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The Experience of Light for Health and Wellbeing An evidence-based approach
Rosalyn Cama, FASID, EDAC
[email protected] camaincorporated.com
Driving the Patient Experience
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“...clues emitted by people and things tell a story to customers...”(Berry & Bendapudi, 2003)
Satisfied Customer Satisfaction = Expectation - Perception
RECOVERY
REPORT
PERCEPTION
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
Perception of Care“...when we’re considering a doctor or a medical facility, most of us unconsciously turn detective, looking for evidence of competence, caring, and integrity – processing what we can see and understand to decipher what we cannot.”
(Berry & Bendapudi, 2003)
Perception of Care“...patients perceived their overall quality of care as better in the more attractive physical environment.”
(Becker & Douglass, 2008)
4 March 2013
22. Would you recommend this hospital to your friends and family?1 Definitely no2 Probably no3 Probably yes4 Definitely yes
UNDERSTANDING YOUR CAREWHEN YOU LEFT THE HOSPITAL
23. During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding what my health care needs would be when I left.1 Strongly disagree2 Disagree3 Agree4 Strongly agree
24. When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.1 Strongly disagree2 Disagree3 Agree4 Strongly agree
25. When I left the hospital, I clearly understood the purpose for taking each of my medications.1 Strongly disagree2 Disagree3 Agree4 Strongly agree5 I was not given any medication
when I left the hospital
ABOUT YOUThere are only a few remaining items left.26. During this hospital stay, were you
admitted to this hospital through the Emergency Room? 1 Yes2 No
27. In general, how would you rate your overall health? 1 Excellent2 Very good3 Good4 Fair5 Poor
28. In general, how would you rate your overall mental or emotional health?1 Excellent2 Very good3 Good4 Fair5 Poor
29. What is the highest grade or level of school that you have completed?1 8th grade or less2 Some high school, but did not
graduate3 High school graduate or GED4 Some college or 2-year degree5 4-year college graduate6 More than 4-year college degree
March 2013 1
HCAHPS Survey
SURVEY INSTRUCTIONS
♦ You should only fill out this survey if you were the patient during the hospital stay named in the cover letter. Do not fill out this survey if you were not the patient.
♦ Answer all the questions by checking the box to the left of your answer.♦ You are sometimes told to skip over some questions in this survey. When this happens
you will see an arrow with a note that tells you what question to answer next, like this: Yes No If No, Go to Question 1
You may notice a number on the survey. This number is used to let us know if you returned your survey so we don't have to send you reminders.Please note: Questions 1-25 in this survey are part of a national initiative to measure the quality of care in hospitals. OMB #0938-0981
Please answer the questions in this survey about your stay at the hospital named on the cover letter. Do not include any other hospital stays in your answers.
YOUR CARE FROM NURSES
1. During this hospital stay, how often did nurses treat you with courtesy and respect?1 Never2 Sometimes 3 Usually4 Always
2. During this hospital stay, how often did nurses listen carefully to you?1 Never2 Sometimes 3 Usually4 Always
3. During this hospital stay, how often did nurses explain things in a way you could understand?1 Never2 Sometimes 3 Usually4 Always
4. During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?1 Never2 Sometimes3 Usually4 Always9 I never pressed the call button
“Would you recommend this hospital to your friends and family?” Definitely no
Probably no
Probably yes
Definitely yes
Patient Satisfaction“Telephone interviews with 380 discharged inpatients have helped determine that environmentalsatisfactionwasasignificantpredictor of overall satisfaction.”
(Harris, et al., 2002)
Patient Satisfaction“There is strong evidence that design changes that make the environment more comfortable, aesthetically pleasing, and informative relieve patient stress and increase satisfaction with the quality of care.”
(Leather, et al., 2003)
Evidence-based Design
Places of Wellbeing
Places of Wellbeing How does light influence healing?
Are we armed with enough data to date to design for health not just healthcare?
What is evidence-based design?The process of basing decisions about the built environment on credible research to achieve the best possible outcomes.
Project WisdomProjectWisdom
ProjectVision
DesignIntelligence
InstitutionalIntelligence
ConstituencyIntelligence
ThoughtLeaders
Intelligence
ResearchIntelligence
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.”
