India’s glorious past in medical education and sciences is world-renowned with famous experts such as Jivaka Kumarabhacca and Charaka showing the world how to treat diseases and illnesses. At a time when surgeries worldwide were done primitively, well-trained surgeons in India such as Sushruta performed the most advanced and complex surgeries, including cataract, plastic and reconstructive surgeries. Sushruta was also a great teacher who enabled students gain practical hands-on experience in surgical skills by making incisions on the skin of fruits. Inspired by such a glorious past, the Mahatma Gandhi Medical (MGM) College and Research Institute has built itself a reputation for medical education in India. The next stage in its evolution of becoming an integrated healthcare player has been the launch of India’s first USGBC LEED Platinumcertified hospital in Chennai, Tamil Nadu – MGM Healthcare. Its genesis is a “health-caring movement”, which redefines the patient experience across all parameters, through design, expertise, technology and environmental sustainability. Lighting was recognised as an imperative element in this health-caring movement to support doctors and therapists during treatments, and promote the healing process in patients with an increased sense of wellbeing. The right light at the right time in the right place was considered critical in this movement characterised by acute cost awareness and savings as a result of lower energy costs. With a built-up area of over 300,000 sq. ft., this 11-floor 400-bedded superspecialty hospital is optimally designed to provide the most comforting ambience for healthcare. Every aspect of the hospital reflects an ethos of healing and a sense of serenity, from the city’s tallest vertical garden to the use of music therapy in critical care areas, to thematic art galleries on each floor celebrating various facets of Tamil Nadu. These myriad tasks and the vastly differential spaces and users demanded a variety of lighting treatments without compromising energy efficiency. Although utility in terms of way finding was nonnegotiable, there was a lot of latitude to experiment with in terms of brightness, colour temperature and colour rendering. However, one general principle followed throughout the hospital was to make the effect of the 100 per cent solid-state lighting as natural as possible so as to provide a better sense of wellbeing among patients and staff.
Lobby and VIP Lounge
The preliminary brief was to provide the functionality and styleof a hospitality environment so as to elicit a certain emotional response from the hospital users. Therefore, the lobby had to be inviting yet professional to complement the furnishings and decor for creating an overall appeal. While a well-lit lobby was essential, care was taken not to flood it with overabundant illumination that might create environments akin to an emergency room. The lobby was divided into entrance, reception and waiting areas, with each area receiving its own lighting treatment to provide a different ‘feel’ for every area. The reception desk is well-lit and prominently highlighted with a decorative pendant in 3000K so that patients and visitors know exactly where to go first, and have adequate illumination for reading and signing necessary paperwork. The VIP Lounge is a waiting area specially allocated for important guests and visitors. The lighting solution was to create a relaxed and soothing atmosphere. Ceiling-mounted cylindrical 3000K downlights with adjustable heads provide accentuated illumination, which can also be used to highlight the paintings on the walls. Decorative floor lamps and wall-mounted up-downlights in 3000K are added next to seating areas to enable guests lounge with a book or socialise. Gold-finish luminaires are specified to match the beige and gold colour scheme used in the entire lobby and lounge areas.
Great care had to be taken while moving patients in stretchers or wheelchairs so as to avoid direct glare from the corridors lighting. Bespoke ceiling-recessed double-asymmetric linear profiles in 4000K ‘wash’ the two walls of the corridors to provide glare-free vertical illumination as well as enable way finding. For night-time use, these linear profiles can be dimmed using an analogue rotary-dimmer mounted on the entry walls of each corridor. Decorative pendants in 3000K highlight the nurse stations in all these corridors. In the executive floor corridors catering to the high-end suite rooms, circular coves with 3000K LED tape are used to provide soft warm illumination akin to a hotel corridor. Bespoke wall mounted decorative up-downlights in 3000K provide supplemental illumination in all corridors.
The doctors’ offices combine the dual tasks of a regular office and an examination room. Office lighting has to be ergonomically correct and individually adaptable. Examination room lighting requires high levels of general illumination and good colour rendering to show the true tone of the skin for visual examination and deciding the right treatment. However, since majority of the consultancy in a doctor’s office consists of simply talking with the patient, soft general illumination was the best lighting solution. Modular panel luminaires in the modular grid ceiling were the best way of reaching the 500lux average requirement with a colour temperature of 4000K and high Ra 90 value.
Direct indirect combined with task lighting provided the optimum-working environment for all paper and screen work in the hospital administration office. Decorative circular pendant luminaires of different sizes and configurations were used to create more intimacy and less of a clinical look. These luminaires were also selected to match with the exposed duct work in the ceiling.
When deciding how to light the cafeteria, it was important to determine the type of mood to be created based on its hours of operation. As this is a high-energy establishment with staff and visitors using the place 24×7, it required bright lighting to keep them awake and alert. The ambient and punctual lighting elements define the design and feel of this cafeteria. Large windows let in ample amount of natural light during the day, while the rhythmic composition of ‘floating’ 3000K linear profiles integrated between the wooden rafters provide illumination at night.
The training rooms for conducting special training sessions for doctors also doubles up as an auditorium for hosting major conferences. Therefore these rooms were much more than spaces where doctors come to sit and learn – they’re dynamic environments where people meet, learn, share ideas and collaborate. In order to provide such flexibility, lighting has been designed for easy pre-programming and dimming. Ceiling coves with LED tapes in 4000K provide ambient illumination to eliminate glare and fill in the shadows on faces so that people look well. Additional spotlights in 4000K provide accentuated illumination.
The pre-function area outside the training rooms features the city’s tallest vertical garden in the form of a living green wall. Although the large skylight allows ample natural light required for photosynthesis, supplemental illumination was required for those sections of the wall not receiving the required illumination. Additionally, the living wall becomes a night-time feature especially during conferences, hence required special highlighting. Linear grazers in 4000K were used from the top-downwards and below-upwards to evenly wash the green wall. Rest of the lighting in the pre-function area was kept to be bare minimum to maintain focus on the green wall.
Façade and Landscape
With the aim of becoming India’s first USGBC LEED Platinumcertified hospital, the criteria were fairly clear with respect to minimising light trespass from the building and site, reducing sky-glow to increase night sky access, improving night-time visibility through glare reduction and reducing development impact from lighting on nocturnal environments. Minimal lighting is provided to highlight the façade patterns and low level bollards are used to provide glare-free exterior lighting.
Few hospitals have a perfect lighting system, as the lighting demands are complex, and the need is for unique solutions that benefit both staff and patients. MGM Healthcare has strived to realise its motto of providing better health with lighting as one of the key elements.
Dr. Amardeep M. Dugar,
IALD, MIES, MSLL, Founder & Principal,
Lighting Research & Design