Lighting Trends in the Health Care Space

Health care lighting exemplifies the intersection of form and function — the integration of attractive lighting systems, non-institutional in appearance, with contoured shapes and advanced technologies that must also adhere to, and perform under, stringent criteria (Photo 1).

Health care environments are complex. The requirements for lighting a patient room, an operating room, an MRI suite, or a behavioral health dayroom vary significantly. Across all disciplines, however, lighting dedicated to the health and well-being of those occupying and working in each of these spaces is paramount. Successful installations are facilitated when contractors take full advantage of the support that lighting system manufacturers provide.

A growing understanding of the effects of light on human biology, as well as the importance of lighting to create healing environments, has fostered interest in lighting systems that provide choices beyond static, traditional white light. With a focus on both patient and staff wellness, the architecture, engineering, and construction (AEC) industry and health care facility managers are looking for easy-to-install and maintain lighting systems that promote healing, while balancing visual and circadian needs. By better understanding the nuances of the healthcare lighting market and its related technologies, contractors position themselves as true solutions providers.

Evolving healthcare lighting technologies

Thoughtful lighting design can play a key role in patient outcomes. Giving patients some control over their surroundings allows them a degree of autonomy in an otherwise restrictive hospital environment. Luminaire systems that include a low-voltage controller with dimming option (LVCD) place control in the hands of patients via a pillow speaker, wall switch, or tablet, allowing them to dim or turn off the lights as desired, or raise and lower their motorized shade. This practice has not only been recommended by industry standards (ANSI/IES RP-29-22: Recommended Practice: Lighting for Hospital and Health Care Facilities), but its benefits are consistently reinforced by positive patient responses.

Studies on the body’s circadian rhythm, its relationship to overall health, and how it is impacted by light are increasingly influencing health care lighting design. Bright days and dark nights promote good sleep and, consequently, better health outcomes. Unfortunately, many hospital rooms are typically not bright enough during the day or dark enough at night to entrain – or synchronize – the body’s natural rhythm to the 24-hour cycle. In addition to simply being able to alter light levels, light sources with an adjustable spectral composition, such as tunable white light providing correlated color temperatures (CCTs) that range from warm to cool (e.g., 2,700K to 5,000K) or biodynamic technology (containing blue-rich wavelengths similar to those found in daylight), further enhance the patient environment, and support circadian entrainment by providing time of day cues. Additionally, the change in the quality of light as it transitions from day to night helps prevent the onset of delirium, especially prevalent in Intensive Care Units (ICUs).

Unique needs of behavioral health settings

As the design of Behavioral Health environments continues to evolve, lighting must benefit the diverse needs of populations across a multitude of spaces – from EmPATH units (Emergency Psychiatric Assessment Treatment and Healing), which are behavioral health units embedded in hospital emergency departments, sharing ED resources while providing a calm, therapeutic environment – to outpatient and residential facilities treating a range of diagnoses. Each facility has lighting requirements that are unique to the diverse population it serves. In addition to supporting patients’ health and well-being, these facilities must also ensure the safety of patients, caregivers, and visitors. For example, luminaires with polycarbonate lenses and tamper-resistant fasteners and frames discourage damage to, and weaponization of, the luminaire. Ligature-resistant lighting– from luminaires to wall switches — removes hard edges and corners from the product, thereby reducing the opportunity for self-harm.

As previously mentioned, healthcare facilities are difficult places to maintain proper sleep hygiene. The lack of sleep, in many cases, can negatively impact healing, thereby lengthening the time a patient spends in the hospital. Techniques to support circadian entrainment, such as modulating intensity from day to night via dimmable lighting, or including the enhanced features offered by tunable white or biodynamic lighting, can help preserve normal sleep/wake cycles and maintain hormonal balance.

In addition to providing daylight and views to nature, recent studies on health, performance, and comfort suggest that the ability to tune the color temperature of light, or even introduce color changing from pastels to saturated colors, based on application, need, or occupant preference, yields significant benefits. Personal control over room lighting can positively influence mood and support a patient’s feeling of independence, perhaps the most important benefit of all (Photo 2).

Ease of installation and maintenance

In healthcare projects, the quality of LED lighting products and the service and support provided by the manufacturer cannot be overstated. Forward-thinking manufacturers are continually upgrading and expanding their product lines and incorporating the latest lighting technologies to meet evolving market trends and industry standards. While the products might boast sophisticated engineering, contractors should make sure they are easy to install and maintain. For example, can the electronics be accessed from the room side? Can the LED drivers be remotely located for easy access where necessary? What are the mounting styles? If the mounting is unique, does the manufacturer supply the necessary hardware and clear instructions?