(Ulrich, 1984)
Design for Innovation
Roger’s Innovation Curve
Innovators2.5%
earlyadopters
13.5%
earlymajority
34%
Latemajority
34%
Laggards16%
Restorative Human-centered EfficientEffective
Safe
2
1
3
2
values (belief)
value $$$
lag - baselineinnovate
GET HERE
Determinants of Decision Making
Baseline KnowledgeLaunches Innovation
AlertnessControl - Lamp - Fixture
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsaLeRtNess
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.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsaLeRtNess
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsaLeRtNess
Circadian Rhythm
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCscIRcaDIaN Rhythm
Photon ShowerDelta introduces a device designed to alleviate jet lag via light therapy
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCscIRcaDIaN Rhythm
Light TherapyBus stops in the northern Swedish town of Umeahavebeenfittedwithlighttherapypanelstohelpcommutersfightoffthewinterblues.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCscIRcaDIaN Rhythm
Pain ManagementExposure to natural light reduces pain and the use of pain medications.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsPaIN
Sunlight exposure increases levels of serotonin, a neurotransmitter that inhibits pain pathways.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsPaIN
shaDeD suNNyvs
46% GReateR suNLIGht INteNsIty
Sunlight & PainEffect of sunlight on pain medication usage of patients recovering from spinal surgery.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsPaIN
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
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsPaIN
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsPaIN
Distraction TheoryPatients diverted by a pleasant distraction have less attention to direct to their pain.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsPaIN
Light & Sleep“When I was asleep, I could block out the steady stream of energy that bombarded my senses.”
(Taylor, 2009)
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCssLeeP
Improve SleepThe need for sleep increases with illness, and patients are more susceptible to sleep disturbances.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCssLeeP
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.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCssLeeP
NICU LightingInfants exposed to day/night lighting cycles experienced deeper sleep and a greater rate of weight gain.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCssLeeP
cycled Lighting constant Light
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCssLeeP
Greater rate of weight gain Fed orally soonerFewer days on ventilatorEnhanced motor coordination
cycled Lighting constant Light
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCssLeeP
MoodColder climates have the longest lengths of stay in winter and fall.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsmOOD
MoodShorter length of stay for patients at medical centers located in warmer and drier climates.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsmOOD
Italian HospitalBipolar Depression
East vs. West Rooms
East-facing Shorter Stay:
3.7 days
Canadian HospitalCardiac Intensive Care
Sunny vs. Shady Rooms
Sunny Rooms:Lower Mortality
Rates
Canadian hospital Severe depression
Sunny vs. Shady Rooms
Sunny RoomsShorter Stay:
2.6 days
MoodShorter length of stay for patients at medical centers located in warmer and drier climates.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsmOOD
Light TreatmentAs effective as antidepressant drugs and faster acting.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsmOOD
Antidepressants effective onset:
4–6 weeks
Light treatment effective onset:
2 weeks
Light TreatmentAs effective as antidepressant drugs and faster acting.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsmOOD
Cool MorningsSet the Light to Your Mood
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsmOOD
LightboostDesigned to Improve Sleep Quality
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsmOOD
Warm Afternoons
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsmOOD
Improve patient/family experiencePatients and families want varied lighting to provide outdoor-like experience.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsexPeRIeNce
Improve patient/family experiencePatient wants to be able to read or use electronic devices in bed without glare, at any sitting angle.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsexPeRIeNce
WayfindingWayfindingproblemscannotbetackled piecemeal...hospitals should provide integrated systems that include coordinated elements.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsexPeRIeNce
WayfindingIndividuals create cognitive maps based on relationships between cues in the environment. Older individuals are often impaired inwayfinding,especiallyin environments that lack distinctive features.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsexPeRIeNce
Accentuate key landmarks to help peoplefindtheirwayindependently.
Lighting the Path
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsexPeRIeNce
$220,000 / yr
Hidden cost of direction-giving by people other than information staff at a major regional 604-bed tertiary care hospital.
Accentuate key landmarks to help peoplefindtheirwayindependently.
Lighting the Path
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsexPeRIeNce
Reduce FallsDisoriented patient needs to findbathroomsafelyatnight.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsexPeRIeNce
Satisfaction & Biophilia
Adequate lighting affects overall satisfaction with a hospital stay.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsexPeRIeNce
“Beauty is our word for perfection of those qualities of environment that have contributed most to human survival.”~ e.O. WILsON, 2011
ameRIcaNssPeND abOut
OR mORe OF theIR tIme INDOORs.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsexPeRIeNce
Perception of CareInterior design greatly influences patients’ perceptions of quality.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsexPeRIeNce
AestheticsLight and Art
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsaesthetIcs
AestheticsLight as ArtGlass artist Paul Housberg
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | exPerienCe | AesthetiCsaesthetIcs
Where does the Lighting Field have to Go?
