Considerations in health care lighting include caregiver effectiveness and patient wellbeing.

Image courtesy of Axis Lighting

The built environment can have a positive effect on the overall state of a person’s physical and emotional wellbeing. Nowhere is this more important than in a health care facility.

The contemporary environment of care recognizes that, while the physicality of hospitals must support the effective delivery of care, they are in and of themselves tools in the healing process, supporting wellness through psycho-physiological effects.

Lighting's expanded role

Health care organizations and architecture-engineering-construction (AEC) firms have taken evidence-based design research and expanded it beyond patients with the recognition that the physical environment also affects staff, doctors and visitors.

A growing understanding of the effects of light on human biology as well as the importance of light for helping to create pleasant, non-institutional environments, has created a desire for hospital lighting systems to provide flexibility in spectral output and control. With a focus on both patient and staff wellness, the AEC industry and health care facility managers are looking for thoughtfully configured lighting that balances both visual and circadian needs and promotes healing outcomes.

Health care lighting needs to meet many form-and-function criteria. It needs to be symbiotic with the overall design using advanced technology that provides multiple precise distribution options to deliver the many layers of light required in health care environments. It also must promote circadian entrainment and a glare-free comfortable environment that supports the visual tasks of staff while enhancing the overall wellbeing of patients. Ease of maintenance is another requirement.

This is a tall order but advanced technologies, a deeper understanding of the varied needs of patients and staff, and forward-thinking manufacturers who have sought end-user input are driving better health care lighting products and designs.

In a facility that operates 24/7, conflicting lighting needs, especially during the overnight shift, present a challenge because staff need to be awake and alert at night while patients are resting. To address this, different lighting strategies are needed in patient and staff areas.

Supporting staff health

There are two ways in which light can support staff wellness with respect to circadian rhythms: adequate exposure to daylight during day hours and limited or controlled exposure to light at night. By mimicking natural light patterns that support human circadian rhythms, tunable light fixtures can be programmed to subtly change color temperature and light level throughout the day to help improve patient outcomes and caregiver wellbeing.

In addition to managing circadian alignment, lighting serves a critical purpose in reducing staff errors. Based on studies that cite adequate lighting in medication areas as one of the top environmental solutions for avoiding errors, innovative lighting approaches and technologies should be an important consideration during new construction or renovation. 

It makes sense that the amount of light is directly related to task performance, with better performance correlating with higher and better light levels. “The Impact of Light on Outcomes in Healthcare Settings,” conducted for the Center for Health Design, concludes there is strong evidence that adequate lighting is essential for staff performing visual tasks in hospitals, and poor lighting conditions can result in errors.

Form meets function

Architectural lighting works to serve and enhance the architecture, not merely as an accessory, but to create a cohesive spatial experience. However, in health care facilities, there are additional considerations – caregiver effectiveness and patient wellbeing.

For years, health care lighting has been a tale of two extremes – offering either functional but institutional appearance, or extremely decorative forms. Forward-thinking manufacturers and progressive designers have come to realize that there doesn’t need to be a tradeoff.

To move the industry forward, it’s critical to understand architects’ and designers’ perspectives of wanting luminaires with sleek, low-profile styles to elevate health care lighting design while also providing glare-free, comfortable lighting that supports the visual tasks of staff and enhances the overall wellbeing of patients.

But there is another important consideration in health care lighting – maintenance. To combat health care-associated infections (HAIs), luminaires must withstand hospital cleaning protocols and hold up to the most stringent infection control requirements.

Improved safety, reduced maintenance

Hospitals are continuously looking for ways to reduce HAIs and tragic deaths. One solution is sealed luminaires designed to withstand harsh cleaning protocols while also reducing maintenance time and costs.

Contaminants in light fixtures that aren’t sealed can travel through the facility’s HVAC system. However, installing luminaires with sealed housings prevents transference of pathogens from patient room to plenum to help reduce risk of HAIs. An ingress protection rating ensures the fixtures are sealed against contaminants and an NSF2 rating guarantees cleanability.

Health care facility managers are all too aware of the time and effort it takes to perform maintenance on ceiling luminaires throughout the hospital. Pulling out the oftentimes 130-pound ceiling patient room fixtures to take back to the maintenance department for repairs requires two people and a lift. However, when repairs are needed on a lightweight aluminum, fastener-free fixture with dropdown door frames, work can be done quickly in the patient room and then plug and play. This reduces costs and prolongs sustainability of the luminaire system.

A vital role

Meeting the architectural design priorities, addressing the myriad functions and performance requirements, and being mindful of facility considerations are the issues health care lighting must address.

If health care luminaires only complement the architecture without considering the human element, then they overlook a vital role. Yet, the functional luminaires that have been standard for decades in hospitals ignore the importance architectural form and luminaire design play in promoting patient healing and staff wellbeing.

Recognizing that there no longer needs to be a tradeoff in form and function will bring dramatic advances in health care lighting.

Colette Fleming is director of health care for BalancedCare and may be reached at BalancedCare was launched by Canadian-based Axis Lighting after years of comprehensive research and development, including consulting designers and health care personnel. For more information, please visit the Balanced Care website.