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The New Normal: Evaluating innovative lighting solutions for inpatient rooms
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Transcript of 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
$$$Changing Economics
and Rewards
OutcomesHealthcare Systems Increasingly Focus on Outcomes Backed by Evidence
TechnologyRapid Improvement in Technologies From Healthcare and Other Domains
Allow New Solutions
ApplicationsBest Practice Examples Show Functions are Achievable
Science & ResearchNew Science is Showing Visual and Non-visual Impacts on Individual and Organizational Outcomes
New Normal New Functions for Inpatient Lighting Systems
• Independent controls• Intuitive controls• Varied nature-like experience• Non-visualbenefits
$$$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
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 & 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
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
Relax
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
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 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.
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
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?
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
The science of decision making, action, and innovation
How can we help decision-makers adopt change?
How can we be confident that new lighting solutions bring value to patients?
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
Animal models(new receptors)
fMRI
Controlled human experiments determine mechanism
(e.g., role of blue light exposure)Lab ergonomic
studies
FGI Guidelines
How can we help decision-makers adopt change?
How can we be confident that new lighting solutions bring value to patients?
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
Animal models(new receptors)
fMRI
Controlled human experiments determine mechanism
(e.g., role of blue light exposure)Lab ergonomic
studies
Philips HealwellMedical Lighting Speeds Up Recovery
Cool MorningsSet the Light to Your Mood
LightboostDesigned to Improve Sleep Quality
Warm Afternoons
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
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.
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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Nearly CertainNo Confidence Somewhat Likely
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/