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?
Discussion
Consider the innovative evidence-based possibilities for controls, lamps, fixtures that improve health outcomes
For a copy of this presentation please visit http://camaincorporated.com/posts/
Thank you.
satIsFIeD custOmeRBerry, L., & Bendapudi, N. (2003). Clueing in customers. Harvard Business Review, 81(2), 100-106.
Satisfaction = Expectation - PerceptionUpali Nanda, Healthcare Design Conference 2013, Orlando, FL
the NeW NORmaLDubose, J. & Zimring, C. (2013). The New Normal: New Functions for Inpatient Lighting Systems, Healthcare Design Conference, Orlando, FL.
vIsuaL & NON-vIsuaL eFFectsDubose, J. & Zimring, C. (2013). The New Normal: New Functions for Inpatient Lighting Systems, Healthcare Design Conference, Orlando, FL.
PeRcePtION OF caReBerry, L., & Bendapudi, N. (2003). Clueing in customers. Harvard Business Review, 81(2), 100-106.
PeRcePtION OF caReBecker, F. & Douglass, S.J. (2008). The ecology of the patient visit: Physical attractiveness, waiting times, and perceived quality of care. Journal of Ambulatory Care Management, 31(2), 140.
PatIeNt satIsFactIONHarris, P. B., McBride, G., Ross, C., & Curtis, L. (2002). A place to heal: Environmental sources of satisfaction among hospital patients. Journal of Applied Social Psychology, 32(6), 1276–1299.
PatIeNt satIsFactIONLeather, P., Beale, D., Santos, A., Watts, J., & Lee, L. (2003). Outcomes of environmental appraisal of different hospital waiting areas. Environment & Behavior, 35(6), 842–869.
ebD DeFINItIONhttp://edac.healthdesign.org/
Artwork by Kevin Conklin, Afternoon Walk, 2008
PROJect WIsDOmCama, R. (2009). Evidence-Based Healthcare Design, John Wiley & Sons.
betteR vIeW OR betteR LIGht?Ulrich,R.S.(1984).Viewthroughawindowmayinfluencerecovery from surgery. Science, 224, 42–421.
“...clues emitted by people and things tell a story to customers...”(Berry & Bendapudi, 2003)
Satisfied Customer Satisfaction = Expectation - Perception
RECOVERY
REPORT
PERCEPTION
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
Perception of Care“...when we’re considering a doctor or a medical facility, most of us unconsciously turn detective, looking for evidence of competence, caring, and integrity – processing what we can see and understand to decipher what we cannot.”
(Berry & Bendapudi, 2003)
Perception of Care“...patients perceived their overall quality of care as better in the more attractive physical environment.”
(Becker & Douglass, 2008)
4 March 2013
22. Would you recommend this hospital to your friends and family?1 Definitely no2 Probably no3 Probably yes4 Definitely yes
UNDERSTANDING YOUR CAREWHEN YOU LEFT THE HOSPITAL
23. During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding what my health care needs would be when I left.1 Strongly disagree2 Disagree3 Agree4 Strongly agree
24. When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.1 Strongly disagree2 Disagree3 Agree4 Strongly agree
25. When I left the hospital, I clearly understood the purpose for taking each of my medications.1 Strongly disagree2 Disagree3 Agree4 Strongly agree5 I was not given any medication
when I left the hospital
ABOUT YOUThere are only a few remaining items left.26. During this hospital stay, were you
admitted to this hospital through the Emergency Room? 1 Yes2 No
27. In general, how would you rate your overall health? 1 Excellent2 Very good3 Good4 Fair5 Poor
28. In general, how would you rate your overall mental or emotional health?1 Excellent2 Very good3 Good4 Fair5 Poor
29. What is the highest grade or level of school that you have completed?1 8th grade or less2 Some high school, but did not
graduate3 High school graduate or GED4 Some college or 2-year degree5 4-year college graduate6 More than 4-year college degree
March 2013 1
HCAHPS Survey
SURVEY INSTRUCTIONS
♦ You should only fill out this survey if you were the patient during the hospital stay named in the cover letter. Do not fill out this survey if you were not the patient.
