Putting the spotlight on informed lighting choices and the bottom line in hospitals
By Denise Fong and Lauren MacLeod
Lighting is essential to any space, but in a healthcare environment it is crucial to the patients’ health and wellbeing. With patients and staff impacted by lighting around the clock, medical facilities understand the need for careful and informed lighting choices that can impact circadian rhythms, infection control, personalized lighting, and more.
Both research development and technology advancements are making lighting decisions more complex, while still meeting the changing needs of patient and staff. The following takes a look at how intentional lighting design can benefit patients and healthcare workers.
At Shriners Hospital in Portland, Oregon, a recovery room provides bright light levels during the day and low light levels at night when electric light sources are dimmed to low. (Photography: Lara Swimmer Photography; Architect: SRG Partnership)
_q_tweetable:Electric lighting to support circadian response would be fully programmed to change color and intensity to mimic the 24-hour daylight cycle._q_
Connected lighting systems
The integration of light, sensors, and information technology creates intelligent systems networked to automatically monitor energy usage, track equipment and space utilization, and report maintenance issues in real time.
Light fixtures are used as the node in the mesh network and integral sensors can collect data for multiple systems, including those that monitor patient or staff location and hospital equipment such as wheelchairs or supply carts. Equipment requiring maintenance would be identified and scheduled for service at the best appropriate time. Room vacancies could also be coordinated with janitorial staff to minimize down times between patients, while sensors provide real-time occupancy status through a room reservation system.
Electric lighting to support circadian response would be fully programmed to change color and intensity to mimic the 24-hour daylight cycle. However, a local override would allow users to modify lighting to their current needs.
These systems are most effective in spaces without access to daylight where people spend long periods of time. It is equally important to also consider similar lighting needs for staff spaces as healthcare employees often work extended shifts and spend their entire workday indoors.
A patient room at Swedish Issaquah Medical Center in Washington. Electric lighting to support circadian response is important in healthcare settings. (Photography: Ben Benschneider; Architect of Record: CollinsWoerman)
Electric light to aid in infection control
The annual cost of hospital-acquired infections (HAI) is staggering. It is estimated to be about $10 billion (with cost shifting to private payers) and $45 billion if cost shifting is included in the equation. That amounts to about $1 million per hospital per year. There is now lighting technology that can seamlessly aid in reducing the frequency of HAIs.
An overhead lighting system that provides light in the 405 nm, and appears visibly as violet to the human eye, has proven to be effective at killing gram-positive and gram-negative bacteria, as well as bacterial endospores, yeast, mold, and fungi.
It would seem an obvious application for surgical suites and patient rooms, but perhaps less obvious would be those spaces that are impossible to clean between each use or are in continuous use throughout the day such as emergency rooms, cafeterias, public restrooms, labs, offices, lobbies, or other public areas where people gather. While product types are somewhat limited at this time, manufacturers are applying the technology to a number of different lighting form factors beyond the ever-present 2x4.
WELL Building standards for healthcare
WELL is an evidence-based program that utilizes peer-reviewed scientific procedures to create healthy buildings. The new Version 2 includes 10 concepts: air, water, nourishment, light, movement, thermal comfort, sound, materials, mind, and community. Connected lighting systems allow for continuous monitoring of building performance, as well as the human experience.
Light concept of WELL has been expanded to include light exposure and light education, visual lighting design, circadian lighting design, glare control, enhanced daylight access, visual balance, electric light quality, and occupant control of lighting. WELL is not yet as widely adopted as LEED, but it is gaining traction. It’s encouraging to see this much emphasis on lighting, and, over time, it is expected to add value to projects.
Swedish Issaquah Medical Center. (Photography: Ben Benschneider; Architect of Record: CollinsWoerman)
Smart or personalized lighting for patient rooms
Personal hand-held wireless smart devices are becoming more prevalent in patient rooms as a supplement to nurse-call bed paddles. Icons on the devices for various lighting and control options are incorporated to allow for control of color and/or intensity preferences, shade control, as well as “scenes” for different times of day or events, such as watching TV or reading.
The interfaces, when designed using simple icons that people are familiar with from phones and other devices, make the learning curve short and results in a high level of patient satisfaction.
HIPAA has brought many changes to the healthcare industry from electronic medical records to single-occupant hospital rooms. The improved privacy this act has garnered has had some impact on lighting design by tailoring for a task and, in many cases, providing the opportunity for more individualized control. When in a stressful situation where many things are out of someone’s control, the simple act of dimming the lights can reduce stress and bring some calmness back into the situation.
Lighting design experts work with clients to achieve their goals. Every project is different, and every project has a budget. While keeping up-to-date with rapidly changing and interlocking technologies is important, working with the owner and design team to address specific needs is mission critical.
This story was first published in Medical Construction + Design.
About the authors
Denise Fong, IALD, LEED AP, is a principal in our Seattle office and a leader of our lighting design discipline. Denise is the author of numerous articles for national publications on the topic of green design and building for a sustainable future and speaks frequently on this subject.
Lauren MacLeod, IALD, MIES, LEED AP, is a principal and senior lighting designer in our Lighting Design team. Knowing that light can affect well-being (good and bad), Lauren stays abreast of leading scientific research and uses findings to design lighting scenarios that benefit users of spaces in cultural, hospitality, education, healthcare, residential, retail, corporate and exterior landscape environments.