In making design changes at Sacred Heart Children's Hospital in Spokane, Washington, Executive Director Peggy Mangiaracina and her design team chose to place greater focus on the use of art. Reflecting on that decision today, she says, “After we opened the new space in 2003, I was amazed at how frequently I saw children and families stop to take a moment to have fun during their hospital stay for what was probably a life-changing diagnosis. The laughter, the giggles, the ‘look what I found’ filled the hallway nearly every day.

“What I did not realize right away, but have come to see over the years, is that the artwork we used would become the icons of Children's Hospital. Families come back and tell us that those moments of interacting with the art helped them with the long struggle of being hospitalized. In fact, they have asked us never to change some of these imaginative works as they love to come back and see if they can still find the hidden elements in the artwork.”

The artists that Sacred Heart used were Rolf and Peter Goetzinger, who refer to themselves as “artistbrothers.” The Goetzinger brothers have been creating art for medical facilities for more than 20 years, and their connection to improving hospital spaces is personal: Rolf Goetzinger spent long days in pediatric facilities with his daughter for many years.

On an out-of-town trip to meet with his daughter's neurologist, he and 8-year old Ellie wandered through the hospital, searching for a lunch place. “As my daughter and I slowly made our way around this unfamiliar hospital, the cold, monolithic concrete with steel doors and reinforced windows made me feel incarcerated. The wards looked like they were built to keep people in. I had to wonder how much more intimidating this place appeared to my little girl, clinging to her walker,” he says. Rolf Goetzinger later approached the hospital administrator about enlivening the space with art, but the administrator explained that he didn't have the budget for such things.

Seattle Children's Hospital, where the Goetzinger brothers began their hospital specialty, made a different choice. Twenty years after its first art project with the Goetzingers, Children's Hospital continues to extend artwork deeper into the working areas, where patients spend the most critical time-treatment rooms, imaging rooms, pre-operating rooms, and exam rooms. The murals in the entry and waiting areas are no longer just for first impressions; they set the tone for what is to come.

While art has often been used to create spectacular lobbies, it is now working its way deeper into many hospitals. “Another space where Rolf and Peter created art for us was the ceiling in the treatment room, where children with burns undergo a painful debridement procedure,” Mangiaracina says. “The birds hanging from the ceiling have made for wonderful distraction stories for our children, while undergoing treatment. Our child-life specialists continually remark how much the art has helped when providing care to children. There is much evidence-based practice to show that distraction images and art actually assist in the physical healing of children.”

Shriners Hospitals for Children-Spokane also has taken art into the working areas of the hospital in order to overcome the anxiety and claustrophobia patients feel when undergoing long imaging processes. The artistbrothers were hired to create numerous murals throughout the hospital, one of them being a scene in the radiology unit of Canadian geese flying over an estuary.

The value of art for healing is a simple equation: Art affects emotions, and emotions affect outcomes. Art that calms and enlivens can lift the spirits of patients and staff. It can reduce stress or boredom, significantly decreasing a patient's reluctance to be in a hospital. Reduction of stress improves health. Staff turnover is likely to be lower in a creative and embracing environment. Frustration, anger, or anxiety may be reduced as patients wait with something more than white walls and faded medical posters to stare at. Waiting times do not feel as long. Visitors feel more comfortable coming to a less austere facility and may be far more inclined to say, “When I have a procedure done, this is where I'd like to come.” Even donors may be more likely to give to a facility that showcases their gifts well.

The Goetzingers' people-friendly art ranges from playful to heartfelt. They aspire to keep people of all ages who will use a medical facility in mind as they design-patients and their families, doctors, nurses, and hospital staff. Their holistic approach to art translates to site-specific solutions for each project they propose. Their art takes on many forms, from murals of indigenous wildlife to sculptural orca whales swimming up a structural column. It may also be functional, such as iconic signage or hands-on exhibits. The brothers intend for their art to brighten the lives and lift the spirits of children and their parents under stressful and often frightening circumstances. The way their art plays with space encourages children to see their temporary surroundings as safe and friendly. This fosters the facilities' ability to give healing treatment.

Many artists do not like to think of their work in such functional terms, but the Goetzingers are problem-solvers who enjoy the challenge of creating solutions that will meet a site's specific needs. Because they are formally educated in architecture and are contractors, as well as designers, they understand the language and needs of architects and builders. They recognize that their work has to meet health codes, fit realistic budgets, and ultimately endure cleaning and commercial wear.

The artistbrothers' handcrafted work goes beyond generic art, inviting a child's imagination into a place of healing. HCD

More information about Rolf and Peter Goetzinger can be found at To learn more about Sacred Heart Children's Hospital, visit For more information on Seattle Children's Hospital, visit Healthcare Design 2011 March;11(3):62-63