In recent years, conversations about human-centric lighting (HCL) have grown in popularity as healthcare organizations become more knowledgeable about the health and wellness benefits and improved patient outcomes associated with the approach.
“Our healthcare clients are much better educated about lighting than they were historically and have a higher level of expectation of what lighting is going to provide to a space,” says Matt Alleman, lighting specialist at SmithGroup (Los Angeles).
He attributes the growing adoption of HCL to more research into how light impacts people physiologically, as well as development of more lighting products in response to that research. “There is a pretty consistent understanding that lighting is important and needs to be designed thoughtfully,” he says. “The tide changed when designers were able to tie lighting design to patient outcomes because at the end of the day that’s what these healthcare systems are laser-focused on.”
Ryan Conover, associate principal and director of light and health at The Lighting Practice (Philadelphia, Pa.) agrees, noting that more clients are requesting advanced lighting systems, such as circadian and tunable lighting and control systems in both new-build and hospital renovation projects. These systems simulates natural light—as it changes in color, tone, and temperature over a 24-hour cycle from day to night—and its effects on the human body’s natural rhythm.
Circadian lighting prioritized in Stamford Health project
Circadian-supportive lighting is being prioritized in areas where patients, visitors, and staff spend prolonged periods of time and where abundant access to natural light is not available, including patient rooms, exam and clinical rooms, post-anesthesia care units (PACUs), and workstations. These systems utilize LEDs to adjust the intensity (brightness), tone (color), and temperature (warm during the day and cool at night) of light. In healthcare environments, circadian lighting can help regulate sleep-wake cycles as well as other physiological processes including body temperature, blood pressure, bowel movements, and the release of melatonin and cortisol, which improve mood and reduce stress.
For example, during a renovation in 2024 of the Whittingham Pavilion Cohen Neonatal Intensive Care & Maternity Unit at Stamford Hospital in Stamford, Conn. (part of Stamford Health), CannonDesign (Boston) introduced circadian lighting in staff areas, including the nurses’ stations, respite spaces, and lunch and meeting rooms. Dr. John Ciannella, director of the division of neonatology at Stamford Health (Stamford), says the result has been improved practitioners’ moods and the overall environment. “It’s night and day,” he says, adding, “it’s had an effect on me.”
Karen Murphy, lighting director at design and engineering firm HDR (Princeton, N.J.) and a chairwoman on the Illuminating Engineering Society Healthcare Lighting Committee, says she’s also seeing providers use these lighting systems to help aid recovery for specific patient populations, such as stroke victims, who can experience a change in their “sleep/wake” as part of their medical condition.
Circadian-supportive lighting can also help patients in PACUs by using the color and temperature of lighting to provide an intuitive understanding of the time of day, helping to reduce confusion as patients come out of surgery.
“Nothing I design with an electric lighting system is going to be as good as the daylight outside,” Murphy says. “If we can get natural light to the patients and the staff, do that. But there are spaces where you just can’t, where the light doesn’t reach, and that’s when we’re having those conversations with providers about circadian lighting.”
Promoting patient autonomy with lighting controls
Human-centric lighting also recognizes that people have varied needs for lighting and define comfort differently depending on the time of day as well as what they’re doing, says Sheri Teymouri, health planner at HDR (Omaha, Neb.). “Putting lighting controls in the hands of patients and staff is allowing them to personalize their environment to the extent possible,” she says. “It can be dimmable fixtures, bed light controls, which are fairly common now, or task lighting.”
HDR’s Murphy notes that task lighting is more than plugging in a table lamp and adding it to a desk. “It’s really about creating smaller zones so that the user can control architectural [built-in] lighting without it affecting the entire space,” she says.
Another strategy to support different user groups or functions is zoned lighting, says Kate St. Laurent, lighting design discipline director at CannonDesign (Boston). For example, a typical patient room may include an area for the patient, another for family and visitors, and one for clinicians and staff. Light sources for each section can be designed to be adjusted independently while still operating on the same system.
In the patient zone, controls might include keypads with tactile buttons and dimmer functions installed in pillow speakers for patients, while in the clinician work space, panels can be added at the headwall to adjust the intensity of task lighting that’s installed in the ceiling.
St. Laurent adds that she often includes a charting light that’s on a separate control switch and an amber nightlight for staff in the patient room. “The charting light will often double as a light near a sink and be on the corridor side of the room,” she says. “This provides enough light for a clinician to come in and take and record vitals, but both fixtures are shielded from the direct view of the patient and at a low enough level that it’s not disruptive to a patient.”
Importance of lighting design in behavioral health settings
One area where lighting designers see room for improvement is in applying HCL strategies in behavioral health environments, where the benefits of providing some sense of control are more pronounced for patients who often feel powerless, The Lighting Practice’s Conover says. “We’re getting to a better place where the product offerings for behavioral health environments are becoming more consistent with the rest of the hospital,” he says. “We don’t want people to feel differently in these environments, and so designers are pushing with innovation and by telling manufacturers that we want to be able to provide these lighting solutions for all patients.”
While product offering has improved in recent years, Murphy notes that the most persistent challenge to lighting in behavioral health is safety, with fixtures that need to be anti-ligature and tamper-resistant. While these requirements can add another layer of complexity, designers are finding ways to incorporate HCL elements in behavioral health exam rooms and common areas.
For example, simulated skylights or faux transoms with lighting can be programmed to change color, tone, and temperature throughout the day via an anti-ligature touchpad or screen on the wall. Also, Murphy says, more controls are being built into weighted light fixtures for behavioral health settings, such as task lights that turn on and off with a tap or by sliding a finger up and down, avoiding safety risks associated with a more traditional switch.
Beyond behavioral health settings, lighting designers say they expect more healthcare systems and project teams to continue to look for new ways to apply HCL to all healthcare spaces. “I’d like to see continued advancement in design strategy and product offerings to push the boundaries, to make [HCL] a level playing field so that lighting can have a positive impact on everyone, whether it’s a behavioral health patient or in a surgical space,” Conover says.
Robert McCune is senior editor of Healthcare Design. He can be reached at [email protected].
