“As the management of light is a matter of importance in Architecture, it is worth inquiring, how far this remark is applicable to building. I think then, that all edifices calculated to produce an idea of the sublime ought rather to be dark and gloomy.”
Contemporary designers, of course, would beg to differ with the great British political philosopher's views, at least insofar as they might apply to healthcare facilities (sublime or not). Natural light, colors both lively and warm, a calm, soothing ambience, and more-all found now not only in upscale hotels, but in healthcare facilities and (fittingly enough) fully supported by scientific evidence of their contribution to healing. The challenge for the designer today is in knowing how to vary lighting appropriately so that it does just the right job and no more from space to space, and to choose from the ever-widening array of lighting choices. For this issue of Healthcare Building Ideas, Contributing Editors Richard L. Peck and Shannon Powers-Jones gleaned insights from a variety of healthcare project participants.
Associate Vice-President, HGA Architecture, Los Angeles, California
With so many more options becoming available in healthcare design, what are the challenges of lighting design?
It is narrowing down the choices and achieving a balance between design and functional lighting, while not over-lighting. There are many options on the market today-multifunctional lighting, compact fluorescents, and LED lighting, for example.
Is the new emphasis on hospitality in healthcare a challenge?
I'd say it's more an opportunity-an opportunity to work with the interior designer, the electrical engineer, the lighting designer and, together, developing an idea of the patient's experience as he or she moves through the facility. As an example of what can be done, for the Cedars-Sinai Medical Center Samuel Oschin Comprehensive Cancer Institute, we implemented varying levels of lighting based on the sequence of movement through the space, and we designed lighting for the infusion area that complements an overhead skylight, in a way mimicking the circadian changes in the natural light throughout the day. We integrated backlit vision panels using different color lights and dimmer switches set behind abstract nature scenes that gradually change color and brightness throughout the day. It is not something you would notice on a brief visit, but you would if you were a patient spending as much as 12 hours a day in a chair receiving infusion therapy. It is a way of using the effect of natural lighting, which many studies have found contributes to healing, without overdoing the lighting in the space.
You mentioned before the various new, or relatively new, lighting options available. Would you elaborate?
LED lighting has great promise-it has a long life span and consumes far less energy than more traditional lighting. But, unfortunately, at its current price point it can be unaffordable. The technology is advancing rapidly, though, and color rendition is being addressed-someday soon it will get to the point of color testing against specific finishes and paints so that we can get a good idea of how it reflects, refracts, and so forth. So it's a Catch-22 for us: We can see that LED lighting is going to be great, but we can't design for it right now because of its cost. This is especially true on larger healthcare projects in California, where design and construction can take a number of years.
Efficient lighting with fluorescents is a part of HGA's commitment to sustainable design. Today's fixtures operate much more efficiently and economically than traditional bulbs. They are very useful for task lighting and downlighting, and through daylight controls and sensors can be optimized with careful balancing to provide just the right lighting against daylighting.
In treatment areas and patient rooms, we now have lighting that is multifunctional; one fixture can serve, as needed, as a downlight, an uplight, a night light, even an examination light, all in one.