gained perspective

on values for its own health care system and

important criterion for its burgeoning visual

arts program.

interviews

It was important to MetroHealth that

different perspectives, departments and

ideals inform the development of its visual

arts program. To that end, staff including

the President and Chief Executive Officer,

Senior Vice President of External Affairs,

process 9

Image sources:"Hanging Out Again" by Cornelia Baltes, image from vitalarts.org.uk, (top)“Big Dipper” by Joby Williamson, image from vitalarts.org.uk, (bottom)Cleveland downtown and neighborhood images by LAND studio

metrohealth visual art plan10

process

Vice President of Ambulatory Operations

and Integration and Senior Vice President

of Campus Transformation were asked for

their feedback related to art program goals,

audience, branding, procurement, design,

funding and more.

survey

In an effort to more wholly engage health

care staff and stakeholders, surveys

were also administered to the health

care system’s Arts in Medicine Advisory

Committee, who responded to questions

related to arts program goals and the

feelings it should inspire. Committee

members, including internal stakeholders,

external stakeholders, employees,

community members and arts experts,

offered numerous words (see p.11) to suggest

what emotions the art program should aspire

to generate among health care system

patients, visitors and staff. Repeatedly,

words related to community, joy, hope, calm

and peace were suggested.

Additionally, survey participants suggested

that the artwork should present both a sense

of familiarity and exposure to new things,

encouraging the program to mindfully

balance both of those experiences.

process 11

CalmCommunity HopeJoy PeaceA welcoming atmosphere Trust CaringOptimism

Discussion Understanding Harmony Relief Flow StrengthEmpathy Escape Warmth

Happiness Inspiration Natural world Justice

Diversity Creativity Compassion Serenity

HealingWellness Positive Comfort Love

left page images: details from artwork selected for MetroHealth’s Westlake Campus. artists, from top to bottom: Brittany Graham (photograph), Ali Forbes (watercolor), Liz Maugans (mixed media)

committee feedback

FEELINGS THE ARTWORK SHOULD INSPIRE:

metrohealth visual art plan12

It was also recommended that the artwork

serve as a reflection of the viewer as well

as the community, creating spaces for

both individual reflection and togetherness.

To that end, future art curation should be

guided in great part by the space in which

it will live, as different spaces will require

different types of works or works that

support a certain feeling or set of feelings

(see p.13). For example, while a private exam

room should help to foster a sense of calm or

familiarity for a patient or doctor, members

of the health care system community who

are waiting in a lobby or working in a public

space might enjoy more stimulating or

fun artwork that enlivens the waiting area,

hallway or cafeteria.

committee feedback

Findings that arose from precedent

programs, interviews and surveys were next

discussed with the MetroHealth Aesthetics

Committee, who distilled the information

into ideals that would frame a purpose

statement, core themes and policies related

to acquisition and maintenance. The ensuing

document details these components of the

visual arts program.

process (continued)

Calming

Caring

Healing

Not sterile

Relaxation

Familiar

PRIVATE SPACE

committee feedback

ARTWORK TONE:

process 13

Caring

Comforting

Confident

Empathetic

Fun

Healing

Inviting

Joy

Warm

Not sterile

Stimulating

Unique

Community

PUBLIC SPACEPRIVATE SPACE

Hope

committee feedback

ARTWORK TONE:

"Animals!" by Chris Haughton, image from vitalarts.org.uk

purposestatement

The MetroHealth System’s visual art program will

inspire a transformative experience for every person

who engages with the health care system.

It will embody MetroHealth’s global diversity and

local focus and inspire a sense of hope, healing and

community.

"Imaginary Menagerie" by Miller Goodman, image from vitalarts.org.uk

themes

metrohealth visual art plan18

hope

MetroHealth patients, visitors and employees

will encounter artwork throughout the

facilities. Regardless of a person’s relation

to MetroHealth, hope is an important part of

the atmosphere. Patients and their visitors

may hope for recovery, for new life, for

peace and calm. Employees also hope for

these things for patients and may hope for

themselves that they continue to provide

excellent care in whatever role they serve the

healthcare system.

Hope can mean a variety of things to

different individuals. Artworks can feel

uplifting, positive, optimistic, dreamlike,

aspirational and promising. Content can

be bright and playful, engaging patients,

visitors and employees to consider the

possibilities of their lives outside of their stay

with MetroHealth.

themes 19

healing

A theme particularly relevant to patients,

art can be a refuge from intense emotions

that can accompany illness. Especially in

health care settings, where patients are

away from home and their personal support

network – sometimes for extended periods -

art is essential to creating an environment

that is welcoming, interesting and positive.

