A range of new healthcare lighting strategies can improve experiences for providers and patients alikeBy Craig Casey
Photo: Chris Cooper
In September 2021, the IES brought together leaders from the lighting industry and healthcare sector to participate in a virtual panel discussion entitled “Well-Lit for Well-Being in Hospitals: The Connection Between Quality Light and Enhanced Healthcare Environments.” The panelists presented their professional viewpoints and research findings about how lighting can be part of an enhanced healthcare experience. We are pleased to provide a high-level overview of this timely conversation.
Moderated by Karen Murphy, chair of the IES Healthcare Lighting Committee and director of lighting design at HDR, the panel consisted of: John Curran, a long-time design and construction leader in healthcare; Brooke Silber, associate principal director of lighting for BR+A; and Andrea Wilkerson, lighting engineer/researcher for Pacific Northwest National Laboratory. (Editor’s note: This article’s author, Craig Casey, represented Lutron Electronics and the manufacturer’s perspective.)
As technology-driven industries, both healthcare and lighting are constantly evolving. The discussion focused on two important and emerging trends in the design of healthcare environments: patient experience and the need to deliver flexible lighting solutions that adapt over time. This article summarizes the conversation and provides high-level strategies to consider when embarking on your next (or first) healthcare project, as well as common-sense tips that can be helpful immediately.
The first—and all panelists agreed, most significant—topic centered on patient experience, specifically, the importance of giving patients control over their lighting. Curran observed that the pandemic gave providers and design professionals a new window of understanding about what patients may be going through. Over the last two years, so many people have had less control over their own lives. That experience echoes what patients and their families may experience when they enter the hospital, and it’s one reason why it is critical to give patients easy ways to control their environments whenever possible.
The idea of giving patients more control is backed by scientific research. In April, Wilkerson and three of her colleagues completed a study titled “Lighting Control in Patient Rooms: Understanding Nurses’ Perceptions of Hospital Lighting Using Qualitative Methods,” which concludes both patients and nurses desire greater control over the lighting in patient rooms. These findings reaffirm and strengthen findings from previous studies. In fact, one of the major tenets of Ulrich’s 1991 Supportive Design Theory, which explores how designers can structure the built environment to minimize stress, calls for giving users a sense of control. Additionally, many studies point to the positive impact of light on behavioral health patients. “Providing control in a behavioral health setting is empowering,” Silber says.
Wilkerson is currently studying data in a behavioral health facility, in which she is observing the number of times a patient adjusts his or her lighting. “We are getting objective data that helps us better understand a person’s mental health, behavior and progress,” she adds.
Putting lighting control in the hands of patients and their caregivers is one aspect of healthcare’s transformation from primarily clinical, sterile environments to warm, welcoming spaces designed to put people at ease.
“We’ve started to see a shift to a much more patient-experience focus,” Silber says. “Environments help support the patients themselves and their families. Rooms are designed to feel like hotels; the lobby has a welcoming atmosphere.” Lighting plays an important role in creating this inviting atmosphere by setting appropriate moods in the different spaces.
While top priority is given to patients and their families, it’s critical to consider the many other people who use the space, such as nurses, doctors and other clinicians. What are their needs and how do they use lighting and controls? Wilkerson uses the ubiquitous hospital corridor as an example. “Lighting designers need to think differently about a corridor. Ask ‘How am I going to adapt this space for the people who are there, the clinical staff, and others who are away from windows and natural light?’ ” she says. “Then there’s a whole different group of people working at night. What do they need to do their tasks and to support their circadian rhythms?”
Thanks to the work of Wilkerson and other researchers, it’s becoming easier to discern specifically how a space is used and what each stakeholder needs. “Data-driven research is helping take the guesswork out of designing effective lighting systems that reflect and meet the needs of patients as well as clinical staff,” Wilkerson says.
This presents a tremendous opportunity for designers and clinicians to better understand what “comfort” means to individual patients, to identify how lighting and control can help, and then to apply that knowledge in future designs.
Another factor driving change is COVID-19. Moderator Karen Murphy summed it up best, stating, “We’ve learned so much and our industry has changed because of COVID.”
One of the most significant changes has been smart, centralized lighting systems that can be monitored and adjusted remotely, in real time. This allows facility managers to quickly assess needed repairs and maintenance regardless of where they are and can help control the flow of traffic and minimize non-essential personnel in patient spaces.
It is possible to zone a hospital so that only the people who have to go into an area are able to do so, make targeted repairs and leave less of a footprint. This is critical, especially for children’s hospitals where the patients may have less immunity. Curran explained that ensuring that fewer people go into a space helps minimize the spread of germs.
The pandemic especially highlighted the importance of flexibility. As hospitals were inundated with COVID-19 patients, spaces had to evolve to meet the need. A space designed for one purpose may now be used for something completely different. As a manufacturer, another renovation trend we see is taking one large space and dividing it into smaller spaces. Having a system that minimizes disruption and downtime is critical. Being able to rezone systems digitally instead of having to rewire a space is tremendously beneficial, and one of the primary reasons that wireless and addressable systems are becoming more and more popular. Wireless lighting controls are easy to install, flexible, reliable, readily available on distributor shelves, and an excellent choice for helping to future-proof healthcare facilities.
Silber points to isolation rooms as a specific example of evolving space layout. “Two years ago, isolation rooms were distributed throughout a hospital, maybe one or two on a floor. Now, we’re redesigning a lot of space to see them collected on a single floor,” she says. A digital lighting control system makes it easier to redesign hospital spaces, and simply reprogram the lighting to suit changing needs.
With each panelist bringing years of experience to the discussion, Murphy encouraged the group to share their best practices. High on the list of importance: identifying all the systems that will be controlled by the patient, collaborating on how to integrate these systems through an intuitive device, and establishing early and frequent communication throughout the design and construction process. Consider the following checklist to ensure a successful project outcome:
1. Collaborate from the get-go. “Get the right people in the room early,” Silber says. “Talk to the user groups and define goals and budget up front for greatest impact. Ask a lot of questions about how the client wants the system to behave. Think through the use case of every person who will use the space and develop your sequence of operation based on that data.”
Silber also commented that today’s connected, and many times, app-based lighting controls ultimately become the responsibility of a hospital’s information technology (IT) team to manage. She encouraged designers to make sure IT gets involved at the earliest stage to ensure full understanding of the system and address issues such as firewalls and access.
2. Focus on simplicity and flexibility. Both are key to successful lighting systems that make a positive impact and ensure long-term satisfaction. The goal is to make programming and reprogramming lighting as simple as possible, with user-friendly solutions that allow a client’s staff to consistently maintain the system, and quickly and easily make changes.
3. Use data. Wilkerson sees data as one of the tools driving future success. “So much time is spent guessing,” she says. “Now we have data, and we can fine-tune lighting and controls based on it.”
4. Consider customized training. Another suggestion is to tailor the level of training for each user group. For example, a one-hour training for clinical staff may be sufficient, whereas IT might need two days of training to fully understand the system capability, how to run reports, etc.
While some trends can be transient, we feel confident the focus on patient experience and the need for flexibility will shape healthcare lighting design for years to come. Lighting designers, electrical contractors, engineers and other professionals have an opportunity to help healthcare providers, patients and their families realize an improved experience through the implementation of smart lighting control systems.
This article has been adapted from the live IES panel discussion, “Well-Lit for Well-Being in Hospitals: The Connection Between Quality Light and Enhanced Healthcare Environments.” The full discussion is now available as an archived webinar and CEU course in the IES eLearning portal at https://elearning.ies.org.