2014 0217 the experience of light for health and wellbeing

The Experience of Light
for Health and Wellbeing
An evidence-based approach
Rosalyn Cama, FASID, EDAC
rcama@camainc.com
camaincorporated.com

Driving the Patient Experience

- AF

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aut
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riential
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estorative
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OM
-I

Satisfied Customer

Satisfaction = Expectation - Perception

RECOVERY

“...clues emitted by
people and things tell a
story to customers...”
(Berry & Bendapudi, 2003)

REPORT

PERCEPTION

Technology

Rapid Improvement in Technologies
From Healthcare and Other Domains
Allow New Solutions

Science &
Research

New Normal

New Science is Showing
Visual and Non-visual
Impacts on Individual and
Organizational Outcomes

$$$

Changing Economics
and Rewards

New Functions for Inpatient
Lighting Systems
•
•
•
•

Applications

Best Practice Examples Show
Functions are Achievable

Independent controls
Intuitive controls
Varied nature-like experience
Non-visual benefits

Outcomes

Healthcare Systems Increasingly Focus
on Outcomes Backed by Evidence

Visual & Non-visual Effects
Better Science Showing Visual and Non-Visual Impacts
of Lighting on Individual and Organizational Outcomes

Outcomes
Non-visual effects
Alertness
Circadian rhythm
Pain
Sleep
Mood
Comfort
Experience
LIGHT

Functional PERFORMANCE

INCREASE SAFETY

REDUCE COST

Visual acuity
aesthetics

Visual effects

IMPROVE PATIENT OUTCOMES

IMPROVE PATIENT EXPERIENCE
AND SATISFACTION

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.”

Perception
of Care

“...patients perceived their
overall quality of care as
better in the more attractive
physical environment.”
(Becker & Douglass, 2008)

22. Would you recommend this
hospital to your friends and
family?

 Definitely no
 Probably no
3
 Probably yes
4
 Definitely yes
1
2

“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
environmental satisfaction was a significant
predictor of overall satisfaction.”

ABOUT YOU

There are only a few remaining items
left.
26. During this hospital stay, were you
admitted to this hospital through
the Emergency
HCAHPS Survey Room?

 Yes
2
SURVEY INSTRUCTIONS
 No
1

UNDERSTANDING YOUR CARE
27. In general, how would you rate
WHEN YOUshould only fill out this survey if you were the patient during the hospital stay
♦ You LEFT THE HOSPITAL

your overall health?
named in the cover letter. Do not fill out this survey if you were not the patient.
1
23. During this hospital stay, staff checking the box to the left of your answer.
♦ Answer all the questions by
 Excellent
took my preferences and those of
♦familyare caregiver into to skip over some2 Very good survey. When this happens
You or sometimes told
questions in this
my
3
you will see an what my
 Good
account in decidingarrow with a note that tells you what question to answer next, like this:
4
health care needs would be when I
 Yes
 Fair
5
left.
 No  If No, Go to Question 1  Poor
1
 Strongly disagree
You may notice a number on the survey. This number is usedyoulet us know if
28. In general, how would to rate
2
 Disagree
you returned your survey so we don't have tooverall mental or emotional
your send you reminders.
3
Please
 Agree note: Questions 1-25 in this survey are part of a national initiative to measure the quality
health?
of care in hospitals.
4
 Strongly agree OMB #0938-0981
1
 Excellent
2
 Very good
24. When I left the hospital, I had a
3
Please understanding of the things I
3.  During this hospital stay, how
good answer the questions in this
Good
survey about your for inat the hospital
often did nurses explain things in
4
was responsible stay managing
 a way you could understand?
Fair
named on the cover letter. Do not
my health.
5
 1Poor
include any other hospital stays in your
1
 Never
answers.
2
2
29. What isSometimes grade or level
 the highest
 Disagree
3
of school that you have
3
 Usually
YOUR CARE FROM NURSES
Agree
completed?
4
4
 Always
 During this hospital stay, how
Strongly agree
1.
1
 8th grade or less
often did nurses treat you with
2
4.  Duringhigh school, but did not you
25. When I left the hospital, I clearly
Some this hospital stay, after
courtesy and respect?
pressed the call button, how often
understood the purpose for taking
graduate
1
did you get help as soon as you
 my medications.
3
each ofNever
 wanted it? graduate or GED
High school
2
 Sometimes
4
1
 1Some college or 2-year degree
 3Strongly disagree
 Never
 Usually
5
2
 24-year college graduate
 4Disagree
 Sometimes
 Always
6
3
 3More than 4-year college degree
 Agree
 Usually
4
Strongly agree
4
 Always
5
 often did given any medication to
I was not nurses listen carefully
9
 I never pressed the call button
you? I left the hospital
when

