As a way to increase healthy engagement, a multi-disciplinary team from Children’s Hospital of Philadelphia (CHOP) created Picture This!, a novel project that uses colorful and interactive murals to inspire creative and educational moments in primary care exam rooms – encouraging parent/child conversations, building imagination, serving as an assessment tool for pediatricians, and elevating the overall patient/family experience. Made possible by a grant from the William Penn Foundation, Picture This! is currently being offered at the Nicholas and Athena Karabots Pediatric Care Center in West Philadelphia, with plans to expand throughout the CHOP Care Network.
“Our goal was to reimagine our medical waiting spaces, creating more opportunities to model the types of interactions that help children thrive,” said Danielle Erkoboni, MD, a pediatrician at CHOP’s Nicholas and Athena Karabots Primary Care Center in Norristown, PA, and faculty member in CHOP’s PolicyLab. “As a pediatrician, I also use the murals to assess a child’s development, alongside the books we provide through Reach Out and Read (ROR). Programs like ROR have successfully used books to discuss the importance of singing, talking and reading for more than three decades; we’re very excited to bring images like those in the books to the walls of the primary care clinic, ensuring that learning through play is always visible throughout the space!”
During the initial concepting phase, a team of CHOP physicians, researchers, nurses, child life specialists and hospital administrators worked closely with artists to create the murals. Displayed on the walls of the clinic, the murals were designed to mimic large storybook pages, using the proven power of wordless picture books to foster creativity and organic conversation. For interested families, each mural also has an associated QR code that links to an interactive web-based portal, designed to guide families through the mural with a set of age-appropriate prompts, written by pediatric experts alongside parents and caregivers. These developmentally-targeted prompts include various question types, such as seek-and-find activities and story starters to get families talking.
The content incorporates social and language development milestones as well as relational concepts of bullying, safe street habits, sharing, and healthy relationships. To connect further with patients and families, the vibrant scenes also include CHOP and Philadelphia-centric illustrations like a soft pretzel stand, City Hall, the Liberty Bell, community gardens and a neighborhood playground.
Prior to the COVID-19 pandemic, the murals were intended to be projected on the walls of the waiting rooms. However, as the pandemic forced many clinical settings to evolve their typical waiting areas for families, the team at CHOP was able to pivot quickly and create easy-to-clean large poster-size murals that could be secured on the walls in exam rooms.
“Having the murals located in individual exam rooms provides a safe, individualized way for families to have fun and learn while waiting to see their care providers. Even more, our evaluation of the murals has shown that they create the types of conversation that help a child’s brain grow and develop even more than the standard exam or waiting room,” said Dr. Erkoboni. “As we continue to observe so many positive responses, we know this is just the beginning. We look forward to not only growing this project, but also understanding the social and developmental effects these installations have on our patients and families, and how these interactions translate from the primary care clinic to the home.”