Medicine is only part of the healing process;

art is another vital component.

In application, healing is a theme that can be

manifested in a variety of ways. Like hope,

it can be found in relaxation and stepping

outside of one’s immediate surroundings to

contemplate other worlds and situations.

Healing can come from interaction and

engagement. Thus, artworks centered

on healing can range from subdued and

calm to interactive and fun, symbolizing

rejuvenation, growth and energy.

medaesthetics.

wordpress.com

images: (top left) LAND studio, (middle left) image from

domusweb.it, (bottom left) image from oonaculley.com,

(top right) image from nnbj.com, (middle right) image

from blog.chrishaughton.com, (bottom right) Catherine

Opie's photographs at the Cleveland Clinic. photo by

Neil Lantzy, image from pbs.org/art21

metrohealth visual art plan20

community

As the county health care system,

MetroHealth is invested in Cuyahoga

County and the communities surrounding its

locations. MetroHealth strives to be seen as

welcoming to all and as an integrated piece

of the community fabric. As a component of

this involvement in the community, art should

reflect the locale.

Artwork should reflect the communities

surrounding neighborhood MetroHealth

facilities, emphasizing what makes them

distinct. While artwork embodying this theme

can literally reflect Cuyahoga County

locations, it’s more critical that artwork

showcases the essence or spirit of the region.

Local artists are well equipped to highlight

these unique features as their perspectives

often focus on overlooked subjects.

Artwork can also create a sense of

community by offering an opportunity for us

to connect as human beings. International,

national, regional and local artists can

create new and different environments

where visitors can experience joy and

wonder together. A variety of subject matters

and mediums can be used to remind us of

our own humanity and connect us to each

other.

images by LAND studio

"Land-escapes", digital prints by Shahzia Sikander, image from vitalarts.org.uk

policies

metrohealth visual art plan24

art selection guidelines

The artwork itself should adhere to the

following parameters. More specific criteria

may be included as appropriate for

individual facilities.

theme and content

• The artwork adheres to an existing art

theme and/or broader art program

goals.

• The artwork is engaging, uplifting and

visually appealing.

• No artwork should have religious themes,

portray violence or contain elements

that could be portrayed or used as a

weapon.

• The artwork should not be perceived as

confusing, scary or inappropriate.

quality and value

• The artist has an existing or emerging

body of work that illustrates their

aptitude as an artist.

• The acceptance of the art would add

value to the collection that would not

otherwise be possible.

process 25

care and maintenance

• There must be funding to frame and/or

display artwork properly.

• Consideration should be given to

determine whether a piece needs

restoration work that would be cost

prohibitive.

images: (top left) art for sale for Vital Arts by Jochen Klein

with image from vitalarts.org.uk, (middle left) commission

by Donna Wilson with image from donnawilson.com,

(bottom left) "Piece 8" commission by Sophie Smallhorn

with image from vitalarts.org.uk, (top right) commission by

Bob And Roberta Smith with image from vitalarts.org.uk,

(middle right) art for sale for Vital Arts by Blaise Drummond

with image from vitalarts.org.uk, (bottom right), image

from"Beyond the White Cube: Art and Medicine at the

Cleveland Clinic" article via arthopper.org

metrohealth visual art plan26

integration - new

facilities

An emphasis should be placed on

commissioned site-specific artworks in new

facilities. However, MetroHealth recognizes

that there may be instances in which existing

artwork is more appropriate for a variety of

reasons.

In either situation, effort should be made to

select artists in advance of final construction

so as to give ample time and opportunity

for meaningful and effective integration

and artwork design and/or selection. The

following is the process by which artwork

shall be commissioned and/or selected for

new facilities:

1. MetroHealth’s Chief Experience Officer

and Director of Arts in Medicine provide

the new facility’s details to the visual art

team, such as location contact, site plans

and themes or special instructions to

ensure integration into the facility.

2. Along with the Chief Experience Officer,

the Director of Arts in Medicine, and

the Senior Vice President of Campus

Transformation, the visual art team meets

with the appropriate facility members,

such as architects, interior designers and

temporary installation by Lothar Gotz, image from

vitalarts.org.uk

process 27

construction managers, to identify both

spaces for artwork and whether or not

commissioned or existing artwork will be

used.

3. As appropriate, The Chief Experience

Officer and the Director of Arts in Medicine

assemble stakeholders for a preliminary

meeting to discuss goals and parameters

for forthcoming commission/curation.

4. The visual art team, with direction and

feedback from The Chief Experience

Officer and the Director of Arts in

Medicine, proposes artwork(s) and/or

artist(s) for site.