 Never
 Sometimes
3
 Usually
4
 Always
1

(Harris, et al., 2002)

2

4

March 2013

March 2013

1


“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)

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
Vision

Institutional
Intelligence

Constituency
Intelligence

Design
Intelligence

Project
Wisdom

Research
Intelligence

Thought
Leaders
Intelligence

Project Wisdom

PATIENT ROOMS

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)

SHORTER STAY
LESS PAIN MEDS

Innovators
2.5%

Restorative

Early
Adopters
13.5%

Early
Majority
34%

Human-centered

Roger’s Innovation Curve

Late
Majority
34%

Laggards
16%

Efficient
Effective

Safe

Determinants of Decision Making
values (belief)

3

2

GET HERE

innovate

lag - baseline

2

1
value $$$

Baseline Knowledge
Launches Innovation


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.


Circadian
Rhythm


Photon Shower

Delta introduces a device designed to
alleviate jet lag via light therapy


Light Therapy

Bus stops in the northern Swedish town of
Umea have been fitted with light therapy panels
to help commuters fight off the winter blues.


Pain Management

Exposure to natural light reduces pain and
the use of pain medications.


Sunlight exposure increases levels of serotonin,
a neurotransmitter that inhibits pain pathways.


Shaded

vs

Sunny

46%
greater
sunlight
intensity

Sunlight & Pain

Effect of sunlight on pain medication usage of
patients recovering from spinal surgery.


Shaded

vs

Sunny

21%

46%
greater
sunlight
intensity

Sunlight & Pain


reduction
in med cost

22%
less pain
meds


Distraction Theory

Patients diverted by a pleasant distraction have
less attention to direct to their pain.


Light & Sleep

“When I was asleep, I could block out the steady
stream of energy that bombarded my senses.”
(Taylor, 2009)


Improve Sleep

The 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.


NICU Lighting

Infants exposed to day/night lighting
cycles experienced deeper sleep and
a greater rate of weight gain.


Cycled Lighting

Constant Light


Cycled Lighting

Greater rate of weight gain
Fed orally sooner
Fewer days on ventilator
Enhanced motor coordination

Constant Light


Mood

Colder climates have the longest
lengths of stay in winter and fall.


Mood

Shorter length of stay for patients at
medical centers located in warmer
and drier climates.


Mood

and drier climates.

Canadian Hospital
Cardiac Intensive Care
Sunny vs. Shady Rooms

Sunny Rooms:
Lower Mortality
Rates

Italian Hospital
Bipolar Depression
East vs. West Rooms

Canadian hospital
Severe depression

East-facing
Shorter Stay:
3.7 days

Sunny Rooms
Shorter Stay:
2.6 days


Light Treatment
As effective as antidepressant
drugs and faster acting.


Light treatment
effective onset:
2 weeks

Antidepressants
effective onset:
4–6 weeks

Light Treatment


Cool Mornings
Set the Light to Your Mood


Lightboost

Designed to Improve Sleep Quality


Warm Afternoons


Improve patient/
family experience

Patients and families want varied lighting to
provide outdoor-like experience.


Improve patient/
family experience
Patient wants to be able to read or
use electronic devices in bed without
glare, at any sitting angle.


Wayfinding

Wayfinding problems cannot be
tackled piecemeal...hospitals should
provide integrated systems that
include coordinated elements.


Wayfinding

Individuals 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.


Lighting the Path
Accentuate key landmarks to help
people find their way independently.


$220,000 / yr
Hidden cost of directiongiving by people other
than information staff at
a major regional 604-bed
tertiary care hospital.

Lighting the Path


Reduce Falls

Disoriented patient needs to
find bathroom safely at night.


