Calming Nature Photography in Medical Waiting Environments

For medical clinics and professionals looking to decorate their patient spaces, understanding the impacts of displayed artwork on clientele is a must. Every space within the clinic affects a patient's short- and long-term perception of their healthcare experience and, by extension, their willingness to visit again. In this post we are going to explore what peer-reviewed research says about the effects of calming nature-themed photographs in medical waiting environments and what measurable positive impacts they can have on the patient experience.

Let's get the housekeeping out of the way first. I am not a PhD, psychologist, researcher, nor even a particularly well-educated individual; I'm a photographer. On top of that, I am clearly biased in this context as I just so happen to sell nature photography wall art on this very site. However, I also want my images to provide tangible benefits to my clients and their customers; art should be more than just a pretty picture on the wall. So, in an effort to keep the contents of this post both useful and authentic, I have drawn my conclusions from a study done by Eileen R. Cardillo and Anjan Chatterjee which examines the impacts of visual art in healthcare environments. The study is linked here, as well as at the end of the post, and I encourage readers to review it.

When I take and edit my photos I do so with my mind on the specific experience I want the viewer to have when they view the final result. Some of the things that I consider in that process are factored into the study, but not all of them. Additionally, none of my images have been studied by researchers with the intention of understanding their effects on viewers in any context. Ultimately, the decision is up to the reader whether or not they believe my work can deliver value to their clientele. Please consider carefully, and don't hesitate to reach out via the contact form with any questions.

In their study Cardillo and Chatterjee examine 25 different papers that consider the impact of art on patients in hospital environments. These studies cover most facets of the patient experience, from waiting rooms to patient rooms, exam rooms, and more. For the purposes of this post, we are only interested in the aspects related to waiting environments, which limit us to the portions of the paper that deal with waiting rooms and exam rooms (while waiting for the physician to arrive). On a philosophical level I would be inclined to also include patient rooms in the waiting category, as the patient is essentially waiting for the healing process to be completed. However because the studies they examine break that out into a separate category and draw their conclusions based on a longer time horizon than is relevant to our purpose today, we will not include them in our considerations.

Their assessment of studies that examine the impacts of art on waiting environments concludes that realistic nature imagery (as opposed to abstract, educational, or non-nature themed realistic imagery) does have measurable positive impacts on the patient experience. The studies observed reduced agitation, pacing, stretching, fidgeting, desk queries, noise levels, staring at others, and instances of getting up from their seats in patients who waited in a room that displayed some form of realistic nature imagery compared to standard waiting rooms. They also observed a boost in positive social interactions such as casual conversation in the same group.

These observations suggest that for many clinics and medical practices a wide range of tangible positive patient and staff benefits can be produced for a relatively small amount of work. In clinics where patients regularly demonstrate some or all of the observed negative behaviours, inclusion of realistic nature imagery such as nature photography in the waiting room décor may have the double benefit of increasing patient dwell satisfaction and lowering staff stress/cognitive load by reducing interruptions and complaints.

Some of the studies examined not just behavioural changes, but also physiological changes. One RCT found that patient groups in a surgery unit waiting room displaying nature photography imagery demonstrated measurably lower stress levels (especially when paired with relaxing music) immediately prior to entering surgery than those waiting in a standard room without the imagery (or paired music). Another study that focused on patient exam rooms found that patients who waited for 10 minutes in a standard exam room, which displayed medical posters, had consistently higher arterial pressure, systolic pressure, and diastolic blood pressure than counterparts who had waited the same amount of time in exam rooms with landscape photography on display. 63% of participants in this study also preferred the nature photograph room, describing it with positive emotional adjectives (soothing, peaceful etc.) rather than more distant ones (professional/educational).

In fact, as far as I can tell, every study that measured patient preference found that patients preferred the spaces with realistic nature imagery, such as nature and landscape photographs, over the presented alternatives. In their research Cardillo and Chatterjee seem to support this assessment, stating in their conclusion:

"Humanizing the healthcare environment to include visual art is more than a design trend. It is good medicine. The benefits of nature imagery are observed in every study undertaken; support for other forms of visual art is promising but should be considered with care. In particular, realistic nature imagery benefits patients by reducing psychological and physiological indices of stress and anxiety, as well as pain perception. These effects are most consistently observed in studies involving invasive procedures or in waiting rooms."

The results of these studies suggest that, even in patients and settings where explicit medical benefits are not observed, patient satisfaction and mental relaxation are more likely when displaying nature photography over other common alternatives.

It is important to note, all of the studies referenced had differences in the format and environments in which they tested the effects of art on room occupants. Some studies used videos of nature images playing on loop, others hung traditional wall art. Some tested their chosen visual format with and without the inclusion of calming music, others tested with single images or groupings. All this variation results in many edge cases and makes it difficult to assert any specific conclusive techniques. To further complicate things, other unrelated (non-clinical) studies have tested the effects of art on viewers without art training vs. viewers with, and the changes in viewer interest/benefits after being trained. In general, the consensus seems to be that deeper engagement with appropriately selected and placed artwork produces more significant and consequential benefits for the viewer. However, how those findings translate to the clinical environment is not well studied. Other factors such as wall colour, ambient noise (music), and general décor undoubtedly also have significant impacts on the viewers' ability to experience benefits.

My own observation is that this may in part explain why studies that engaged participants with both visual and musical stimulation also tended to find those participants experienced amplified benefits. Based on all these factors, it is advisable for readers who wish to leverage the potential benefits of nature photography in their business to regularly assess the experience of patients in their waiting spaces.

Ultimately, no matter why a clinic is considering visual updates for their waiting spaces, it still needs to make business sense. It makes sense then to consider whether or not it is sensible to invest in putting nature photography art on the walls.

While the research Cardillo and Chatterjee examined focused almost exclusively on larger institutions and hospitals, my observation is that some of the potential benefits they outline in their paper could also apply to smaller practices and clinics. Rather than describe them myself, I think in this case it makes more sense to quote them:

Positive benefits for patients and staff can translate into tangible benefits for medical businesses of all sizes. In the context of a clinic, I believe the relevant benefits could even be amplified over larger institutions like hospitals. Hospitals have a lot of operational inertia, which gives them certain advantages over a private clinic. Most hospitals will have a large medical team of both nurses and doctors that can cover for and fill in for each other. They also tend to have large budgets and administrative teams to spread the work out. In each team there will usually be at least a few specialists who have the time and experience to address problems and issues. In private clinics on the other hand, team members often need to wear multiple hats outside their specialization. Reception may need to assist doctors with room prep, nurses and doctors may need to assist with admin. There likely isn't the budget to hire the moment a staffing issue is identified, putting pressure on the team to pick up the slack for longer. There are also fewer options when staff who fall ill or wish to take a vacation. If they need a day off there may be nobody to fill in for them. It is my opinion that many of the benefits identified by Cardillo and Chatterjee, relating to operational efficiencies gained by displaying nature photography in waiting spaces, will also be experience in smaller clinics.

For any readers who own or work at small- to medium-sized medical clinics in any field, I would greatly appreciate any insights on the impacts of art in the clinic's the waiting spaces.