the new normal: evaluating innovative lighting solutions for inpatient rooms

The New NormalEvaluating Innovative Lighting Solutions for Inpatient Rooms

Jennifer DuBoseKhatereh HadiRosalyn CamaCraig Zimring

ApplicationsBest Practice Examples Show Functions are Achievable

Science & ResearchNew Science is Showing Visual and Non-visual Impacts on Individual and Organizational Outcomes

New Normal New Functions for Inpatient Lighting Systems

• Independent controls• Intuitive controls• Varied nature-like experience• Non-visualbenefits

$$$Changing Economics

and Rewards

OutcomesHealthcare Systems Increasingly Focus on Outcomes Backed by Evidence

TechnologyRapid Improvement in Technologies From Healthcare and Other Domains

Allow New Solutions

Visual & Non-visual EffectsBetter Science Showing Visual and Non-Visual Impacts of Lighting on Individual and Organizational Outcomes

NoN-visual effeCts

aleRtNessCiRCaDiaN RHytHmPaiNsleePmooDComfoRtexPeRieNCe

visual aCuity aestHetiCs

visual effeCts

fuNCtioNal PeRfoRmaNCe

imPRove PatieNt outComes

imPRove PatieNt exPeRieNCe aND satisfaCtioN

ReDuCe Cost

iNCRease safety

outComes

liGHt

PatieNt Rooms

sHoRteR stayless PaiN meDs

Better View or Better Light?

“...patients assigned to

rooms with windows looking

out on a natural scene had

shorter postoperative

hospital stays and took

fewer pain killers than

patients in similar rooms

with windows facing a brick

building wall.”

sHaDeD suNNyvs

46% GReateR suNliGHt iNteNsity

Sunlight & PainEffect of sunlight on pain medication usage of patients recovering from spinal surgery.

sHaDeD suNNyvs

Sunlight & PainEffect of sunlight on pain medication usage of patients recovering from spinal surgery.

21%ReDuCtioN

iN meD Cost

46% GReateR suNliGHt iNteNsity

22%less PaiN

meDs

Light & Mood

Light & Sleep

11:00 Pm

Light & Circadian Rhythm

7:00 am

RoDsLow lightNo color

CoNesSufficientlight

Color vision

Blind Mice Make

Third Photoreceptor - ipRGC

imaGe-foRmiNG CeNteRs of tHe BRaiN

NoN-imaGe-foRmiNG CeNteRs of tHe BRaiN

i

pRGC

GaNGlioN

This research opens up a whole new field in terms of light applications, both for use therapeutically and for the general population.

AIA Guidelines Require Natural Lightis this enough?

meaN Day oveRall

meaN Day sPRiNG

meaN Day sum

meR

meaN Day fall

meaN Day w

iNteR

foR CiRCaDiaN

eNtRaiNmeNt

lux

of

liG

Ht

400

800

1200

1600

0

AIA Guidelines Require Natural Lightis this enough?

Patient Room

Contribution of Natural Light






and Rewards



Allow New Solutions

Improve Recovery Hospital wants lighting to restore circadian rhythms and improve sleep.

Improve SleepThe need for sleep increases with illness, and patients are more susceptible to sleep disturbances.

Improve patient/family experience Staff wants to be able to remain aware of patients at night from outside the room without light from the hallway disturbing patient or family while they sleep.

Concentrate

Safer CareNew provider needs to turn on exam light quickly and accurately without prior knowledge aboutthespecificroomcontrols.

Cleaning to reduce infectionCleaners need to turn on lights that allow highly effective cleaning (high CRI, oblique angles) then reliably restore lights to original settings.

Reduce FallsDisoriented patient needs to findbathroomsafelyatnight.

Quality CareProvider needs to assess the integrity and health of the patient skin and tissue from the patient bed.

OLEDsOrganic Light-Emitting Diodes:Diffuse area light sources, incredibly thin and lightweight

Energize

Improve patient/family experiencePatients and families want varied lighting to provide outdoor-like experience.

Improve patient/family experiencePatients in all rooms can get a morning lighting experience from natural and electric lighting regardless of windows, building orientation and geographic location.

Photon ShowerDelta introduces a device designed to alleviate jet lag via light therapy

Light TherapyBus stops in the northern Swedish town of Umeahavebeenfittedwithlighttherapypanelstohelpcommutersfightoffthewinterblues.

Reading

Improve patient/family experienceFamily member wants to turn on reading light without waking patient or requiring staff assistance or training.

Technology Trends Percent of American Adults (18+) Who Own:

91% of American adults have a cell phone, and 56% own a smartphone.

Pew iNteRNet PRoJeCt

Improve patient/family experiencePatient wants to be able to read or use electronic devices in bed without glare, at any sitting angle.






and Rewards



Allow New Solutions

How can we be confident that new lighting solutions bring value to patients?

