Rewriting Lighting for Healthcare: Applying Emerging Technologies for Circadian Support and Patient Well-Being

Rewriting Lighting for Healthcare: Applying Emerging Technologies for Circadian Support and Patient Well-Being

This piece was originally published in the February 2018 issue of electroindustry.

Dorene Maniccia, Director, Office & Industry Global Strategy, Research Americas, Philips Lighting, Patricia Rizzo, Senior Lighting Applications Designer, Research Americas, Philips Lighting

Ms. Maniccia is a LEED AP professional with a specialty in lighting control design and applications.

Ms. Rizzo’s focus is on bridging lighting research and design practice.

Healing, sleep, patient and staff satisfaction, circadian regulation, universal design, and energy efficiency are all important considerations for healthcare design.

How do we juggle these priorities and provide an elegant system solution that is sensitive to patient, family, caregiver, and facility operator needs? Is it possible to balance all of these seemingly conflicting priorities and provide a system that suits everyone? As the recipient of the U.S. Department of Energy’s SSL R&D Program’s first application-based research award, Philips Lighting was challenged to explore these questions, move beyond the healthcare lighting status quo, and redefine lighting for the patient room application.

The goal was to deliver an innovative light-emitting diode (LED) patient suite (i.e., patient room and bathroom) lighting system solution that was 40 percent more energy efficient than traditional fluorescent technologies; would meet all the visual and nonvisual needs of patients, caregivers, and visitors; and would improve the patient experience. The solution was built upon application- and stakeholder-driven value propositions that considered 21st-century design best practices, end-user and owner attitudes and expectations, visual and nonvisual needs, health and well-being, and policy and regulatory requirements.

Supporting Natural Rhythms

The system concept was created by first developing a lighting design that demonstrated best practices for patient room lighting—illuminance and uniformity for task performance, reduced glare, and intuitive controls—and gave patients control over the lighting in their environment. A framework was defined to deliver circadian support via software behaviors. Through that process, luminaires were identified that could accommodate multichannel LED platforms, provide uniform color mixing, and deliver target design light levels. A skylight luminaire was selected for the patient bed area to give the illusion of the sky while providing white light on the patient bed. Luminaires used either tunable white or tunable color LED platforms as well as Power over Ethernet (PoE) drivers.

Software that was flexible and nuanced in its complexity was written to set behaviors for myriad lighting scenes in the room throughout the 24-hour day, all of which could be overridden by manual controls. This included a dynamic tunable white program, three color-changing automatic programs that simulated degrees of sunrise to sunset palettes, and an amber night lighting system that offered visual cues for postural stability to minimize the risk of falls.

All programs were carefully designed to provide visual comfort for all occupants, support critical task performance for staff, and support the patient’s 24-hour diurnal rhythms. A full-scale mockup room was constructed in Philips Lighting’s Research and Development labs in Cambridge, Massachusetts. The lighting system was installed and tested and its functionality was demonstrated to ensure smooth operation of system components: luminaires, drivers, switches, wall controls, patient remote, and daylight and occupancy sensors.

Redefining Standard of Practice

How did the system perform? It met visual criteria, confirmed by calculations, simulations, and measurements in the mockup. It met nonvisual criteria, confirmed by setting circadian stimulus targets and performing calculations using the calculator developed by the Lighting Research Center. Finally, human factors validation studies were conducted to gain insight from healthcare professionals. The general consensus was positive, with requests to pilot the system in hospitals.

The importance of the research completed under this grant is that it allowed the exploration and development of a unique lighting system, one that would deliver a blend of visual and nonvisual benefits in patient room design for today’s healthcare environment. The research investigated the area of multichannel LED technology, multichannel PoE drivers, and integration with automatic and manual controls as a system. It married visual needs of patients and staff with support for 24-hour rhythms, placing value on the well-being of the patient while successfully saving energy over incumbent technologies.

The project outcomes redefined the standard of practice for lighting the individual patient room suite in U.S. hospitals and demonstrated that patient-centered design for light color and quality, tunability, and health and well-being can—and should—be elevated in importance over energy efficiency. The outcome was a novel patient suite portfolio that maximized energy efficiency while providing spectral tuning and control functionality for delivering health and well-being benefits not previously accomplished with traditional systems in the U.S.

Its value to the public can best be expressed by a patient experiences director who, after spending several hours immersed in the environment, analyzing all its features, commented: “This rewrites lighting for healthcare.”

A completed full-scale mockup operating in circadian support mode. Photos courtesy of Philips Lighting

This project was partially funded by the U.S. Department of Energy for comprehensive application-specific system development opportunities. The authors thank the U.S. Department of Energy (Award No. EE0006704) for its support of this work.

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