Satisfaction
& Biophilia

Adequate lighting affects overall
satisfaction with a hospital stay.


“Beauty is our word for perfection of
those qualities of environment that have
contributed most to human survival.”
~ E.O. WILSON, 2011
Americans
spend about

or more of their
time indoors.


Perception of Care

Interior design greatly influences patients’
perceptions of quality.


Aesthetics
Light and Art


Aesthetics

Light as Art
Glass artist Paul Housberg

Where does the Lighting Field have to Go?

Third Photoreceptor - ipRGC

Non-Image-forming
centers of the brain

i

G
pR

C

Ga
ng
lio
n

Image-forming
centers of the brain

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 Light
Is this enough?

800
lux of light

AIA Guidelines
Is this enough?

1600

1200

400

0

c

n

n

n

n

n

ir

s

O

r

te

er
m

m

pring

a ll
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ve

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win

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a dien
m

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ay

ay

ay

ay

a in

D

D

D

D

D

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for t
en

ea
M

ea
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ea
M

ea
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ea
M

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 Customer
Berry, L., & Bendapudi, N. (2003). Clueing in customers.
Harvard Business Review, 81(2), 100-106.

Satisfied Customer


 Definitely no
 Probably no
 Probably yes
 Definitely yes

PERCEPTION

4


the Emergency
HCAHPS Survey Room?

1
 Yes
2
SURVEY INSTRUCTIONS
 No

your overall health?
named in the cover letter. Do not fill out this survey if you were not the patient.
1
23. During this hospital stay, staff checking the box to the left of your answer.
♦ Answer all the questions by
 Excellent
took my preferences and those of
2
♦ You or sometimes told
questions in this
my familyare caregiver into to skip over some  Very good survey. When this happens
3
you will see an what my
 Good
account in decidingarrow with a note that tells you what question to answer next, like this:
4
health care needs would be when I
 Yes
 Fair
5
left.
 No  If No, Go to Question 1  Poor
1
You may notice a number on the survey. This number is usedyoulet us know if
28. In general, how would to rate
2
 Disagree
you returned your survey so we don't have tooverall mental or emotional
your send you reminders.
3
Please
 Agree note: Questions 1-25 in this survey are part of a national initiative to measure the quality
health?
of care in hospitals.
4
 Strongly agree OMB #0938-0981
1
 Excellent
2
 Very good
24. When I left the hospital, I had a
3
Please understanding of the things I
good answer the questions in this
Good
often did nurses explain things in
survey about your for inat the hospital
4
was responsible stay managing
 a way you could understand?
Fair
named on the cover letter. Do not
my health.
5
 1Poor
include any other hospital stays in your
1
 Never
answers.
2
2
29. What isSometimes grade or level
 the highest
 Disagree
3
of school that you have
3
 Usually
YOUR CARE FROM NURSES
Agree
completed?
4
4
 Always
Strongly agree
1
 8th grade or less
often did nurses treat you with
2
4.  Duringhigh school, but did not you
25. When I left the hospital, I clearly
Some this hospital stay, after
courtesy and respect?
pressed the call button, how often
understood the purpose for taking
graduate
1
did you get help as soon as you
 my medications.
3
each ofNever
 wanted it? graduate or GED
High school
2
 Sometimes
4
1
 1Some college or 2-year degree
 3Strongly disagree
 Never
 Usually
5
2
 24-year college graduate
 4Disagree
 Sometimes
 Always
6
3
 3More than 4-year college degree
 Agree
 Usually
4
Strongly agree
4
 Always
5
 often did given any medication to
I was not nurses listen carefully
9
 I never pressed the call button
you? I left the hospital
when

Probably no

Upali Nanda, Healthcare Design Conference 2013,
Orlando, FL

26. During this hospital stay, were you
admitted to this hospital through

2
3

UNDERSTANDING YOUR CARE
27. In general, how would you rate
WHEN YOUshould only fill out this survey if you were the patient during the hospital stay
♦ You LEFT THE HOSPITAL

Definitely no

REPORT

There are only a few remaining items
left.

1

RECOVERY

“...clues emitted by
people and things tell a
story to customers...”