5. Methods for commissioning artwork

a. Open competition - the least

restrictive type of call for artists,

typically open to all interested artists

b. Limited competition - a moderately

restrictive call for artists that may

require, for example, that artists be

from a specific geographic area or

work in a certain medium

c. Invitational competition - selecting

several artists, based on their skills or

interests, to submit proposals

metrohealth visual art plan28

d. Direct selection - purchasing

an artwork or selecting an artist

without a competitive process,

typically due to constraints related to

timeline or skills.

6. Existing artwork

a. The visual art team curates an art

collection, presenting it in document

format that provides details on

themes, artwork locations, wall sizes,

artists, media and budget estimate.

b. The Chief Experience Officer and

the Director of Arts in Medicine review

the document and provide preliminary

feedback to consultants.

c. The visual art team responds to

feedback.

7. The Chief Experience Officer, the Director

of Arts in Medicine, stakeholders, and the

visual art team convene for a presentation

of the commissioned design(s) and/or

curated collection. General feedback is

solicited from stakeholders and should

focus on:

a. The collection’s quality, including

commissioned designs and existing

artwork, as a complete group

local artist Ali Forbes work in progress,

image by LAND studio

process 29

rather than specific pieces,

understanding that not all individuals

will respond identically to the same

artwork.

b. The collection’s adherence to the

defined themes – both overarching and

location specific – as well as

the restrictions stated in “Selection of

Art”.

8. In the event that changes need to be

made, the artist refines their concept and/or the visual art team responds to changes

for existing artwork. Revised concepts

and/or documents are then submitted for

review to the Chief Experience Officer and

the Director of Arts in Medicine.

9. The Chief Experience Officer and the

Director of Arts in Medicine will review

changes and give final approval or

continue the revision process.

10. Upon final approval, the visual art team

coordinates with the Chief Experience

Officer, the Director of Arts in Medicine,

and, if applicable, the artist to schedule an

installation date.

11. Upon completion of project, the visual art

team provides a final itemized expense

sheet for the project.

metrohealth visual art plan30

integration - existing

facilities

For instances in which an existing facility

requires the curation of an art collection,

artwork should be as integrated as possible –

responding to the facility’s environment and

needs. Where appropriate, commissioned

artwork should be used.

Upon the identification of a facility, the

process by which artwork is selected shall be

the following:

1. MetroHealth’s Chief Experience Officer

and Director of Arts in Medicine forward

location details to the visual art team, such

as location contact, site plans and themes

or special instructions.

2. The visual art team schedules a site visit at

which they identify where commissioned

pieces versus existing artwork will be used.

3. As appropriate, the Chief Experience

Officer and the Director of Arts in Medicine

assemble stakeholders for a preliminary

meeting to discuss goals and parameters

for forthcoming commission/curation.

4. The visual art team, with direction and

feedback from the Chief Experience

installation in parking garage in Detroit.

image by LAND studio

process 31

Officer and the Director of Arts in

Medicine, proposes artwork(s) and/or

artist(s) for site.

5. The Chief Experience Officer and the

Director of Arts in Medicine schedule

a stakeholder meeting for review of

collection.

6. Methods for commissioning artwork

a. Open competition - the least

restrictive type of call for artists,

typically open to all interested artists

b. Limited competition - a moderately

restrictive call for artists that may

require, for example, that artists be

from a specific geographic area or

work in a certain medium

c. Invitational competition - selecting

several artists, based on their skills or

interests, to submit proposals

d. Direct selection - purchasing

an artwork or selecting an artist

without a competitive process,

typically due to constraints related to

timeline or skills.

metrohealth visual art plan32Cleveland neighborhood images by LAND studio

7. Existing artwork

a. The visual art team curates an art

collection, presenting it in document

format that provides details on

themes, artwork locations, wall sizes,

artists, media and budget estimate.

b. The Chief Experience Officer and

the Director of Arts in Medicine review

the document and provide preliminary

feedback to consultants.

c. The visual art team responds to

feedback.

8. The Chief Experience Officer, the Director

of Arts in Medicine, stakeholders, and the

visual art team convene for a presentation

of the commissioned design(s) and/or

curated collection. General feedback is

solicited from stakeholders and should

focus on:

a. The collection’s quality, including

commissioned designs and existing

artwork, as a complete group rather

than specific pieces, understanding

that not all individuals will respond

identically to the same artwork.

process 33

b. The collection’s adherence to the

defined themes – both overarching and

location specific – as well as the

restrictions stated in “Selection of Art”.

9. In the event that changes need to be

made, the artist refines their concept and/or the consultants respond by selecting

new artwork. Revised concepts and/or

documents are then submitted for review

to the Chief Experience Officer and the

Director of Arts in Medicine.

