Why Hospitals Pay More for Cheap Lights
June 1, 2015 | Rich Manning
Typically the payback period of LED lighting is less than twenty-four months. But the value of its improvements in the quality of care? Priceless. Quality LED lighting prevents the healthcare equivalent of selecting black instead of navy blue socks from the sock drawer.
QUALITY OF CARE
It is crucial to accurately discern certain color variations in blood and skin when analyzing lab work, looking for signs of jaundice, or starting an IV.
The Color Rendering Index (CRI) rating system measures the color accuracy of different types of light sources. Different light sources exhibit the color of an illuminated object differently. The closer the rating to 100, the more accurate the representation of the actual color. The spectrum of color categories ranges from R1 which measures pale pink to R14 which measures olive tones. R9 and R13 are two common and vitally important colors in healthcare because they represent the colors of blood and Caucasian skin tone.
Source: The Lighting Handbook, Ninth Edition, Illuminating Engineering Society via Acuity Lighting
R9 values = strong red tones
A fixture with an R9 value higher than 60 greatly improves the ability of the caregiver to discern color variations. For patient rooms, exam rooms, ORs, restrooms, labs, pharmacies, and staff work areas, we specify premium LED light fixtures with an R9 around 82 for clients who understand the long-term benefits of higher quality lighting.
The majority of healthcare facilities use linear fluorescent lighting in patient care and support spaces. Linear fluorescent lighting (listed as 3 Narrow Bands FL in the chart) has an R9 of 1, with significantly sub-optimal color rendition performance. While we have not been able to locate research proving that hospital staff have a lower error rate after installing LEDs, the image below illustrates the drastic difference in high versus low R9 color accuracy.
R13 values = caucasian flesh tones
Similarly, light fixtures with a high CRI R13 value help caregivers assess rashes, lesions, and skin pigmentation. In NICUs, LED light fixtures enhance the ability of nurses to check for jaundice or “blue baby.”
While the fluorescent CRI value is 96 at the 3,000 Kelvin color temperature, it’s important to know the Kelvin color temperature preferred by the facility. The 3,000 Kelvin color temperature with the corresponding CRI value of 96 is a “warm white.” However, many hospitals prefer a “clean white” Kelvin temperature of 4,100K. At this temperature, the R13 CRI drops to 78 for typical T8 fluorescent lamps.
Fortunately LED manufacturers have become aware of the need for better color rendering in all color categories. Modules are now available with overall CRI values as high as 95 and an R13 CRI value of 98.
The older we get, the less light is transmitted to our retinas, and the higher light levels we need to perform our tasks. As the nursing workforce continues to age, hospitals need increasingly brighter levels of light to enable staff to see well.
Source: Acuity Lighting
When light levels are too dim for the 50+ caregiver, they experience eye strain and fatigue. This is especially true when staff members must remain in an environment with no control over the lighting level. Physical strain corresponds to lower morale, more time off, and other physical ailments.
Below, these guidelines describe the appropriate light levels for critical care areas. In general, staff over the age of 65 need four times as much light to perform the same task as a 25-year-old.
Source: The Lighting Handbook, Tenth Edition, Illuminating Engineering Society via Acuity Lighting
One study reveals the relationship between error rates and brightness. In a high-volume Army outpatient pharmacy, researchers investigated the relationship between the level of illumination (45, 102, and 146 foot-candles) and the prescription-dispensing error rate. An illumination level of 146 foot-candles was associated with a significantly lower error rate (2.6%) than the baseline level of 45 foot-candles (3.8%) (Buchanan et al 1991).
In the interest of avoiding liability claims, better lighting quality can enhance a caregiver’s ability to diagnose correctly, identify reactions, prevent secondary infections, and minimize readmissions.
ABOUT THE AUTHOR
Richard J. Manning PE, LEED AP
Senior Electrical Engineer
Rich Manning delivers energy efficient design solutions on challenging healthcare projects , with particular emphasis on the development of creative lighting controls and designs.
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