-By Ar. Ashish Batra, General Manager (Architecture and Planning), Total Synergy Consulting Private Limited (TSCPL)

Illumination or Lighting is the intended use of light to achieve an aesthetic effect. Lighting includes the use of both natural light by capturing daylight as well as artificial light sources like lamps and various lighting fixtures. Enhanced aesthetics incorporated into fixture design, as well as the ability for the luminaire to light architectural details, are certainly important. However, lighting does play a very crucial role in hospitals and can contribute greatly to improve a patient’s condition.

Types of Artificial Lights

In general there are three basic types of lighting that work together:

Ambient lighting: Provides an area with overall illumination. Also known as general lighting, it emits a comfortable level of brightness without the glare effect.

Task lighting: This kind of lighting often helps a person perform a specific task such as reading, working and cooking.

Accent lighting: This kind of lighting adds drama to a room by creating visual interest. As part of an interior design scheme in any area or building. Accent lighting is used to draw the eye to paintings, sculptures or unique features etc.

Lighting in Hospitals: An Integrated Approach

The occupancy rate of hospitals is very dynamic and changes frequently. In hospitals, the lighting need for every occupant is very different from the other, and sometimes even conflicting. The visual and physical environment of hospitals impacts the psychological senses of the patient – the hospital staff, doctors and relatives. Efficiently designed lighting in the building structure satisfies the biological, visual and emotional needs of the users. It also affects the biological activity of a person, influencing body functions, concentration and creating a relaxed and soothing environment. Many twenty-four seven working areas of hospitals add importance to the lighting design and lend criticality to the lighting design of hospitals.

DThree core values applied to light in healthcare

The three core values applied to lighting in healthcare is Performance, Efficiency and Comfort normally quoted as PEC.

Performance: To provide an optimal lighting solution. In hospitals, day-cares and clinics, this can lead to quicker reactions and task completion with minimal mistakes resulting in great standards of care.

Efficiency: Efficiency is concerned with the energy economics, consumption and practical aspects of a lighting installation scheme; and

Comfort: The ability to give people satisfaction and simulation. Lighting impact attention and mood feeling which is also concerned with atmosphere, reassurance, and in the healthcare environment, the well-being of a patient.

Lighting design considerations in different areas of the Hospitals

Entrance: The key feature in the entrance area of a hospital is its functionality and aesthetics. Interesting lighting in the entrance or lobby area can make a hospital more inviting and lively. Generally, the entrance hall consists of four zones – the entrance, reception desk, the waiting area and the other areas that lead to the people in to the rest of the building. Four kinds of lighting are best suitable for entrance area in the hospitals, i.e. General Lighting, Lighting suspended above the counter, Accent lighting back wall and wall mounted lighting. Refer Image 2 for a picture showcasing lighting in the entrance area of Hospital.

Waiting Rooms/Areas: In waiting areas of hospitals, lighting has an important role to play in creating and welcoming friendly atmospheres. Lobbies and transition spaces must put the patients and visitors at ease instantly. Special attention is required in waiting rooms/areas to grading the luminance and reflectance of successive spaces, to create soothing, friendly and welcoming environment. Refer Image 3 for picture showing enhanced lighting in waiting area of a hospital.

The layering of light in waiting areas can create a pleasant and relaxing environment. Using a combination of overhead, recessed and indirect lights can enliven these areas. Glare-free appearance is an important factor to consider here. These small but critical areas in a healthcare setting can set the tone for the entire visitors and patients experience in hospital.

Corridors: For a hospital, which is often open 24 hours a day, corridors and circulation areas are the arteries of the building. They link the different areas together. Patients and visitors travelling through corridors will naturally benefit a bright illuminated corridors rather than a dark one and particular lighting can be used to optimize guidance.

In areas where patients and visitors circulate, factors of key importance are guidance, safety and re-assurance, which can be supported by using diffused homogenous lighting and avoiding dark spots. For corridors where patients are wheeled along on trolleys, it must be taken into consideration that sharp contrasts can be extremely uncomfortable when they are looking upwards. Refer image 4 for picture showing a well-lit and visually comfortable corridor of a hospital.

Colour selection of finished material used in corridor ceilings, walls and floors in relation to incident reflectance is critical in corridors. Elimination of glare is one of the most important design criteria for corridors. Recessed indirect or cove lightings are recommended in corridors.

Examination Rooms: Patient evaluation and medical procedures begin in the examination room of any hospital. Visual comfort and the visual appeal must all be addressed in the lighting design process for these areas. Refer image 5 for a picture showing an examination room in a hospital with efficient lighting.

Indirect lighting and the ability to switch the level of lighting intensity is critical in examination rooms. Consideration for a combination of recessed indirect/direct luminaries and specific task lighting is important. Skin and tissue tones are best rendered under light sources with a high color rendering index (CRI) of 80 and above.

Patient Rooms: Patient rooms are the areas where in-house patients spend most of their recovery time. Dynamic white light with ceiling modules that provide daylight rhythm with varying light levels and warmer or cooler colours are preferable. System flexibility must be allowed in the patient rooms to have individual control with additional switching locations for the healthcare professional. Refer to image 6 for pictures showing patient rooms in a hospital with efficient and soothing lighting. Glare and excessive brightness must be eliminated in the patient rooms.

Operation Theatres (OT): The visual requirement in the operation theatre is the detailed examination of tissues, organs and instruments at the site of the operation. It is always preferable that the illumination level for lighting the operating area should be between 2,000 to 10,000 lux. Each lighting fixtures should be provided with separate switching, to enable the individual requirement of light for special considerations in special cases. Refer image 7 for a picture showing detailed lighting in an operation theatre of a hospital.

Switching and dimming controls should be considered for these areas and reflective glare can be compounded if inappropriate finishes are selected for these areas. Recessed fluorescent lighting fixtures can control ceiling surface glares and can also provide the recommended illuminance levels on surfaces. Importantly in OTs, the luminaires should meet the requirements or electromagnetic interference/compatibility (EMI) and radio frequency interface (RIF).

Conclusion

Hospitals need to ensure that there are adequate lighting and illumination in the circulation area, indoor areas, and procedure rooms, in front of the facilities and the other important areas of the hospital. The hospital also needs to ensure that it uses energy-efficient measures like the use of natural light and energy-efficient bulbs like LEDs.

Although in hospitals all the lighting types and fixtures are not used together, it is considered that a proper blend of lighting types, results in an inviting, relaxed and pleasing environment. In healthcare spaces, choosing and providing the desired lighting is an important element of interior design, given that it is not just an illumination, but a factor that contributes to patients’ recovery and wellbeing.

General Lighting Design Considerations In Hospitals By Ar. Ashish Batra, Pg 31
Ar. Ashish Batra, General Manager (Architecture and Planning), Total Synergy Consulting Private Limited (TSCPL)