Animal models(new receptors)

fMRI

Controlled human experiments determine mechanism

(e.g., role of blue light exposure)Lab ergonomic

studies

How can we help decision-makers adopt change?



fMRI



studies

The science of decision making, action, and innovation



Accessible physical and virtual models

Lighting mockups as part of design

Sample language for lighting narratives Plug-and-play

products and controlsCost data

Examples, stories, images measured outcomes


fMRI



studies

FGI Guidelines



Accessible physical and virtual models

Lighting mockups as part of design

FGI Guidelines

Sample language for lighting narratives Plug-and-play

products and controlsCost data

Examples, stories, images measured outcomes

Natural experiments and epidemiological studies: links to healthcare outcomes

Field ergonomic studies: do new controls support tasks?

Evaluated functioning clinical mockups


fMRI



studies

Philips HealwellMedical Lighting Speeds Up Recovery

Cool MorningsSet the Light to Your Mood

LightboostDesigned to Improve Sleep Quality

Warm Afternoons






and Rewards



Allow New Solutions

The New NormalWorksheet of NeW fuNctioNs for iNpatieNt LightiNg systems

Healthcare Design, November 2013Rosalyn Cama, Jennifer DuBose, Craig Zimring1

New economic realities in healthcare, emerging research linking lighting to individual outcomes, new technologies and best practice examples are all creating a “new normal” where lighting in inpatient rooms needs to serve additional functions. This worksheet is intended to help design teams achieve the “new normal.” It is not intended to be exhaustive, but rather is a discussion aid that a design team can use throughout the project to monitor whether or not they are achieving new and more demanding functions: it can be part of the lighting narrative that is given to the electrical engineer; it can be used for design review during each step in the design process for the design

Rosalyn Cama - [email protected] / Jennifer DuBose - [email protected] / Craig Zimring - [email protected]

team to verify that they are meeting the new normal; and it can help drive the investigative phase of the evidence-based design process.

We suggest the worksheet be used as part of discussion among team members and that each item is scored by consensus, looking particularly for items where the team does not have confidence that the design will satisfy the function. These are opportunities to look for better technologies or designs. Solutions may exist outside of healthcare in areas such as aviation, hospitality and manufacturing. They are also opportunities for owners, designers and manufacturers to work together to create innovative solutions.

This worksheet provides several specific scenarios that illustrate the new normal where different stakeholders can control lighting systems to support their needs and where they can receive visual and non-visual benefits. It does not cover all requirements of a lighting system that are covered in codes and standard but focuses on new opportunities.

1. safer care: New provider needs to turn on exam light quickly and accurately without prior knowledge about the specific room controls.

2. Quality care: Provider needs to assess the integrity and health of the patient skin and tissue from the patient bed.

3. cleaning to reduce infection: Cleaners need to turn on lights that allow highly effective cleaning (high CRI, oblique angles) then reliably restore lights to original settings.

4. reduce falls: Disoriented patient needs to find bathroom safely at night

5. improve recovery: Hospital wants lighting to restore circadian rhythms and improve sleep.

6. improve patient/family experience: Patients and families want varied lighting to provide outdoor-like experience.

7. improve patient/family experience: Patients in all rooms can get a morning lighting experience from natural and electric lighting regardless of windows, building orientation and geographic location.

8. improve patient/family experience: Staff wants to be able to remain aware of patients at night from the outside the room without light from the hallway disturbing patient or family while they sleep.

9. improve patient/family experience: Staff needs to observe patient from the bedside at night without light disturbing patient or family while they sleep.

10. improve patient/family experience: Family member wants to turn on reading light without waking patient or requiring staff assistance or training.

11. improve patient/family experience: Patient wants to be able to read or use electronic devices in bed without glare, at any sitting angle.

12. improve patient/family experience: Patients want to lie at any angle without looking directly at glare from fixtures or reflective surfaces.

13. reduce energy use: Hospital wants to achieve appropriate lighting levels without creating increased heat in the space.

14. reduce energy use: Hospital wants to maximize use of natural daylight when available, shutting off unnecessary artificial lighting.

1 2 3 4 5 6 7 8 9 10

Nearly CertainNo Confidence Somewhat Likely

1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


1 2 3 4 5 6 7 8 9 10


iNstructioNs: The design team should evaluate their lighting proposal from the perspective of whether they can achieve the following scenarios. Hold a discussion and decide as a team how certain you are that the proposed design will meet the scenario on a 1 to 10 scale: 1-No Confidence; 3-Some confidence; 5-Somewhat likely; 7-Quite likely; 10-Nearly Certain. How certain are you that the proposed solution will satisfy these scenarios:

Worksheet Downloadcamaincorporated.com/posts/

the new normal: evaluating innovative lighting solutions for inpatient rooms

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