♦ Answer all the questions by checking the box to the left of your answer.♦ You are sometimes told to skip over some questions in this survey. When this happens
you will see an arrow with a note that tells you what question to answer next, like this: Yes No If No, Go to Question 1
You may notice a number on the survey. This number is used to let us know if you returned your survey so we don't have to send you reminders.Please note: Questions 1-25 in this survey are part of a national initiative to measure the quality of care in hospitals. OMB #0938-0981
Please answer the questions in this survey about your stay at the hospital named on the cover letter. Do not include any other hospital stays in your answers.
YOUR CARE FROM NURSES
1. During this hospital stay, how often did nurses treat you with courtesy and respect?1 Never2 Sometimes 3 Usually4 Always
2. During this hospital stay, how often did nurses listen carefully to you?1 Never2 Sometimes 3 Usually4 Always
3. During this hospital stay, how often did nurses explain things in a way you could understand?1 Never2 Sometimes 3 Usually4 Always
4. During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?1 Never2 Sometimes3 Usually4 Always9 I never pressed the call button
“Would you recommend this hospital to your friends and family?” Definitely no
Probably no
Probably yes
Definitely yes
Patient Satisfaction“Telephone interviews with 380 discharged inpatients have helped determine that environmentalsatisfactionwasasignificantpredictor of overall satisfaction.”
(Harris, et al., 2002)
Patient Satisfaction“There is strong evidence that design changes that make the environment more comfortable, aesthetically pleasing, and informative relieve patient stress and increase satisfaction with the quality of care.”
(Leather, et al., 2003)
What is evidence-based design?The process of basing decisions about the built environment on credible research to achieve the best possible outcomes.
Project WisdomProjectWisdom
ProjectVision
DesignIntelligence
InstitutionalIntelligence
ConstituencyIntelligence
ThoughtLeaders
Intelligence
ResearchIntelligence
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.”
(Ulrich, 1984)
DesIGN FOR INNOvatIONKumar, V. (2013). 101 Design Methods: A Structured Approach for Driving Innovation in Your Organization,Hoboken, NJ; John Wiley & Sons.
INNOvatION cuRveRogers, E.M (1995). Diffusion of Innovations, New York, NY; Simon & Schuster Inc.
aLeRtNess & LIGhtING cONtROLsHue by Philipshttp://www.meethue.com/en-US
LIGhtING that ImPROves the exPeRIeNceThe New Normal Worksheet
aLeRtNess & GestuRaL cONtROLsLumen Being by OLED Lighting Design CenterAcuity Brandswww.acuitybrandsoled.com/creations/lumen-being/
cIRcaDIaN Rhythm & ambIeNt LIGhtINGAirbus ambient lighting schemeshttp://www.airbus.com/aircraftfamilies/comfort/lighting/
cIRcaDIaN Rhythm & Jet LaG Photon Shower by Deltahttp://www.wk.com/campaign/delta_photon_shower
cIRcaDIaN Rhythm & ILLumINateD suRFacesSwedish Bus Stophttp://www.news.com.au/lifestyle/health/feeling-down-look-into-the-bus-stop-light/story-fneuzlbd-1226525544042
DayLIGht & PaINUlrich, R.S., Zimring, C., Zhu, X., DuBose, J., Seo, H., Choi, Y., Quan, X., Joseph, A. (2008). A Review of the Research Literature on Evidence-Based Healthcare Design. HERD 1(3), 82.
DayLIGht & PaINWalch, J. M., Rabin, B. S., Day, R., Williams, J. N., Choi, K., & Kang, J. D. (2005). The effect of sunlight on post-operative analgesic medication usage: A prospective study of patients undergoing spinal surgery. Psychosomatic Medicine, 67, 156–163.
Design for Innovation
Roger’s Innovation Curve
Innovators2.5%
earlyadopters13.5%
earlymajority34%
Latemajority34%
Laggards16%
Restorative Human-centered EfficientEffective
Safe
AlertnessControl - Lamp - Fixture
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCeaLeRtNess
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.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCeaLeRtNess
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCeaLeRtNess
Circadian Rhythm
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCecIRcaDIaN Rhythm
Photon ShowerDelta introduces a device designed to alleviate jet lag via light therapy
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCecIRcaDIaN Rhythm
Light TherapyBus stops in the northern Swedish town of Umeahavebeenfittedwithlighttherapypanelstohelpcommutersfightoffthewinterblues.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCecIRcaDIaN Rhythm
Pain ManagementExposure to natural light reduces pain and the use of pain medications.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCePaIN
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
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCePaIN
DIstRactION theORyMcCaul, K. D. and Malott, J. M. (1984). Distraction and coping with pain. Psychological Bulletin, 95(3), 516–533.
