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Lighting is of critical importance in hospitals. In my previous article I had covered in brief the importance of Human Centric lighting in Healthcare. Elaborating on that in a more holistic manner it is necessary to understand that an adequate level of lighting is essential for Hospitals for even basic tasks are to be carried out. Hope you enjoy reading it. We shall be glad to assist you with further information for projects.

  Not only are the healthcare locations often open long hours, but they also need to promote a sense of pleasantness, calmness, and wellbeing. Of course, the restricted areas which are essentially critical task areas need adequate lighting to ensure smooth operations often very critical and taking long hours. The quality of the visual environment has a positive effect on the occupant’s feeling of well-being and in the case of hospitals and healthcare buildings this can affect staff performance and patient recovery. Furthermore, another important factor is substantial savings is possible if energy efficient, effectively controlled lamps and luminaries are installed, with maintenance being considered at the design stage itself.

  The importance of lighting often goes beyond the practical, especially in locations such as healthcare facilities.

Key Considerations

  The work undertaken in a healthcare location can sometimes vary day to day, making greater insights into your lighting essential for optimal conditions. Some things to consider, include:

• Your hours – do your hours vary and/or are you a 24 hour or emergency location?
• How will your lighting requirements change between laboratories / patient rooms/surgical sites/outdoor areas, etc.?
• How will you create a welcoming first impression?
• How can lighting assist with directions and location information?

  Carefully designed lighting can transform the appearance of a space, making it attractive, welcoming and either restful or stimulating depending on the effect created. It can enhance the architectural appearance of the space and contribute to orientation and wayfinding. For example, harsh lighting has been identified as one of a series of stressors that can lead to episodes of delirium in a critical care unit. In the neonatal ward, appropriate lighting can result in improved development, development of sleep patterns and reduced retinal damage. The elderly and partially sighted particularly benefit from good quality, low-glare lighting

Daylight and powered light integration

  Both daylight and electrically powered light play a part here. Daylight infusion inside the spaces needs careful consideration, because it needs to be addressed at the initial building design stage itself.

  In fact, even the underground car parking area of hospitals which does not receive direct light from the sky, needs careful light planning to avoid unfriendly start to a hospital visit. Light from the sky is particularly important in hospitals. It gives excellent colour rendering making many clinical tasks easier. Integration of electric light with daylight is essential for optimum energy efficiency. This will mean assessing the daylighting performance and ensuring that electric lights can be controlled to complement daylight as and when required in a user-friendly way.

  The diurnal variation in daylight can help patients (particularly those who are in hospital for a long time) maintain their body clocks. As Daylight is also constantly changing as the sun moves round the sky and as clouds form and move about, the short-term variation gives variety and interest helping in early recovery of the patient. Along with day light view out is also particularly important for people in hospitals (staff and visitors as well as patients). Nursing staff work long hours in high-stress conditions and are often deprived of natural daylight, which is the main driver regulating our circadian rhythm. These caregivers need their circadian rhythm reg­ulated just as much as their patients do. Providing right kind of light reduces feelings of isolation and claustrophobia. It provides contact with the outside world and can add interest to the environment, particularly if things are happening outdoors.

Lighting Designing

  The lighting of hospital tasks is important as is the lit appearance of the interior. There can be a conflict of requirements. On the one hand, there are high technology and critical precision-oriented tasks, some of which can have life or death implications and on the other hand there are diverse kind of patients with ailments being treated towards curing and caring for them and bringing them relief and happiness. Also, obvious aim is using energy-efficient lighting equipment, but it must be balanced by visual performance requirements also. It also means only applying the lighting required for both the task and appearance, which does not mean flooding the whole areas of a hospital space with light that is unnecessary. The lighting installation needs to be designed to not only provide the lighting required, but also control it to the best effect. Examples of this are switching lighting off when there is sufficient daylight or when rooms, or areas, are not occupied such as toilets and bathrooms. This will require the lighting circuits to be planned. For example, zoning lighting circuits relative to the windows so that those nearest the window can be switched off while those furthest from the windows can be left on as necessary. Positioning and labelling of switches can help with this but in some cases automatic controls might be appropriate; however, for hospitals the designer must be sure that these will not interfere with the hospital’s operation.

  The importance of each area from lighting context will thus vary as will the solutions depending on application. It is impossible to categorise in detail the elements of lighting design because of the number of variables, which makes it important to commission an experienced lighting consultant. Some of the most important areas in a hospital to consider while designing of the required lighting are:

• Entrance Area
• Reception 
• Waiting Area
• Circulation Areas
• Day Care Areas
• Bedded Care Areas
• Nurses Workstations
• Medicine & Medical Equipment Store
• Pharmacy 
• Examination Rooms
• Imaging Rooms
• Surgical Rooms 
• Special Clinical Task Areas
• Bathroom & Toilet facilities – Especially for the patients admitted
• Kitchen of the F&B facility inside the hospital as well as that of staff cafeteria

  A further element of lighting appearance is concerned with the colour appearance of the light. it is preferable to use a lamp colour that blends reasonably well with daylight but does not appear too cool at night. For this, a lamp with a CCT of 4000 Kelvins is recommended
Insufficient illumination, glare or excessive differences of brightness within the field of view can cause considerable discomfort to those who must perform a task which requires visual concentration. The muscles of the eye, which regulate the pupil opening and which are responsible for accommodation and convergence of the eye, become tired and fatigued. Although the eye is highly durable, it is an organ that can easily become strained by adverse conditions.

Lighting Cost

  Like any other hospital building services, lighting has costs attached to it. They must be seen in context. The total capital cost of the electric lighting installation will be tiny compared with the cost of other building services and even smaller when compared with the total cost of the building. But unfortunately, lighting equipment is installed towards the end of a construction plan when cost savings are often being sought. Pressure should be avoided to reduce the quality of the installation. If the quality of the lighting installation is reduced, this could have detrimental effects on the operating costs. The life of a lighting installation will be ten years at least and often much longer. Therefore, if the installation uses more energy than it needs, because of less than ideal equipment, the running costs will be high. This will usually cancel out the apparent savings made through reduced equipment costs. The same thing applies to a costly maintenance programme, either through poor equipment that has a short life or through the need for complicated or difficult maintenance work. This means that the costs must be assessed through a life-cycle costing investigation. It is important to adopt such an overall approach even when capital and operating costs are borne by two different organisations or budgets. The remaining issue to be considered regarding lighting costs is that if good lighting is not provided then the staff will not be able to perform accurately and efficiently. Also, if the quality of the internal environment is compromised through poor lighting, the recovery rate of patients could get worse. Both will be considerably costlier in the context of the reputation of the hospital than the lighting – hence the necessity for a balanced approach where all the elements are considered.

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