In the first part of this eight page survey on lighting for healthcare, US-style, Lighting Journal reports on some unconventional and inventive lighting design projects at the University of Wisconsin Hospitals and Clinics in the USA.
With no windows in sight, an innovative lighting scheme at the University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA, has managed to evoke clouds and daylight. Hospital personnel work long hours under high-stress conditions, but if that weren't enough, they are usually deprived of zeitgebers (time givers) -- the main external factors such as temperature, physical activity, ambient noise and daylight patterns that help synchronize a person's circadian rhythms over a 24-hour period. As we know, the most important of these is daylight, the principal stimulus for regulating the body clock.
Staff and patients at the hospital now receive a healthy dose of this zeitgeber, as a result of a lighting design project executed by Steven L Klein, of consultants, Klein Lighting. The 200,000 sq m facility is entirely indorrs and offers very little access to daylight. The project was part of the renovation of the hospital's Department of Emergency Medicine, for which Klein Lighting provided the design concepts, reflected ceiling plans, construction details, elevations drawings and specification of lighting equipment.
Not surprisingly, the hospital's philosophy centers on wellness and health, with stress reduction as a key component in the healing process. The lighting design at UWHC was especially challenging because of the scrutiny of health professionals who are typically concerned with evidence based outcomes. There was always a keen sense of 'this better work or else' concerning each design concept, most of which the hospital had not previously conceived of or attempted.
A new lighting design vocabulary was developed that departed from the institutional designs of the past. First were the daylight references. As a trick of appearance, scores of faux 'skylights' (or miniature luminous ceilings) were specified for the examination and recovery rooms, as well as several office spaces. These appealed to users not only as a supplementary daylight reference, but as a welcoming departure from conventional, institutional-looking lighting equipment.
Obviously the configuration is artificial and there is no window in the ceiling. The faux 'skylights' are actually deeply recessed coffers with a simulated sky panel diffuser created by a silk screening. One secret to the successful integration of the fixture is the trim that separates the lens from the planer ceiling. By breaking the ceiling plane, the articulation of the fixture is given a metaphoric presence. The blue-sky-and-clouds diffuser makes the figurative appear quite literal -- they look like the real thing for people who need a connection to the outside. Because the application is not actual, but is psychologically appropriate, people easily accept the figurative metaphor of the skylight. This effect has less to do with the amount of light produced than with the quality of light.
At the same time, the 'skylight' replace conventional lighting equipment and accommodate all the seeing tasks. The specified colour temperature (4100K) and CRI (85), which is 'boosted' by the blue and white of the silk screen sky, is essential for reinforcing this sense of daylight -- as well as being able to accurately render the skin tones of people seeking medical attention, whose can be more easily evaluated when their skin melanin pigments are not enhanced. Warmer lamps of 3000K and 3500K do enhance skin melanin pigments and this colour exaggeration increases the difficulty of conducting an accurate visual triangle.
The faux skylight system was also extended into the hospital's Cancer Radiotherapy department, where, understandable, the total lighting ambient was designed to be visually uplifting, and calming, in order to comfort patients, family, and friends under extreme duress. The waiting room has a particularly notable lighting scheme which brings nature and quality lighting into the challenging windowless basement level, to create a unique atmosphere with an illusion of daylight. Multiple effects have been realized using a single fiber optic system, powered by a 70W metal halide illuminator.
The rustic stone walls are emphasized by bringing out the stones' natural beauty and texture, using close-offset down lighting--the same system frames and highlights a series of painting nature scenes by a local artist. Delicate balances of cool and warm interior colours are enhanced using the highest colour rendering lamps -- carefully integrated T5 fluorescent lamps are used throughout to minimize cove depths and maximize the available ceiling heights.
Waiting Under the Clouds Innovative lighting techniques were also carried through to the Emergency department waiting room. here the waiting room ceiling has eleven translucent lycra-wrapped 1200x1200nm custom fixtures that act as figurative clouds. Each unit features a twin 39W 4100K compact fluorescent strip, and eight Color Kinetics iColor NXT tubes, with RGB mixing. The fixtures' amorphous shapes pay homage to Kazuhide Takahama's light sculptures and can be visually interpreted as clouds due to their opaque nature and shape.
The custom-made liminaires express the characteristics of clouds that usually appeal to people -- opacity, form and kinetic movement. The fixtures slowly cycle between the two selected colours -- blue and green -- chosen because they are closest to that part of the spectrum (around 500nm) the human eye is most responsive to. As a result, the pupillary mechanism doesn't adapt to the radiance created and the result is a perception of greater brightness. The supposition behind the design is that in a stressful situation people's emotional can be manipulated by conveying the impression of brightness. The concealed light sources indirectly illuminate the inside of the lightbox, to wash coloured light across the space below and they are equipped with auxiliary compact fluorescent lamps to assist night time cleaning and maintenance tasks.
The light level is quite subdued most of the time. Direct illumination from 100nm diameter clear open 35W metal halide reflector downlights are limited to specific areas for supplementary tasks like reading. In this subdued luminous environment, the main lighting is capable of minimizing anxiety and offers a subliminal soothing effect. A post occupancy survey conducted by the hospital confirmed that people who have to wait are indeed calmer, demonstrating that the lighting can help to begin the healing process before the patient ever sees a doctor -- an outcome that satisfied our evidence-driven clients.
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Credits: Lighting Designer: Steven L. Klein, IALD, LC Interior Architect/Designer: Ardis Hutchins, AIA, IIDA Photography: Joe Demaio Photography