Malenbaum, S., Keefe, F. J., Williams, A. C., Ulrich, R., and Somers, T. J. (2008). Pain in its environmental context: Implications for designing environments to enhance pain control. Pain, 134: 241–244.
LIGht & sLeePTaylor, J.B. (2009). My Stroke of Insight: A Brain Scientist’s Personal Journey, New York, NY; Penguin Group.
LIGht POLLutION & NeeD FOR sLeePSouthwell, M. T., & Wistow, G. (1995). Sleep in hospitals at night— Are patients’ needs being met? Journal of Advanced Nursing, 21(6), 1101–1109.
cycLeD LIGhtING & NIcu DeveLOPmeNtMiller, C.L., White, R., Whitman, T.L., O’Callaghan, M.F., & Maxwell, S.E. (1995). The effects of cycled versus noncycled lighting on growth and development in preterm infants. Infant Behavior and Development, 18(1), 87-95.
cLImate, LeNGth OF stay, & mORtaLItyFederman, E. J., Drebing, C. E., Boisvert, C., & Penk, W. (2000). Relationship between climate and psychiatric inpatient length of stay in veterans health administration hospitals. The American Journal of Psychiatry, 157(10), 1669.
cLImate, LeNGth OF stay, & mORtaLItyFederman, E. J., Drebing, C. E., Boisvert, C., & Penk, W. (2000). Relationship between climate and psychiatric inpatient length of stay in veterans health administration hospitals. The American Journal of Psychiatry, 157(10), 1669.
Beauchemin, K. M., and Hays, P. (1996). Sunny hospital rooms expedite recovery from severe and refractory depressions. Journal of Affective Disorders, 40(1–2), 49–51.
Benedetti, F., Colombo, C., Barbini, B., Campori, E., & Smeraldi, E. (2001). Morning sunlight reduces length of hospitalization in bipolar depression. Journal of Affective Disorders, 62(3), 221–223.
Beauchemin, K. M., & Hays, P. (1998). Dying in the dark: Sunshine, gender and outcomes in myocardial infarction. Journal of the Royal Society of Medicine, 91, 352–354.
LIGht tReatmeNt vs aNtIDePRessaNtsGolden, R. N., Gaynes, B. N., Ekstrom, R. D., Hamer, R. M., Jacobsen,f.m.,suppes,etal.(2005).Theefficacyoflighttherapy in the treatment of mood disorders: A review and meta-analysis of the evidence. American Journal of Psychiatry, 162(4), 656–662.
mOOD & vaRIabLe LIGhtING schemesHealWell by Phillipshttp://www.lighting.philips.com/gb_en/application_areas/healthcare/healwell.wpd
ILLumINateD suRFacesJason Bruges Studio - Great Ormond Street Hospitalhttp://www.jasonbruges.com/projects/uk-projects/nature-trail
Distraction TheoryPatients diverted by a pleasant distraction have less attention to direct to their pain.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCePaIN
Light & Sleep“When I was asleep, I could block out the steady stream of energy that bombarded my senses.”
(Taylor, 2009)
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCesLeeP
Improve SleepThe need for sleep increases with illness, and patients are more susceptible to sleep disturbances.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCesLeeP
Greater rate of weight gain Fed orally soonerFewer days on ventilatorEnhanced motor coordination
cycled Lighting constant Light
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCesLeeP
MoodColder climates have the longest lengths of stay in winter and fall.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCemOOD
MoodShorter length of stay for patients at medical centers located in warmer and drier climates.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCemOOD
Italian HospitalBipolar Depression
East vs. West Rooms
East-facing Shorter Stay:
3.7 days
Canadian HospitalCardiac Intensive Care
Sunny vs. Shady Rooms
Sunny Rooms:Lower Mortality
Rates
Canadian hospital Severe depression
Sunny vs. Shady Rooms
Sunny RoomsShorter Stay:
2.6 days
MoodShorter length of stay for patients at medical centers located in warmer and drier climates.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCemOOD
Antidepressants effective onset:
4–6 weeks
Light treatment effective onset:
2 weeks
Light TreatmentAs effective as antidepressant drugs and faster acting.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCemOOD
Cool MorningsSet the Light to Your Mood
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCemOOD
Improve patient/family experiencePatients and families want varied lighting to provide outdoor-like experience.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCeexPeRIeNce
Improve patient/family experiencePatient wants to be able to read or use electronic devices in bed without glare, at any sitting angle.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCeexPeRIeNce
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCeExpEriEncE
WayfindingWayfinding problems cannot be tackled piecemeal...hospitals should provide integrated systems that include coordinated elements.
