In many areas of the United States—especially Arizona and Florida—healthcare has become the leading industry. This trend will balloon as 78 million baby boomers move into their retirement years. Developing healthcare lighting expertise can have handsome payoffs for electrical contractors.
The next decade will yield incredible medical technological advances that will generate demands for diverse lighting de-sign. Savvy electrical contractors can become consultants to healthcare facility managers on lighting control systems for spe-cific applications.
A healing therapeutic environment is key to effective healthcare. However, hospitals and other healthcare facilities are archi-tecturally challenging and have unique lighting considerations. An array of lighting needs must be met for a variety of people: medical staff, patients, their families and visitors. Acute care hospitals, for example, operate 24/7, 365 days a year. Lighting systems are continually energized, making it essential to provide efficient and ecologically sound lighting options.
Advanced lighting controls can make life more pleasant for those for which hospitals were built: the patients. Illumination in multibed rooms should be unobtrusive to one patient while remaining adequate for the other. Automated shading and daylighting systems give patients access to outdoor views, which reduce disorientation and promote healing without subjecting patients to glare or heat. In all areas of the facility, universal design considerations are critical. For example, paddle-style switches and dimmers are easier for people with impaired mobility to operate than old-fashioned toggle switches.
Lighting designers must consider both the immediate objectives and the services that might eventually be required in each facility. For instance, areas originally illuminated for one specific task in a facility may eventually serve other needs. Thus, building in adaptability can be more economical in the long run. While lighting should serve the needs of the medi-cal staff, it ultimately should provide a comfortable, low-stress environment for patients.
Lighting to aid security
Like most commercial applications, medical facility security lighting is important. Proper lighting systems should help prevent accidents and avert danger.
“Protecting staff, patients and visitors is critical,” said Jennifer Butler, Healthcare Solutions marketing manager, Cooper Lighting, Peachtree City, Ga. “The lighting should be glare-free, and luminance ratios must be similar, so visibility is not negatively impacted.”
In addition, the theft of controlled substances is a major concern for hospital security, and lighting in the storage areas in-creases the substances’ visibility and make them difficult to steal. “Hospitals must make provisions for controlled medications with limited access, patient safety and security,” said Tom Myers, CSI, LEED AP, corporate accounts senior sales manager, Lu-tron Electronics Co., Coopersburg, Pa.
Lighting in a sensitive environment
Electrical contractors will look for UL-listed fixtures and, depending on the area being illuminated, sometimes radio frequency filters to ensure electromagnetic interference will not conflict with critical monitoring or electronic equipment, Butler said.
“There also is increased interest in antimicrobial paint finishes on lighting fixtures. This finish … helps prevent bacte-ria from growing on the housing,” Butler said.
According to Myers, in a post-9/11 world, hospitals must evaluate their capabilities to handle sudden large numbers of patients with high contamination levels resulting from a terrorist attack or other large-scale disaster, such as a hurricane or other major event. Planning for emergency lighting is also a concern for hospital facility managers.
Scanning areas such as magnetic resonance imaging (MRI), open MRI and computer assisted tomography (CAT) present unique lighting demands. Because of intense magnetic polarity from diagnostic equipment in MRI suites, luminaires must be constructed of nonferrous materials, such as aluminum, brass, certain types of stainless steel and polymers to prevent injury to patients and MRI technicians.
Mimicking the time of day
Lighting plays a critical role in health and recovery for most ill or injured patients. For example, one of the challenges for ICU patients is “ICU psychosis”—disorientation caused by disruption of circadian rhythms in units that are fully lit 24 hours a day and lacking windows. Lighting systems that mimic natural lighting cycles (e.g., the use of time clocks and dimmable ballasts) with lower lighting levels at night can help mitigate these effects.
Alzheimer’s disease patients also experience disruption of normal sleep-wake cycles. Lighting can aid in preventing disorientation by providing visual cues about the time of day.
Lighting also can help establish circadian rhythms for newborns. Some neonatal units and nurseries use cycled colored lights to help newborns adjust to a 24-hour day. Nursery lighting must provide a delicate balance between sufficient light to perform medical procedures while avoiding overexposure. Design should include dimming and switching plus flexibility to provide varying illumination levels.
