Paul Nulty‘s essay was included in Ab Rogers Design’s Living Systems, the winning proposal for the 2021 Wolfson Economics Prize. Entrants were asked, ‘How would you design and plan new hospitals to radically improve patient experiences, clinical outcomes, staff wellbeing, and integration with wider health and social care?’ The entry took a collaborative approach that centred around the hospital building itself becoming part of the care team.
Nulty’s lighting specifics
So often we see functionality at the forefront of hospital lighting design. Of course, this is a crucial factor as it affects the way a hospital and its staff need to operate, but the emotion can get left behind. We have to remember why hospitals exist.
We need hospitals to make people feel better, to keep patients safe and envelop them in warmth and security while they go through something frightening. We all want hospitals to make people feel comfortable, but sterile design and lighting do quite the opposite. Lighting in hospitals is key and plays an important part in cultivating a safe and collaborative environment for both staff and patients. Through the use of layers of light, varying levels of illumination can provide both functional and aesthetically pleasing qualities.
The quality of light used in a hospital is really important. Different ages have different requirements for light – if you’re over 60, you will need on average about three times the amount of light as you do when you’re in your 20s. The location of a light source can be an important factor in reducing glare, which many elderly patients are sensitive to.
Melanopic lux
Directional light is also really significant. These days we talk about ‘a melanopic lux’, which is basically the amount of light delivered from a certain angle. You have rods and cones in your eye, which are the two receptors: one sees in colour and is for daylight, while the other sees in black and white. Anything below one lux and you tend to see in grey. This means that with different levels of light you have different abilities to see and process that light.
Research has found we have a third receptor in the eye, which reacts specifically to blue light and regulates hormone production in the body, such as melatonin, serotonin and cortisol. If a person has too little or too much of this, it can lead to a seasonal affective disorder and the body won’t function properly. All of this shows that in a space like a hospital where doctors need to be able to operate, patients need to feel rested and everyone in the space needs to be taken care of, a balance of different layers of light can be very important.
Although there are many ways that we can light a hospital, it’s imperative to remember the role that daylight plays in health. Daylight and vitamin D prevent illnesses such as scurvy and rickets. Natural daylight also helps to create a calm and comfortable atmosphere as it provides a welcome break from artificial light – especially significant for those patients who are spending a long stint on a ward. It can also make a real difference to the staff who work extensive hours in the hospital. They too need various types of light as this will be of benefit to their eyes, productivity and mental health.
Hospitals are illuminated in a standard way so that they are always prepared for emergencies. Whether you’re in a hospital ward, emergency room or hospital corridor, the overall layer of illumination needs to be practical so that the doctors and nurses can do their jobs effectively.
But this doesn’t mean that there has to be just one layer of functional lighting.
There could also be more personalised or localised light that changes colour temperature throughout the day to give a sense of time passing from day to night. You could also implement small gobo projectors in downlights to create a dappled light effect on the floor of the hospital, which could mimic moving trees or plants, or recreate moonlight. Where there are interesting objects in the hospital space, they could be properly illuminated to create focal points.
It’s great from a functional perspective to have uniform panels of light in the ceiling, but this can be quite dull as the eye doesn’t have anything to look away from. Instead, bouncing light off walls or allowing it to change and be dynamic in the space, encourages different emotional responses to each area of the hospital. All of these things help to achieve a warm environment, as opposed to a clinical and sterile one.
It seems strange to think about feeling at home in a hospital, but for staff and patients creating an environment that feels as close to home as possible could arguably help to boost morale.
Lighting could potentially play a part in making this conception of a hospital come to life. Bedside lamps placed next to each hospital bed could create the sense of being in a bedroom rather than a ward. Pendant lights, shades and localised lighting solutions above beds could make a space feel more domestic. When combined with functional overhead lighting, these simple changes could help a patient feel more comfortable in the space they’re in.
This story first appeared in the June issue of Commercial Interior Design magazine, which you can read here after signing up for our paywall.