WayfindingIndividuals create cognitive maps based on relationships between cues in the environment. Older individuals are often impaired in wayfinding, especially in environments that lack distinctive features.
Accentuate key landmarks to help peoplefindtheirwayindependently.
Lighting the Path
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCeexPeRIeNce
Reduce FallsDisoriented patient needs to findbathroomsafelyatnight.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCeexPeRIeNce
Satisfaction & Biophilia
Adequate lighting affects overall satisfaction with a hospital stay.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCeexPeRIeNce
“Beauty is our word for perfection of those qualities of environment that have contributed most to human survival.”~ e.O. WILsON, 2011
ameRIcaNssPeND abOut
OR mORe OF theIR tIme INDOORs.
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCeexPeRIeNce
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCeexPeRIeNce
Perception of CareInterior design greatly influences patients’ perceptions of quality.
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.
ImPROveD PatIeNt/FamILy exPeRIeNceLumen Being by OLED Lighting Design CenterAcuity Brandswww.acuitybrandsoled.com/creations/lumen-being/
WayFINDINGCarpman, J. R., & Grant, M. A. (1993). Design that cares: Planning health facilities for patients and visitors (2nd ed.). Chicago: American Hospital Publishing, Inc.
WayFINDINGDavis, R., Therrien, B., West, T. (2009). Working Memory, Cues,andWayfindinginOlderWomen.Journal of Applied Gerontology, 28, 743.
cOst OF FLaWeD WayFINDINGZimring, C, (1990). The cost of confusion: Non-monetary and monetary cost of the Emory University hospital wayfinding system. Atlanta: Georgia Institute of Technology.
ReDuce FaLLsUniversity Medical Center of Princeton at Plainsboro. Lighted handrail concept by HOK.
satIsFactIONUlrich, R.S., Zimring, C., Zhu, X., DuBose, J., Seo, H., Choi, Y., Quan, X., Joseph, A. (2008). A Review of the Research Literature on Evidence-Based Healthcare Design. HERD 1(3), 109.
bIOPhILIaWilson, E.O. in Kellert, S.R. and Finnegan, B. (Producers). (2011). Biophilic Design: The Architecture of Life [Motion picture]. United States: Tamarack Media.
PeRcePtION OF caReBecker, F., Sweeney, B., Parsons, Kelley. (2008). Ambulatory Facility Design and Patients’ Perception of Healthcare Quality. HERD 1(4), 35-54.
Berry, L., & Bendapudi, N. (2003). Clueing in customers. Harvard Business Review, 81(2), 100-106.
thIRD PhOtORecePtORDubose, J. & Zimring, C. (2013). The New Normal: New Functions for Inpatient Lighting Systems, Healthcare Design Conference, Orlando, FL.
Lok, C. (2011). Vision science: Seeing without seeing: There is more to the eye than rods and cones — the discovery of a third photoreceptor is rewriting the visual rulebook. http://www.nature.com/news/2011/110119/full/469284a.html
a WhOLe NeW FIeLDSteven Lockley, a neuroscientist at Brigham and Women’s Hospital quoted in Vision science: Seeing without seeing: There is more to the eye than rods and cones — the discovery of a third photoreceptor is rewriting the visual rulebook. http://www.nature.com/news/2011/110119/full/469284a.html
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AIA Guidelines Require Natural LightIs this enough?
Consider the innovative evidence-based possibilities for controls, lamps, fixtures that improve health outcomes
GuIDeLINes FOR NatuRaL LIGhtBernhofer, E. I., et al. (2013). Hospital lighting and its association with sleep, mood and pain in medical inpatients. Journal of Advanced Nursing
aeRaAera LED luminaire system designed by Acuity Brands and offered by Winonahttp://news.acuitybrands.com/US/acuity-brands-reveals-new-led-lighting-system-concept-at-lightfair/s/2978ac77-9003-4b69-9298-df16278371a3
ReveLRevel by OLED Lighting Design CenterAcuity Brandshttp://www.acuitybrandsoled.com/creations/revel/