Dust can be another concern in these areas. To minimize dust accumulation, select fixtures designed with smooth sur-faces in critical care areas where airborne contamination is a concern, Butler said. Look for fixtures with germ-guard doors that seal the fixture.
“Surgical suites have defined dust control requirements for HVAC equipment and the associated filter components, for example, HEPA ratings,” Myers said.
Something for the caregivers
System flexibility should meet unique demands of the night shift. A good solution might be dimming ballasts with multiple locations of control for caregivers and medical personnel.
Medication prep rooms tend to be small for performing complex activities and usually have counters, refrigerators, storage cabinets, sinks and double-locked controlled storage. High-intensity recessed luminaires with adjustable optics can improve fo-cus and visual accuracy to read pharmacy labels and dispense the right medication to the correct patient at the right time. Un-der-cabinet task lighting can improve both counter and cabinet illumination.
Light that enables doctors to note important skin color nuances should not produce glare or overexpose the patient’s ret-ina. Lighting control systems that automatically dim lights in patient rooms at bedtime can improve nursing staff productiv-ity.
In addition, “Lighting for the exam area will have different illumination requirements than a corridor,” Butler said. IESNA’s “Lighting for Hospital and Healthcare Facilities” provides guidelines.
Operating rooms command an unequaled level of multitasking and precision. Lighting design must adjust illuminance lev-els for a wide range of surgical procedures. Proper lighting design and luminaire selection can assist in limiting eyestrain, focus problems and fatigue, Butler said.
Accurate color rendering and discernment is critical to surgeons for processing images as well as during procedures. High-level tasks require extremely high CRI sources. Cooper Lighting recommends high color rendering lamps in the majority of critical care areas.
“As electronic imaging plays an increasingly larger role in surgery and diagnostics, physicians need greater control over ambient light levels in operating rooms and diagnostic suites,” Myers said.
Because many healthcare facilities operate around the clock, energy demands are high. According to GE, lighting ac-counts for 18 percent of the average healthcare facility’s electricity bill. Because lighting control is an important factor, seek out fixtures with integrated dimming and switching capabilities.
Advanced lighting control strategies, such as using occupancy sensors and dimming corridors during nonvisiting hours, can have a major impact on the facility’s bottom line.
One such product is Leviton’s Decora wall switch vacancy sensor. It is CEC Title 24-compliant and is useful in healthcare facilities where a manual-on occupancy sensor is needed.
ECs can play a consultative role to healthcare facility managers on lighting control systems for specific applications.
“These lighting solutions can be implemented locally—for example, using Lutron’s GRAFIK Eye systems or stand-alone controls—or through a facility-wide intelligent lighting system—such as Lutron’s EcoSystem,” Myers said.
Fixtures should incorporate the latest lamp and ballast technologies (T8 and T5HO fluorescent and LED lamp sources) and use the latest optical technologies to reduce the number of lamps needed per fixture. Ensure fixtures meet the recommended foot-candle levels for the various areas of the healthcare facility.
Lutron’s Myers said, in general, when commercial/industrial products are specified for the healthcare market, there are no specific “hospital-grade” lighting controls, as there are for receptacles. Because of the demanding environment, products highly rated for durability and reliability are preferred. However, “hospital-grade” and tamper-resistant receptacles (per UL 498 and NFPA 70) must be used in defined applications. Hospital-grade GFCIs and isolated ground receptacles must comply with UL 498.
Hospitals could use GE Lighting’s PulseArc metal halide lamps, which reach full output quickly, so they increase light levels while saving energy.
Ease of installation
The lighting industry can offer something for the EC. As technology progresses, you will find more easy-to-install lighting fix-tures designed for toolless installation.
“Fixtures designed for shallow plenums will facilitate easier installation. Low maintenance is a key feature when se-lecting light fixtures. Toolless lens removal, easy access to the lamps, and smooth, easy-to-wipe-down surfaces are key requirements,” Butler said.
And the healthcare construction market shows no signs of slowing down. As advancements in the healthcare field keep pouring in, well-designed medical facility lighting can help pave the path to profits. EC
WOODS writes for many consumer and trade publications. She can be reached at firstname.lastname@example.org.