Though the young mother expressed fears and concerns about the development of her 13-month-old daughter, the child’s well visit proceeded like any other that Danielle Erkoboni, M.D., had ever done. But then something unusual happened.
The young girl stood up on the exam table and began calling out a picture of a “doggy” from the colorful mural on the wall behind her. Erkoboni then asked her to point out other animals and she was able to do that as well—an impressive skill for a child her age.
“I stopped the whole visit and I said, ‘Mom, I know you have all these worries and concerns—we all do as parents—but I just want to show you this smart little girl you are working to build and foster,’” says Erkoboni, a pediatrician at Children's Hospital of Philadelphia's Karabots Primary Care Center in Norristown, Pennsylvania. “I think Mom left that visit feeling a lot more lifted and empowered, and I'm not sure we'd have that opportunity if the walls were white.”
Artwork includes team input, web link
The mural is part of Picture This!, a CHOP initiative using colorful and interactive murals to inspire creative and educational moments for its patients, serve as an assessment tool for pediatricians and elevate the patient/family experience. CHOP launched the exam room murals in select locations last year and plans to expand their use throughout the CHOP Care Network in 2022.
A multi-disciplinary team of CHOP physicians, researchers, nurses, child-life specialists and hospital administrators collaborated with artists to create the murals. Designed to mimic large storybook pages, the murals depict familiar scenes from around the Philadelphia area. Each mural also has a QR code that links to an interactive web-based portal; families can access the portal to find age-appropriate activities and questions to prompt additional conversations.
COVID-19 forces change in deployment
Moments like the one Erkoboni shared with the young girl and her mother might not have been possible under the hospital’s original plans. The murals were initially designed to be displayed in clinic waiting rooms to enhance the patient/family experience while they waited to see their provider. But COVID-19 protocols prompted CHOP to shift the program; they reduced the murals to poster-size prints with easily cleanable surfaces and moved them to the exam rooms.
That change gave care providers a new assessment tool in the murals, but they also serve as an aid in conducting more seamless exams—the bright, busy artwork is often a pleasant distraction for children undergoing diagnostic tests and procedures.
“If they had stayed in the waiting spaces, we would've never realized all the additional benefits they have raised for the care providers,” says Melanie Hoynoski, CCLS, CTRS, a child life specialist at CHOP.
Program changes likely to prevail beyond pandemic
The upside of having the murals in the exam rooms means they are likely to remain there even after CHOP can relax pandemic protocols for its waiting rooms. Hoynoski says discussions are underway to add murals back into the waiting rooms to augment the exam room posters. Meanwhile, her team is busy ensuring CHOP’s practitioners are optimizing the program’s benefits.
“We're creating a training program to disseminate to our entire primary care network the benefits of the program for our patients as well as how they can benefit our care providers,” Hoynoski says. “We know our staff has a limited amount of time to see their patients and the patient flow is pretty rapid; we want them to be equipped with this knowledge and hopefully make their jobs easier.”