Better healthcare lighting often means lower overall costs for hospitals, doctors or dental offices, medical facilities and assisted or senior living centers. Given the complications of today’s healthcare system, improved lighting at a lower cost can afford a serious and distinct advantage for patient and doctor alike. This post examines healthcare lighting in detail with specific guidelines, facts and context.
Light factors into medicine. Americans have been isolated, locked down and confined to time indoors. Millions spend days and weeks in front of screens—often, not getting adequate daylight—and this, according to architecture instructor Mariana Figueiro, director of Rensselaer Polytechnic Institute’s Lighting Research Center (LRC), who researches the effects of light on health, including circadian photobiology, can be unhealthy.
Dr. Figueiro contends that light is essential to good health.
“Light is just like diet and exercise,” she told one interviewer. “We tend to think that because we can see clearly in a space, we’re getting enough light for the biological clock, and, in general, we’re not.”
According to a 2012 U.S. Commercial Buildings Energy Consumption study, healthcare is delivered in over 10,000 inpatient healthcare buildings across America. Bearing in mind that light can alleviate anxiety, jet lag, insomnia, sleep deprivation and severe depression, it’s important to note that lighting for medical, health or healthcare projects, buildings and applications requires different needs. Each building is unique in proximity to natural light, user needs and other factors.
Designers, architects and builders increasingly focus on improved healthcare and hospital lighting. After all, reaching functional goals and fulfilling patient and employee needs, some of which necessitate 24-hour, year-round operational capacity, healthcare lighting is in constant demand. Patient rest, health and treatment outcomes aside, lighting can also be crucial to achieve medical staff alertness during night and day shifts.
Whether lighting neonatal, pediatric and geriatric units, emergency, operating or examination rooms or lighting the patient’s room, each instance of putting light on a task, context or for a specified purpose can be pivotal to good health and medicine.
In the patient’s room, for instance, the purpose of lighting can range from successful delivery of cures, medicine and visiting to proper rest, healing, comfort and recovery. In a recent lighting industry article, consultant Craig DiLouie points to studies showing that patient room design can increase the patient’s satisfaction and lower the risk of infection and accidents as well as reducing the need for pain medication and longer hospital stays.
DiLouie reports that elementary lighting design principles for the patient’s room, outlined by the Lighting Research Center and the Illuminating Engineering Society’s (IES) Lighting for Hospitals and Healthcare Facilities, offer clarity in circadian rhythm-based lighting guidelines:
Generally, patient room illumination is best compartmentalized in sections. For example, part of the patient room is where the visitor will typically inhabit a space. In another area, the doctor, nurse or medical attendant will perform a task, perhaps at a machine, on a set of monitors or devices, or with certain equipment. Of course, the patient is often on the bed. Lighting each section should match the purpose of the human intended to inhabit the area, whether for administration, examination, monitoring, visiting or resting.
Accordingly, lighting—ambient, accent or task—should be separately controllable with dimming or multiple level controls, with the patient maintaining control of his lighting from the bed. Controls should be properly labeled for clarity and functionality.
Ideally, each lighting control will have an indicator as to level, giving the user a sense of light in the designated area. The designer should bear in mind that higher light levels suit daytime usage. Natural daylight is always ideal. In rooms designed for more than a single patient, assign dedicated lighting to each individual, factoring for ceiling curtain tracks that may divide spaces. Night lighting should account for clear pathways for trips to the bathroom. Always design sufficient light for a medical attendant, especially the attending physician, nurse or designated assistant. The light level should be lower at nighttime because the human eye adapts for lower light. To overcome a lack of natural light in a given space — or to increase the added benefit of natural lighting on human biology — improved lighting now demands a connection to the outdoors.
Today’s LED color tuning system allows users to control the color of light anytime after installation. Color tuning affords the ability to attune lighting to individual preferences or specific application needs. For example, the user can set the LED light fixture to follow the sun’s natural east-to-west course throughout the day or choose from standard presets (i.e., dawn, morning, midday, afternoon and evening). Color tuning systems are interactive. Color tuning can harvest daylight and control color temperature throughout the day; changing from daylight to cool white to warm white as the day progresses.Aim for balance of light that fosters both healthcare delivery and healing, rest or sleep. But lean toward the patient’s comfort foremost. Avoid glare and direct light on screens, surfaces and spaces where a human may be likely to use a personal device. Patient room lighting design should accommodate rest and relaxation, giving the patient essential control over his environment.
Strive for a residential sensibility, which can be achieved with accessories such as a wall sconce, which may induce a feeling of comfort and warmth in the individual patient. After all, many patients lie on a bed while reading or watching television.
During the most critical times, such as severe pain, sickness or under medical attention, the ceiling is the patient’s predominant perspective. This means that controllable ambient lighting should be designed at both room entrance and near the patient’s pillow, perhaps in a handheld device integrated with bed control. The patient should also be provided with a controllable reading light.
The primary purpose of the patient’s room is the patient’s health. Downlight the space for examination with controls that are instantly accessible by the medical team.
Note that there may be exceptions. Factor and account for any protective environment or critical care space, any necessary isolation caused by an airborne infection, nursery and obstetrical care and psychiatric, geriatric or pediatric patients. Each human has particular lighting requisites. For example, the finish in a pediatric room may require more color and account for extended family use.
“Increasingly, [healthcare] facilities recognize the need for 24-hour circadian rhythm-supportive lighting schemes,” the IES reports.
Factors for circadian rhythmic lighting include intensity, such as the amount of light on the human eye’s photoreceptors, necessitating vertical lighting, spectrum— light’s wavelength, commonly associated with correlated color temperature—timing (when light falls on the eye) and duration (accumulated amount of light exposure).
The Lighting Research Center conducts human-centric research and recently created a circadian lighting metric with conclusions. The center calls the metric a circadian stimulus (CS), with 0.1 being the threshold for circadian response and 0.7 being the saturation point, with 0.3+ recommended for at least one hour in the early part of the day. The center recommends a higher CS during daytime in the patient’s room and a lower CS in the evening.
For example, in a single patient room, one could consider installing recessed linear LED luminaires, a wall-mounted dual task uplight/downlight above the bed, downlighting at the room’s entrance and along the perimeter and a recessed linear wall wash light. Dim each light during daytime until reaching 25 percent of full output in the evening. Keep downlight at full output during the day until dimming to 50 percent in the evening. Adjust all LED lighting from 5000K in the morning to 3000K midday and 3500K in the late afternoon and evening.
In each light design, strive to achieve the sense of purpose with wholeness for patient control and comfort, medical functionality and adaptability. Above all, according to these sources, lighting design must account for and accommodate the individual’s healthcare needs.