Trends in wellness and healthcare offer new opportunities for the lighting industry.
As healthcare becomes a more significant part of the economy, institutions are competing to attract a larger portion of the population. Interestingly, innovative illumination has become part of the draw in the treatment and prevention of diseases as well as assisting an aging demographic.
During the LEDucation 9 industry consortium held in Manhattan this spring, two well-attended seminars outlined the growing role that lighting technology plays in healthcare. According to Karyn Gayle MIES, EDAC, and VP/Healthcare for Acuity Brands, there are functional, physiological, and psychological aspects of lighting that influence facility design. In her CEU-accredited seminar presentation Can Modern Lighting Cure the Ills of Ailing Institutions? she pointed out that healthcare represents 18 percent of the GDP (Gross Domestic Product) and is expected to double within a decade. That growth, however, may be tempered by the implementation of Hospital Consumer Assessment of Healthcare Providers & Systems (HCAHPS), a tool used by the Center for Medicare & Medicaid Services (CMS) for reimbursements based on patient experience.
“Patient perception of the institution has to improve over time or facilities will be missing out on funds,” Gayle explained, adding, that lighting can make an impact on how the patient and staff experience the space.
In a related talk on exactly how light affects people’s beneficial responses, Steven Klein, IALD, LC of Klein Lighting in Milwaukee, described the human receptors of light, the benefits of blue light, and the visual and nonvisual aspects of good lighting schemes. “Lighting helps to create context,” he noted.
In his accredited presentation Lighting Elixir: Tonic for S.A.D. Interiors and Stimulus for Happy Staff and Patient Satisfaction, Klein detailed how LEDs can change a patient or treatment room by recreating a rising sun, early dawn, a starry night, or even the passage of time, thus distracting and de-stressing patients from their clinical surroundings.
Gayle observed, “Bright white lights are associated with a clinical setting, but can different lighting make the space more favorable?” She detailed how light affects patients psychologically by impacting their perceptions during minimally invasive procedures (i.e. radiation therapy, MRIs, dialysis, and oncology infusions). Both Gayle and Klein report that many MRI settings are now instituting additional mood lighting and sounds to allay patient stress. Designs such as an opening in the ceiling that is illuminated to resemble daylight, or a trompe l’oeil sky are popular additions to MRI and radiation treatment rooms.
As researchers investigate lighting’s impact on performance and health, proper illumination also influences several disorders. “With chronic diseases representing more than three-quarters of healthcare costs, prevention will become more important,” Gayle remarked, citing several studies linking sleep deprivation and disrupted circadian rhythms to ailments such as depression (leading to self-medication plus alcohol and tobacco abuse), Alzheimers, high blood pressure, obesity (increased hunger and over-eating), and diabetes (disruption in glucose tolerances). Gayle conceded that maintaining healthy circadian rhythms through light manipulation has become mainstream.
“Everyone is aware of the value of proper circadian rhythms and how lighting design can simulate dawn and dusk,” Gayle added, referencing actor Leonardo DiCaprio’s purchase last year of a $10 million apartment in Manhattan that included vitamin C showers and a dawn simulation lighting scheme.
As research into health and better building design converge, the discipline of Evidence-Based Design (EBD) – in which research on how the physical environment impacts patient stress, staff performance, and effectiveness of care is integrated into built environments – has been influencing projects and opening opportunities for lighting designers.
In the quest to de-institutionalize healthcare spaces, specifiers are exploring more organic forms for lighting fixtures instead of the typical 2×2 and 2×4 luminaires, Gayle stated. “Designers are also using sparkle and dimension to connect with patients,” she said, much in the same way designers use the concept to add layers of light in living spaces. The technique is more effective in waiting rooms, which can color a patient’s perception of care.
Klein elaborated on similar applications. “The best effects with lighting are continuous ones, such as LED strips plugged into continuous curves versus visually segment fixtures,” he noted. “Architects are always looking for opportunities to use saturated light,” Klein said, noting that the most beneficial applications are as perimeter definition and wall-washing, although he also likes to employ cove lighting.
Giving patients the ability to express themselves or their moods through color and light can relieve stress factors and is another area of exploration for designers. “With controls, patients can create more scenes through tablets and break free of the typical [cumbersome] handsets,” Gayle explained. In senior care facilities, designers are coming to terms with clients’ changing lighting demands, she added. For example, studies are proving that high light levels result in lower incidents of patient falls.
The dilemma remains, however, that proper illumination is needed for preparation and operation of any procedure as well as keeping staff alert. Gayle cited a simple change that could benefit both patients and staff.
“In post-anesthesia care units, low light levels help in recovery, but the staff needs brighter illumination to complete tasks,” she commented, “And what do we find in the wall? The common toggle switch. Could simply specifying a dimmer switch in the future be a solution?” She also suggested designing layers of light and adding controls in patient rooms in order to better serve both staff functions and patient comfort.
“The trend has been for more decentralized nursing stations,” Gayle remarked, noting that while it minimizes the amount of walking for the staff, there is a concern for how the light and noise from the stations would affect patient rooms. She also noted that more studies are being done on how corridors should be lit during a 24-hour day as well as how much light is needed at each nursing station based on the age of the staff. She believes flexibility and control will figure more into future lighting specifications.
Klein also addressed the balance between performance and patient benefits as he described the different effects of the blue and green spectrums. “What is it about blue light? It causes a reaction in the iris and sharpens vision. It maximizes visual acuity and would be very beneficial in the operating room for surgeons or X-ray reading rooms,” he suggested. Achieving such saturated environments without distortion should be a goal for today’s lighting designers, according to Klein. He also pointed to emergency rooms where the lighting could cycle between blue and green, to keep medical personnel alert yet comfort patients. He also elaborated on instances where surgeons are actually picking their own spectrums in the operating room – between blue and green – thanks to programmable LEDs.
Gayle concluded the session by reminding designers that the IES RP-28-07 Lighting and the Visual Environment for Senior Living is being revised and will soon be called Lighting for the Aged & Partially Sighted. She advised designers to keep in mind that it’s not only the hospital patients who may be seniors, but also the staff. “Over 50 percent of medical facility volunteers are age 65 or older, adults over 65 visit a physician seven times a year on average (versus 4 times a year for the general population),” she noted.
As studies are continued on the value of proper lighting qualities for all segments of the healthcare population, it is evident that the properties of LEDs and their controllability of color and lumens – as well as their role in miniaturizing fixture designs – will be affecting us all in the future.