10. The Chief Experience Officer and the

Director of Arts in Medicine will review

changes and give final approval or

continue the revision process.

11. Upon final approval, the visual art team

coordinates with the Chief Experience

Officer, the Director of Arts in Medicine,

and, if applicable, the artist to schedule an

installation date.

12. Upon completion of project, the visual art

team provides a final itemized expense

sheet for the project.

metrohealth visual art plan34

donation policy

Proposals for donating artwork are carefully

reviewed by the Arts in Medicine Department.

These are the guidelines considered:

theme and content

• No artwork should have religious themes,

portray or contain elements that could

be seen or used as a weapon.

• The artwork adheres to an existing art

theme and/or broader art program

goals.

• The artwork is engaging, uplifting and

visually appealing.

• The artwork should not be perceived as

confusing, scary or inappropriate.

quality and value

• The artist has an existing or emerging

body of work that illustrates their

aptitude as an artist.

• The acceptance of the art would add

value to the collection that would not

otherwise be possible.

• If artwork is a reproduction, it is high

quality and archival.

care and maintenance

• Adequate funding should be available to

frame and/or display the piece properly.

commissioned work for Barts Hospital in London. images

from vitalarts.org.uk

process 35

• Arwork that needs cost prohibitive

restoration will not be accepted.

• MetroHealth must have an appropriate

space within a MetroHealth facility to

display or store the artwork.

requirements

Displays and artwork must be safe and

appropriate for a health care environment

(secure hardware, durable, cleanable). There

should be little or no maintenance required.

Displays and artwork must meet all state

and federal building, fire, safety and ADA

requirements including a maximum 4" depth

on wall-mounted displays. All donated art

and frames must be in excellent condition

and ready to display. All framed artwork

must use acrylic, not glass.

Donors relinquish all rights to donated

work once the donation has been made

and MetroHealth cannot guarantee that

all donated art will be displayed. Donated

art could be subject to future removal or

relocation or MetroHeatlh could choose to

sell the work and use the funds to support

the Arts in Medicine program.

Anyone looking to donate artwork must

send in completed Visual Art Donation

Submission Form along with high-resolution

images of the artwork to the The MetroHealth

Foundation. See the Office of Patience

Experience website for details.

metrohealth visual art plan36

framing and hardware

recommendations

The following guidelines are to be used

as the default framing and hardware

requirements. Specific facilities may require

additional requirements that should be

prioritized.

Displays and artwork must be safe and

appropriate for a health care environment.

Little or no maintenance should be required

of framed, hung artworks. Displays and

artwork must meet all state and federal

building, fire, safety, and ADA requirements

including a maximum 4" depth on wall-

mounted displays. MetroHealth’s standard

frame should be used whenever possible to

reduce framing costs and ensure cohesion

throughout the collection.

Artworks should be strongly fastened to an

appropriate surface. Framed pieces hung

on a wall should not be easily dislodged.

Anti-theft mounting hardware is encouraged

when funds are available, both to prevent

theft and also to stabilize and protect

the artworks from falls and misalignment.

Mounting hardware should be adequately

rated for the weight of framed pieces.

installation by local artist Lauren Herzak-Bauman. image

from laurenhb.com

process 37

Frames and mounting hardware should be

made of durable, high quality materials

and be reasonably expected to last through

decades of use. Material should not be

susceptible to cracking or overly fragile.

Solid metal frames are preferable, though

high-quality plastic or synthetic resin

components may be considered. No wooden

frames shall be used, in order to maximize

durability and protect the frame from

absorbing humidity, moisture or cleaning

product.

Artwork in frames should be adequately

protected by the frame’s structure and

acrylic plane to prevent intentional or

unintentional direct contact with the framed

piece. Frames and the acrylic plane should

be easily cleanable with a lightly damp

cloth.

All framed artwork must use acrylic, not

glass, in order to discourage breakage or

shattering.

metrohealth visual art plan38

maintenance policy

The maintenance of MetroHealth’s art

collection is vital to ensuring that the

collection remains high quality – both

physically and as an asset. Dedicating

resources to maintenance will add value to

the investment MetroHealth has made and

will continue to make in the future. To that

end, MetroHealth should allocate between

1 and 5% of art budgets for each facility

toward a dedicated maintenance fund, to be

used for the restoration of artwork the repair

and replacement of frames and hardware,

temperature and humidity controlled storage

of artwork not in use, annual inventorying

of the collection, and bi-annual appraisal of

collection.

process 39Cleveland neighborhood image by LAND studio

This plan produced by LAND studio on behalf of the Office of Patient Experience in Dec. 2015.