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(HealthNewsDigest.com) – In healthcare facilities, lighting significantly affects the quality of care. Recent studies show that a well-designed lighting system can reduce medical errors, patient falls, pain, stress, depression, and length of stay while improving sleep and satisfaction.
Designing a quality lighting system to reach these maximum health benefits is a balance of three main factors
Patient Comfort
Medical Staff Demands
Energy Efficiency.
Patient Comfort
Trends in healthcare design have been away from an antiseptic environment to a more “spa-like” atmosphere, which helps to lift a patient’s spirits and enhance recovery. The most successful of these calming interior spaces incorporate gardens, waterfalls and much natural light.
The AIA Guidelines for Design and Construction of Hospitals and Health Care Facilities recognizes the importance of a patient’s access to natural light and to control of the artificial light in their environment: “Hospitals and long-term care facilities should provide a garden or other controlled exterior space, accessible to building occupants” and “Every effort should be made to allow individual control over as many elements of the environment as possible and reasonable, including but not limited to temperature, lighting, sound, and privacy.” These are important guidelines that improve not only the appearance of the healthcare facility but also the recovery of the patient.
Studies have shown that letting the sun in reduces pain and depression in patients, particularly in east-facing patient rooms where the morning sun actually reduces the length of hospital stays. Exposure to natural light increases levels of serotonin, a neurotransmitter that is known to inhibit pain pathways. Patients know that they just feel better when the sun is shining.
By the same token, regulating night and day cycles is important for sleeping, so dimming corridor lighting during evening hours is an essential element of the lighting design. For staff, dim corridors enhance visibility of computer stations near patient rooms and prevent eye fatigue when moving from bright nursing stations to dark patient rooms. Brighter lights should be used for medication dispensing closets as well as central stations.
The US Green Building Council’s Leadership in Energy and Environmental Design (LEED) program also recognizes the effect of lighting on health. It offers credits for “Daylight & Views” and for “Controllability of Systems” in which occupants have control over lighting levels. Giving patients control over lighting levels adds to the feeling they have control over their environment thereby reducing stress levels.
Another resource, the Green Guide for Healthcare, which is a voluntary sustainability program, adds credits specific for “Lighting and Circadian Rhythm,” noting that daytime/nighttime controls for lighting systems in accordance with Circadian rhythms can improve patient sleeping and hence recovery.
Note that daylight is not desired in Neonatal Intensive Care Units (NICUs). Premature infants’ eyes are still developing and a dark environment is best. Where artificial general lighting is used in the NICU it should be all indirect, dimmable and zoned per individual bassinet area.
Medical Staff Demands
Doctors and nurses require appropriate lighting for medical tasks, computer work and long-term comfort for aging eyes. A quality lighting system designed for the needs of the medical staff can improve alertness levels, work performance, satisfaction and health, and reduce medical errors.
Adequate lighting levels must be provided where critical tasks are performed such as in an Operating Room, ICU, Treatment rooms and medication dispensing areas. The source of lighting should be a high color rendering source with a CRI greater than 80 and consideration to full spectrum sources (simulating natural daylight’s visible spectrum).
A large number of the medical staff work the night shift and consideration to lighting controls and systems to help regulate the Circadian rhythms for these workers should be incorporated into the design. Several studies have demonstrated that exposure to intermittent bright light during the course of the night aids the adjustment to nightshift work among staff.
Additional studies show that staff with more than three hours of daylight exposure during their shift has higher job satisfaction. Where daylight is not available, the designer can simulate it with electric lighting systems, creating bright areas and controls to vary the lighting levels throughout the day.
Energy and Efficiency
Healthcare administrators and facilities staff desire energy-efficient, low-maintenance, long-life lighting that supports the quality of care offered by the hospital and enhances the finishes and furnishings in which they have invested. Balancing the energy use, quality, maintenance and aesthetics of lighting options for healthcare institutions is a complicated task.
Energy Efficiency Standards have been consistently becoming more stringent. For example, allowable lighting power budget levels for hospitals in ASHRAE 90.1 Energy Standard for Buildings have dropped from 1.6 watts per square foot in 2001 to 1.2 watts per square foot in 2007. Automated lighting controls are now mandatory for most new construction and renovation projects. Automated control systems to consider are occupancy sensors, overall building lighting control systems and daylight harvesting.
New energy efficient technologies are continuing to be introduced to the market place, along with lighting controls the designer should discuss with the facility opportunities for LED lighting and induction lighting, where these sources are coming down in cost, and offer long lamp life for reduced maintenance.
It is possible to balance the lighting needs of patients, staff and administrators so that everyone comes out a healthy winner. Careful planning and smart design can create an environment that lets the sun shine throughout the healthcare institution.
Mary Alcaraz is an electrical engineer/ lighting designer with EwingCole, a nationally recognized architecture, engineering, interior design, historic preservation and planning firm of more than 350 professionals. Based in Philadelphia, the firm has offices in Irvine, CA and Washington, DC.
Reference: The Center for Health Design, Healthcare Leadership White Paper Series 5 of 5, A Review of the Research Literature on Evidence-Based Healthcare Design, September 2008
IESNA RP-29-06 Lighting for Hospitals and Health Care Facilities
IESNA TM-18-08 Light and Human Health: An Overview of the Impact of Light on Visual, Circadian, Neuroendocrine and Neurobehavioral Responses
www.ewingcole.com
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