Thanks to the advancing age of the baby boomers, the need for healthcare facilities is continually growing. New hospitals are being constructed, and existing hospitals are being renovated and transformed into bigger and better facilities to accommodate the increased need. Ground-up and renovation projects offer the opportunity to design lighting that better addresses today's patients', visitors', and medical staffs' requirements. This new lighting concept should incorporate energy-efficient, environmentally friendly green lighting fixtures, lamps, and controls. Green lighting design can be accomplished through a variety of cost-effective methods.

One trend in healthcare lighting design is to create spaces with warm, relaxing light, generating an environment with a residential rather than an institutional feel. In keeping with the residential experience, many patient rooms, corridors, and waiting areas have wall sconces and other decorative lighting fixtures integrated into the facility's design (figures 1 and 2). This concept allows patients to rest and recover better, without having to look up at a 2′ x 4′ fluorescent troffer. The soft glow from a wall sconce and/or indirect lighting is more relaxing, promoting patient healing.

West Dade Radiation Oncology Center, Nurses' Station, Doral, Florida

West Dade Radiation Oncology Center, Reception and Waiting, Doral, Florida

Corridors are another area where the concept of lighting is evolving. It can be disconcerting for a patient to be pushed down a corridor on a stretcher, looking up at the rows of bright, fluorescent troffers flashing overhead. To improve the patient experience, designers are choosing lighting in corridors that is indirect and evenly washes the walls with light.

As the baby boomers begin to require medical assistance, there will be an influx of older patients, and older eyes require brighter surfaces to facilitate safe movement throughout the facility. Energy-efficient wall washers, architecturally designed on one side of the corridor, can be used to brighten and define the vertical surface. Indirect lighting in the corridor, provides a friendly, safe means of egress (figure 3).

South Miami Hospital Medical Arts Buildings and Ambulatory Surgery, Waiting Area, Miami, Florida

To achieve green lighting's energy-efficient and environmentally friendly attributes, a variety of lamps with a long lamp life are available. The residential, incandescent look can be achieved through the use of energy-efficient fluorescent fixtures using 3000K lamps. Fluorescent decorative fixtures with a golden diffuser can provide additional warmth to light from efficient lamps. Similarly, compact fluorescent downlights can achieve this result through the use of wheat-colored reflectors rather than the standard clear, anodized reflectors.

Another positive feature associated with fluorescent lamps is their ability to emit less heat than incandescent lamps. This attribute helps to lower air-conditioning costs, another green aspect of these lamps. The most efficient fluorescent ballasts are electronic. The T5 lamp, at 5/8″ diameter and 28 watts, is more efficient than the T8 at 1″ diameter and 32 watts.

When incandescent light fixtures are used, they should be on dimmers, which will further extend their lamp life. Compact metal halide lamps are becoming common for general, ambient lighting, but although they have a long lamp life, they are generally not dimmable. Induction lamps are another option; they have an extremely long lamp life: approximately 100,000 hours.

Light-emitting diode (LED) lighting is another green option because of its long life and low heat emission. Colored LED lights can be used for wayfinding, which is crucial in hospitals. Through the partnering of floor patterns with lighting intensity, signs in the crossroads of hospitals can become more prominent, easing any confusion with the facility layout. LED light fixtures can also serve as night-lights in patient rooms.

The most efficient source of light is daylight, which is vital to the healing process and has been documented to provide both psychological and physiological benefits. Incorporating daylight into a hospital's lighting design is an easy green option. The Green Guide for Health Care suggests that automatic daytime dimming controls should be used for light fixtures that are located 15 feet inside and 2 feet to either side of all windows, within 10 feet around all skylights, and within 10 feet from the exterior face of clerestories, to optimize the energy efficiency of the facility's lighting system. Light fixtures located farther into the room, away from the source of natural light, will not be affected by the daylight.

Whenever possible, large windows should be a part of the total hospital experience, from patient rooms to public spaces to staff stations to procedure rooms, such as surgical and MRI suites. However, large windows can increase heat loads. To offset this, automatically controlled shades can regulate the amount of direct sunlight while still providing a view to the outside.

In new construction, design features such as light shelves can be used to enhance the effects of daylighting into the interior spaces. Light shelves are horizontal surfaces placed at exterior windows. Light bounces from the shelf, off the interior ceiling, and into the room.

Green lighting design can be achieved efficiently and cost-effectively through the implementation of any of these lighting methods. These design concepts can be easily incorporated into a hospital project, whether it is new construction or a renovation, and produce significant results. HD

Patricia Rice-Spivey, AIA, is a project manager with MGE Architects, Coral Gables, Florida. She has more than 11 years' experience on major healthcare and education projects, including renovations, newly constructed buildings, and construction documents. MGE Architects provides architecture, master planning, and interior design services for healthcare, educational, and transportation projects in Florida and the Southeast. Contact Rice-Spivey at 305.444.0413.

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Healthcare Design 2006 May;6(3):32-35