The Centre for the Arts as Wellbeing is open to projects that cover any aspect of wellbeing, be it physical or mental, and working within a broad spectrum of artistic endeavours.
ELEVATE at Salisbury Hospital (2014-2015)
Background and scope of the evaluation
ArtCare is the Arts in Health service at Salisbury District Hospital, permanently funded by the Salisbury Health Care Charitable Trust. In July 2013, the ArtCare manager approached the University of Winchester to commission a six months research-based review of Elevate, an art based programme that had been running in the hospital since September 2013. The evaluation was carried out between June and November 2014. The aim was to find out the different aspects of the impact of Elevate on the patients, the hospital staff and the artists.
The evaluation was based on a mixed methods research design that was largely qualitative, but which included some quantitative measures. The design was chosen to match the Elevate team’s interest in finding in-depth information from both the patients and the hospital staff, on the possible impact of the programme on the quality of their lives, work and relationships while in the hospital. The data collection included: observations; individual interviews and in a focus group; a short questionnaire; a five-point rating scale undertaken pre and post an Elevate session.
- Overall, 594 participants were observed in the 27 days of observations. Of these 338 were patients (57%), 213 hospital staff (36%) and 43 caregivers (7%);
- Semi-structured interviews were conducted with 48 participants, of these 23 were patients (57%), 23 hospital staff (38%) and 2 caregivers (5%);
- The total number of respondents to the short questionnaire after the three concerts (from the concert series) was 86. Of these, 28 were patients (33%), 55 were members of the hospital staff (64%) and 3 were visitors (3%);
- Three groups of participants were asked to complete a face scale before and after six Elevate sessions. The groups were patients (n=27), hospital staff (n=16) and the artists themselves (n=15);
- Three focus groups were organized with the 9 Elevate artists, who were also interviewed individually. Semi-structured interviews were conducted with the current ArtCare manager and her predecessor, the programme coordinator and the Chief Executive of Salisbury NHS Foundation Trust.
- The patients involved in the programme reported physical, cognitive, social and emotional benefits;
- The mediation of the artists through the programme’s activities promoted socialization between the patients in the same location through singing, experimenting with small and gentle movements, reciting a poem, or creating a story based in the natural world;
- The symbolic language of arts appeared to be a gentle aid for the patients to reconnect positively with their past;
- The experience of at least one of the Elevate sessions improved the patients’ perception of their hospital experience and made them more relaxed, even if they were undergoing stressful treatments;
- The Elevate concert series exposed some of the patients to new instruments and new music repertoires, pushing their cultural boundaries and stimulating their memories;
- The concerts also enabled the patients and their caregivers to share a special and very different time together in the hospital and to build a positive memory of the hospital as a culturally conducive environment.
- The hospital staff reported that they valued the work of the Elevate artists and the positive impact of the programme on the patients, describing it as relaxing, distracting and enjoyable;
- Staff collaborated on specific occasions with the Elevate team by referring selected patients, such as those exhibiting a negative mood;
- They also engaged with the patients at a more personal level as a result of the mediation activities by the Elevate artists. For example, the music prompted the hospital staff to engage in short conversations with the patients, often about the patients’ musical tastes, sometimes in connection with their past;
- Staff used some of the features of the programme to distract the patients while they were carrying out some minor medical procedures.
- The Elevate artists used an engaging repertoire that was a selection of popular, classical music, and poetry that was considered familiar for the patients. The repertoire ranged from songs and music from the 1920s to the 1950s, and to a selection of classic poems that were taught in schools across that period.
- Artists were observed to use their art forms to elicit a variety of responses in the patients (physical, cognitive, social and emotional).
- They were passionate about their work. The perceived positive impact of their arts on the patients and the support and validation that they regularly received from members of the hospital staff and from the patients, represented a strong motivation to keep them in the job.
- Nevertheless, artists experienced a sense of fatigue at the end of their performance, possibly because of the emotional drain of working with the patients and partly because of the improvisational nature of their work that forced them to make real time decisions based on the continuous assessment of the emotional response of the patients.
The hospital administration:
- Hospital administrators supported the programme and were aware of its different components;
- The programme coordinator and the ArtCare manager were key figures in the success of the programme;
- Elevate created new work and apprenticeship opportunities in the arts through the internship programme.
Elevate, in the context of Salisbury District Hospital appeared integrated into the hospital culture and was part of the psychosocial support offered to the patients. This support proved to be very effective in enabling patients to reconnect with their memories through music, poetry, movement and storytelling, and/or to enjoy a social and engaging break from the hospital routine. The data suggest that Elevate did not only offer a positive distraction, but appeared to have an incidental therapeutic effect, at least on some of the patients. In this respect the programme also facilitated the work of the hospital staff with the patients. Elevate in the context of the hospital represented an occasion for the staff to use the arts to support the care of older people.