ABOUT YOU

22. Would you recommend this
hospital to your friends and
family?

“Would you
recommend this
hospital to your
friends and family?”

Probably yes
Definitely yes


“Telephone interviews with 380 discharged
inpatients have helped determine that
environmental satisfaction was a significant
predictor of overall satisfaction.”

 Never
 Sometimes
 Usually
 Always

Harris, 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.

1

(Harris, et al., 2002)

2

4

3

March 2013

4

March 2013

Technology

Rapid Improvement in Technologies
From Healthcare and Other Domains
Allow New Solutions

Science &
Research

Applications

New Normal


“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)

Leather, 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.

Best Practice Examples Show
Functions are Achievable

New Functions for Inpatient
Lighting Systems

New Science is Showing
Visual and Non-visual
Impacts on Individual and
Organizational Outcomes

The New Normal
Dubose, J. & Zimring, C. (2013). The New Normal: New
Functions for Inpatient Lighting Systems, Healthcare
Design Conference, Orlando, FL.

1

• Independent controls
• Intuitive controls
• Varied nature-like experience
• Non-visual benefits

$$$

Outcomes

Changing Economics
and Rewards

Healthcare Systems Increasingly Focus
on Outcomes Backed by Evidence

Better Science Showing Visual and Non-Visual Impacts
of Lighting on Individual and Organizational Outcomes

OutcOmes
NON-vIsuaL eFFects
aLeRtNess
cIRcaDIaN Rhythm
PaIN
sLeeP
mOOD
cOmFORt
exPeRIeNce
LIGht

Functions for Inpatient Lighting Systems, Healthcare
Design Conference, Orlando, FL.

EBD DEFINITION
http://edac.healthdesign.org/
Artwork by Kevin Conklin, Afternoon Walk, 2008

FuNctIONaL PeRFORmaNce

What is evidence-based design?
The process of basing decisions about the built environment
on credible research to achieve the best possible outcomes.

INcRease saFety

ReDuce cOst

vIsuaL acuIty
aesthetIcs

vIsuaL eFFects

ImPROve PatIeNt OutcOmes

ImPROve PatIeNt exPeRIeNce
aND satIsFactION

Perception of Care

PROJECT WISDOM
Cama, R. (2009). Evidence-Based Healthcare Design, John
Wiley & Sons.

Project
Vision

Institutional
Intelligence

Constituency
Intelligence

Design
Intelligence

Project Wisdom

Project
Wisdom

Research
Intelligence

Perception of Care

Thought
Leaders
Intelligence

“...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.”

Perception
of Care

“...patients perceived their
overall quality of care as
better in the more attractive
physical environment.”
(Becker & Douglass, 2008)

Perception of Care
Becker, 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 ROOms

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)

shORteR stay
Less PaIN meDs

Better View or Better Light?
Ulrich, R. S. (1984). View through a window may influence
recovery from surgery. Science, 224, 42–421.

DESIGN FOR INNOVATION
Kumar, V. (2013). 101 Design Methods: A Structured
Approach for Driving Innovation in Your Organization,
Hoboken, NJ; John Wiley & Sons.

Alertness | cIRcaDIaN Rhythm | PAin | sleeP | mood | Comfort | exPerienCe
CirCAdiAn rhythm

Circadian
Rhythm

Circadian Rhythm & Ambient Lighting
Airbus ambient lighting schemes
http://www.airbus.com/aircraftfamilies/comfort/lighting/

Design for Innovation

INNOVATION CURVE
Rogers, E.M (1995). Diffusion of Innovations, New
York, NY; Simon & Schuster Inc.
Innovators
2.5%

Restorative

early
adopters
13.5%

early
majority
34%

Human-centered

Late
majority
34%

Circadian Rhythm & Jet Lag
Photon Shower by Delta
http://www.wk.com/campaign/delta_photon_shower

Laggards
16%

Efficient
Effective

CirCAdiAn rhythm

Safe

Photon Shower

Roger’s Innovation Curve

aLeRtNess
Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPerienCe

Alertness

Control - Lamp - Fixture

aLeRtNess

Delta introduces a device designed to
alleviate jet lag via light therapy

ALERTNESS & LIGHTING CONTROLS
Hue by Philips
http://www.meethue.com/en-US

Lighting that Improves the Experience
The New Normal Worksheet

CirCAdiAn rhythm

Light Therapy

Bus stops in the northern Swedish town of
Umea have been fitted with light therapy panels
to help commuters fight off the winter blues.