There is no planned downtime in patient room occupancy or procedure scheduling in hospitals. Ease of installation is especially important when you don't want to take a room out of service, particularly one that generates significant revenue, like an operating room (OR), to accommodate a complicated installation. Also, the ceiling/plenum space is often at a premium due to the equipment necessary for medical devices, air filtration, etc., often making access from both the room and plenum sides mission-critical. Plenum access in OR luminaires – where a luminaire provides an access panel to the plenum — can be a desirable feature, albeit one that is easier to install in new construction than in retrofit situations.

To help contractors foster customer relationships when specifying lighting products, it’s important to review manufacturers’ warranties to ensure continued product availability and uninterrupted service. If an intravenous (IV) pole inadvertently hits the lens of a headwall luminaire, what type of warranty does the manufacturer offer in this situation?

Challenges may occur on projects, so it’s key to establish a relationship with the manufacturers’ sales team, as well as access to knowledgeable applications and customer service teams, to help navigate issues ranging from specification and delivery to installation and beyond. Due to long construction cycles in healthcare projects, the rough-in components may be required months earlier than the finished product. For example, with recessed downlights, housings can be installed during the electrical and wiring phase, while reflectors and trim can be added later. Can the manufacturer provide staggered shipping to accommodate this type of construction schedule?

Lighting control systems and compatibility

It is important to not only provide the right light at the right time but to give both patients and providers control over how that light is delivered. Whether the lighting system is simple or sophisticated, its controls must be easy to use. From on/off and dimming to preprogrammed scenes — according to time of day or function — hospital staff need the ability to manually execute or override a control when necessary.

Depending on function and intended effect, LED lighting systems specified for healthcare facilities are typically equipped with the following drivers: 0-10V for static white correlated color temperatures (CCTs) to enable dimming down to 1% or less; 0V-10V or DALI (Digital Addressable Lighting Interface) for dynamic tunable white systems to allow independent control of CCT and intensity; or DMX for color changing technology such as RGB and RGBW.

Specifiers must determine if the luminaires are designed for seamless integration into a variety of wired or wireless control systems. When comparing manufacturers’ products, controls agnostic solutions that provide the ability to integrate with many compatible control systems on the market, help ensure the luminaires and controls meet specific lighting requirements and budgets.

Many hospitals are now future-proofing their designs via systems that offer patients more control over their environment and care during a hospital stay, which is a positive step in healing and recovery. Hospitals are also integrating smart lighting systems, attractive to patients, staff, and facility management. Remote control options, real-time asset tracking and analysis, and even smartphone apps offer a range of benefits from energy efficiency to convenience to enhancing comfort and performance.

From a facility perspective, these systems gather intelligence via sensors that detect and respond to occupancy, execute lighting schedules, and/or integrate into building control/automation systems. From a staff perspective, they are at the highest risk of burnout and should have the ability to adjust light levels to their needs. From a patient perspective, smart systems can be programmed to modulate intensity and spectrum throughout the day to improve sleep quality, reduce stress, and enhance overall well-being.

After-sales support

While specifying the right luminaires during the ordering and quotations process is critical, it’s also important that a manufacturer offers after-sales support. An experienced, committed applications team available to assist with questions regarding the installed products can positively affect both the project and its specifiers’ long-term relationships with the end-users. Enlisting their assistance with product installation, lighting layouts, lumen packages, illuminance calculations, luminaire weights, controls, wiring diagrams, and product modifications, for example, is an important consideration when deciding which manufacturers’ products to specify.

Reputable manufacturers employ field service personnel to support contractors and end-users. These experienced professionals are available to assist with installation questions that might arise on the job site and troubleshoot issues in the field. They can also arrange to have additional components or products shipped directly to the contractor’s facility or job site should the need occur. As such, manufacturer’s field service personnel, intimately familiar with the product and its application, can be a tremendous asset in resolving unanticipated issues efficiently and effectively.

A partnership

Lighting is essential to any space, but in a health care environment, it is crucial to the patients’ health and well-being, and to hospital staff’s ability to perform critical tasks. With lighting’s around-the-clock impact on patients and staff, a manufacturer with experience in this market understands that lighting can impact circadian rhythms, reduce staff errors, and lessen maintenance costs. Engineering luminaires that meet stringent healthcare standards, are sealed for cleanability and infection prevention, and are easy to install and maintain, further solidifies the relationship with contractors and end-users.