Reducing errors
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, lighting approaches and technologies should be an important consideration during new construction or renovation.
Innovatively engineered luminaires that provide the right amount of illumination for staff can reduce eyestrain and fatigue and lessen errors and incorrect assessments.
It makes sense 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 Health-care 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. The study also cites research suggesting these visual lighting needs differ from biological lighting needs, such as to stimulate the circadian rhythm for people working long shifts under artificial light.3 Modifications can be incorporated into the design of the working environment to improve efficiency, productivity, safety, and job satisfaction. Scientists at the Lighting Research Center (LRC) have been exploring the role of light and investigating how it can be used to improve performance and facilitate healthier outcomes for shift workers. Previous studies showed that long-wavelength (red) light exposure increases objective and subjective measures of alertness at night without suppressing nocturnal melatonin and inducing circadian disruption. The LRC’s recent study investigated whether exposure to red light at night would increase measures of alertness and improve performance. LRC researchers hypothesized—and the results supported this—that exposure to red and white light would improve performance, and that only white light would significantly affect nighttime melatonin levels.
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, such as caregiver effectiveness and patient well-being. For years, health-care lighting has been a tale of two extremes—offering either functional but institutional appearance, or extremely decorative forms. Some manufacturers and designers have come to realize there does not need to be a tradeoff. To move the industry forward, it is critical to understand architects’ and designers’ perspectives of wanting luminaires with sleek, low-profile styles to elevate health-care lighting design while providing glare-free, comfortable illumination that supports the visual tasks of staff, and enhances the overall well-being of patients.
Maintenance is another important consideration in health-care lighting. To combat health-care associated infections (HAIs), luminaires must withstand hospital cleaning protocols and hold up to the most stringent infection control requirements.
Infection control and reduced maintenance
Health-care acquired infections (HAIs) are the fourth leading cause of death in health-care facilities in Canada. It is estimated more than 200,000 Canadians acquire a HAI each year and that 8000 of them die as a result.6 Besides the traditional prevention and control strategies of hand hygiene, environmental cleaning, and infection control surveillance, the built environment can significantly contribute to the reduction of HAIs. 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 are not 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 59-kg (130-lb) 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 lightweight luminaires, work can be done quickly in the patient room itself, thereby reducing costs and prolonging sustainability of the luminaire system.
In Canada, the requirements for emergency power and egress lighting are defined in the National Building Code (NBC). Specifically, the code calls for the provision of emergency power supply from a power source such as batteries or generators that will continue to supply power for two hours in the event the regular power supply to the building is interrupted.
Conclusion
Meeting architectural priorities, addressing myriad functions of lighting, and being mindful of facility considerations are critical in health-care facilities. There is evidence supporting the important role lighting plays on patients, visitors, and staff. However, if health-care luminaires only complement the architecture without being human-centric, then they overlook a vital role. Yet, the functional luminaires that have been standard for decades in hospitals ignore the importance architecture and design play in promoting patient healing and staff well-being. Recognizing 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. Fleming has worked in the lighting industry for over 25 years. Her focus has been on health-care product development, marketing, and sales for the last decade. Fleming can be reached at colettef@axislighting.com.