Alertness | CirCAdiAn rhythm | PaIN | sleeP | mood | Comfort | exPerienCe
PAin

Pain Management

Exposure to natural light reduces pain and
the use of pain medications.

Improve patient/
family experience

Circadian Rhythm & Illuminated Surfaces
Swedish Bus Stop
http://www.news.com.au/lifestyle/health/feeling-down-lookinto-the-bus-stop-light/story-fneuzlbd-1226525544042

DAYLIGHT & PAIN
Ulrich, 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.

Patients in all rooms can get a morning
lighting experience from natural and electric
lighting regardless of windows, building
orientation and geographic location.

aLeRtNess

ALERTNESS & GESTURAL CONTROLS
Lumen Being by OLED Lighting Design Center
Acuity Brands
www.acuitybrandsoled.com/creations/lumen-being/

PAin

shaDeD

vs

suNNy

21%

46%
GReateR
suNLIGht
INteNsIty

Sunlight & Pain


ReDuctION
IN meD cOst

22%
Less PaIN
meDs

DAYLIGHT & PAIN
Walch, 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.

PAin

DISTRACTION THEORY
McCaul, K. D. and Malott, J. M. (1984). Distraction and
coping with pain. Psychological Bulletin, 95(3), 516–533.

Alertness | CirCAdiAn rhythm | PAin | sleeP | mOOD | Comfort | exPerienCe
mood

Mood

and drier climates.

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.

CLIMATE, LENGTH OF STAY, & MORTALITY
Federman, 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.

Distraction Theory

Patients diverted by a pleasant distraction have
less attention to direct to their pain.

Alertness | CirCAdiAn rhythm | PAin | sLeeP | mood | Comfort | exPerienCe
sleeP

LIGHT & SLEEP
Taylor, J.B. (2009). My Stroke of Insight: A Brain
Scientist’s Personal Journey, New York, NY; Penguin
Group.

“When I was asleep, I could block out the steady
stream of energy that bombarded my senses.”

The need for sleep increases with illness,
and patients are more susceptible to
sleep disturbances.

Italian Hospital
Bipolar Depression
East vs. West Rooms

LIGHT POLLUTION & NEED FOR SLEEP
Southwell, M. T., & Wistow, G. (1995). Sleep in hospitals
at night— Are patients’ needs being met? Journal of
Advanced Nursing, 21(6), 1101–1109.

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.

Canadian hospital
Severe depression

East-facing
Shorter Stay:
3.7 days

Sunny Rooms:
Lower Mortality
Rates

(Taylor, 2009)

Improve Sleep

Mood

and drier climates.

Canadian Hospital
Cardiac Intensive Care

Light & Sleep

sleeP

mood

Sunny Rooms
Shorter Stay:
2.6 days

mood

Light treatment
effective onset:
2 weeks

Antidepressants
effective onset:
4–6 weeks

LIGHT TREATMENT VS ANTIDEPRESSANTS
Golden, R. N., Gaynes, B. N., Ekstrom, R. D., Hamer, R. M.,
Jacobsen, f. m., suppes, et al. (2005). The efficacy of light
therapy in the treatment of mood disorders: A review and
meta-analysis of the evidence. American Journal of Psychiatry,
162(4), 656–662.

Light Treatment

sleeP

cycled Lighting

constant Light

CYCLED LIGHTING & NICU DEVELOPMENT
Miller, 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.

mood

Cool Mornings
Set the Light to Your Mood

MOOD & VARIABLE LIGHTING SCHEMES
HealWell by Phillips
http://www.lighting.philips.com/gb_en/application_areas/
healthcare/healwell.wpd

Greater rate of weight gain
Fed orally sooner
Fewer days on ventilator
Enhanced motor coordination

mood

Mood

Colder climates have the longest
lengths of stay in winter and fall.

CLIMATE, LENGTH OF STAY, & MORTALITY
Federman, 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.

Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | exPeRIeNce
exPerienCe

Improve patient/
family experience

Patients and families want varied lighting to
provide outdoor-like experience.

Illuminated Surfaces
Jason Bruges Studio - Great Ormond Street Hospital
http://www.jasonbruges.com/projects/uk-projects/nature-trail

exPerienCe

Improve patient/
family experience
Patient wants to be able to read or
use electronic devices in bed without
glare, at any sitting angle.

IMPROVED PATIENT/FAMILY EXPERIENCE
Lumen Being by OLED Lighting Design Center
Acuity Brands
www.acuitybrandsoled.com/creations/lumen-being/

exPerienCe

SATISFACTION
Ulrich, 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.

Satisfaction
& Biophilia

Adequate lighting affects overall
satisfaction with a hospital stay.

Alertness | CirCAdiAn rhythm | PAin | sleeP | mood | Comfort | ExpEriEncE
exPerienCe

Wayfinding
Carpman, J. R., & Grant, M. A. (1993). Design that cares:
Planning health facilities for patients and visitors (2nd
ed.). Chicago: American Hospital Publishing, Inc.

exPerienCe

“Beauty is our word for perfection of
those qualities of environment that have
contributed most to human survival.”

BIOPHILIA
Wilson, E.O. in Kellert, S.R. and Finnegan, B. (Producers).
(2011). Biophilic Design: The Architecture of Life [Motion
picture]. United States: Tamarack Media.

~ e.O. WILsON, 2011
ameRIcaNs
sPeND abOut

Wayfinding

OR mORe OF theIR
tIme INDOORs.

Wayfinding problems cannot be
tackled piecemeal...hospitals should
provide integrated systems that
include coordinated elements.

Wayfinding
Davis, R., Therrien, B., West, T. (2009). Working Memory,
Cues, and Wayfinding in Older Women. Journal of
Applied Gerontology, 28, 743.

Wayfinding

exPerienCe

Individuals 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.

PERCEPTION OF CARE
Becker, F., Sweeney, B., Parsons, Kelley. (2008). Ambulatory
Facility Design and Patients’ Perception of Healthcare Quality.
HERD 1(4), 35-54.

Perception of Care

Interior design greatly influences patients’
perceptions of quality.

exPerienCe

COST OF FLAWED WAYFINDING
Zimring, C, (1990). The cost of confusion: Nonmonetary and monetary cost of the Emory University
hospital wayfinding system. Atlanta: Georgia Institute of
Technology.

Third Photoreceptor - ipRGc

NON-ImaGe-FORmING
ceNteRs OF the bRaIN

ip

RG

c

Ga
NG
LIO
N

ImaGe-FORmING
ceNteRs OF the bRaIN

Lighting the Path

exPerienCe

Reduce Falls
University Medical Center of Princeton at Plainsboro.
Lighted handrail concept by HOK.
This research opens up a whole new
field in terms of light applications,
both for use therapeutically and for the
general population.

Reduce Falls

Disoriented patient needs to
find bathroom safely at night.

Third Photoreceptor
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 Field
Steven 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

Guidelines for Natural Light
Bernhofer, E. I., et al. (2013). Hospital lighting and
its association with sleep, mood and pain in medical
inpatients. Journal of Advanced Nursing

AIA Guidelines
Is this enough?

1600

Lux OF LIGht

1200

800

400

0

ay
D

ay
D

ay
D

ay
D

ay
D

W

L

eR

m

L

R
te
IN

L
Fa

m
su

aL
R
ve

G
IN
R
sP

O

N
Ia t
aD N
c e
IR m
c IN
R Ra
FO Nt
e

N
ea

N
ea

m

m

N
ea

m

N
ea

N
ea

m

m

AERA
Aera LED luminaire system designed by Acuity Brands
and offered by Winona
http://news.acuitybrands.com/US/acuity-brands-revealsnew-led-lighting-system-concept-at-lightfair/s/2978ac779003-4b69-9298-df16278371a3

REVEL
Revel by OLED Lighting Design Center
Acuity Brands
http://www.acuitybrandsoled.com/creations/revel/
Consider the innovative
evidence-based possibilities for
controls, lamps, fixtures that
improve health outcomes

2014 0217 the experience of light for health and wellbeing

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