A Prescription for Better Lighting
by John Philip Bachner
“We don’t mind if you spend more money. It’s fine with us.” That’s not the kind of thing you’re likely to hear anywhere in any type of U.S. health care facility today. Instead, the mantra of “Try to do it for less” is so pervasive, just about all personnel are constantly on the lookout for ways to save.
Be careful. Sometimes even a gilt-edged savings opportunity could be a trap, unless you approach it the right way. Take energy, for example. And lighting. Am I suggesting that installing more energy-efficient, cost-effective lighting could be a trap?
Yes. Exactly so, unless it’s approached in the right way. And the right way begins with a simple question: “Why did we install lighting here in the first place?” And as simple as the question is, that’s about how frequently it’s asked. Which is a shame, because it’s an important question.
The answer to the question is rooted in the concept that lighting is for people and, more often than not, it’s installed to help people work more effectively. As such, the answer to “Why did we install lighting here in the first place?” is “To help people achieve optimal performance.”
Consider, if you will, the task of reading a medical chart. Assume, for the sake of discussion, that we have identified the world’s best medical chart reader, and we put her in a windowless room to test her performance. We give her the traditional “On your mark. Get ready. Set. Go.” and then we immediately turn off all the lights. Suddenly, something that she’s the best at becomes impossible. But then, bit by bit, we start increasing the lighting levels (illuminance) until she can start to read. She won’t do nearly as well as she otherwise could, however, because the lack of sufficient light will slow her down and cause her to misconstrue letters and words, leading to mistaken interpretations.
The location of the light source would also be important, insofar as the distribution of light and the direction that beams of light take in reaching the task surface and our reader’s eyes. If the lights shine more or less like the high-beam headlights of an oncoming car, the reader will have the right amount of light, perhaps, but the nature or quality of that light will not be what’s required to permit the fastest possible, error-free reading.
So what’s the point? Just this. Many health care administrators readily approve lighting energy conservation proposals without considering what type of impact the proposed modification could have on productivity, errors, safety, and a variety of related issues. And the dollars associated with the related issues could be hundreds of times greater than those associated with energy savings alone.
Consider the average administrative office worker. The cost of the energy used to provide the electric illumination that person needs to get the job done could be as little as $30 per year, depending on the lighting system being used and the prevailing energy costs. How much is that person paid? Probably $30,000 per year as a minimum, including wages, taxes, and fringe benefits.
If better lighting could help improve that worker’s productivity by just one percent (i.e., save about 300 seconds per day), the savings would amount to $300, a benefit equivalent to a theoretical 1000 percent energy savings. Or if better lighting could eliminate a glare source that was leading to headaches, neck aches, and eye strain, and thus eliminate one sick day each year, the benefit involved – a savings of about $115 – would have a value equivalent to an almost 400 percent lighting energy savings.
Suppose that the lighting energy conservation measures proposed result in lighting whose quality has been lessened a bit; enough to slow productivity by “just” one percent or to create a nagging glare source? And, thus, the trap, a situation where everyone seems happy about the outcome, not realizing that every dollar saved could result in five or ten or more being wasted.
How to avoid the trap? Simple. Just realize that everywhere that lighting is used, it has a purpose. It almost always is a “people purpose,” meaning that people will be able to perform more effectively – faster, with fewer errors, safer, etc. – with better lighting. Accordingly, before you authorize a lighting system change to lower energy consumption and costs, be certain to evaluate how the change will modify the lighting system and, as a consequence, affect peoples’ performance.
Better yet, you should try to achieve what the National Lighting Bureau calls High-Benefit Lighting®, that is, high-efficiency lighting that, first and foremost, is designed to optimize peoples’ performance, and thus maximize overall investment return. In many facilities, where lighting is five years old or older, evaluating the need for an energy-motivated upgrade also gives administration the ability to evaluate the potential impact of High-Benefit Lighting.
Where could High-Benefit Lighting be of value to you? In administrative areas, of course, many of which rely on lighting that was designed for the performance of “white paper tasks,” i.e., tasks that required a worker to look principally at a piece of matte-finished paper laid flat or nearly flat (in the horizontal plane) on a desk, while typing. Today, most tasks are computer-based, requiring workers to look principally at a computer screen in the vertical plane.
When lighting designed for one task is used for another, problems can arise, which is why so many computer operators are slowed by screen glare that can obscure portions of displays, leading to slower performance and a higher incidence of errors. How much can just one error cost? More than $30 per year?
In many health care facilities, certain areas are subject to frequent spills or other situations that can lead to slip/trip accidents. While lighting may not be able to prevent spills (in some cases it could), it can be used to illuminate areas in such a way that spills become far more evident, and could likewise be used to highlight warning signs. While in some cases this may mean the installation of lighting where none existed before, think about the money that could be saved from accident avoidance: the paperwork that does not have to be performed.
The hiring of replacements or temporaries that becomes unnecessary. The replacement or temporary workers’ orientation and training that goes unneeded. The potential insurance claims that stay potential. The possible lawsuits that are not filed and the bad publicity that never happens. While at times it is difficult to put a dollar value on avoidance, the value most definitely exists. In a number of NLB case histories, that value has been identified through before-and-after comparisons.
How many managers wish they didn’t have so much “before” data? The value of improved safety indoors can be matched and often surpassed when outdoor applications are considered, such as lighting that is installed along walkways, with additional illumination being provided near stairs, or where water or debris typically collect after storms.
In parking lots, better lighting can help prevent auto/auto and auto/pedestrian accidents. More effective lighting can also reduce the incidents of vandalism, auto break-ins, and assaults, among other crimes facilitated by darkness. Different colored lighting can also be used to help those unfamiliar with a facility’s grounds readily distinguish one area from another. Walkways to specific areas can be differentiated from one another in the same way.
Particularly when it comes to outdoor applications, lighting can sometimes permit reductions in security patrols without compromising safety. At some facilities, the value of a ten percent security patrol reduction could be two to three times that of the cost of the lighting used to achieve it.
Security can be enhanced in various indoor areas, too, by using better lighting. In pharmacy areas, for example, various techniques can be applied to integrate lighting into a deterrent system.
Better lighting can also be of value in patient or resident rooms, by helping to soften what could otherwise be a somewhat dreary institutional appearance. Lighting can affect mood, and mood is an important factor in healthcare. Does the lighting installed promote a better mood? If not, maintenance may be a problem. When it has not been performed well over the years, the result can be discolored lenses and/or light bulbs and tubes (known collectively as “lamps”) that have changed color (and lost efficiency) because they have been left in place far too long. New lamps
now on the market can help create a day-lighting effect in patient areas that is generally regarded as far cheerier.
It also is far more effective with respect to evaluating patients’ skin tones. If you haven’t checked into the many alternatives now available, you should, especially so because the new lamps and the luminaires (fixtures) designed to work with them are extraordinarily energy efficient.
And talk about the concept that lighting is for people! In fact, when an electric illumination system is designed well, it can actually help you better achieve your mission, while lowering the amount of money spent on energy, on people, on insurance, on paperwork, etc.
No matter what type of healthcare facility you are involved with, you must have lighting. You might as well have the best lighting available – High-Benefit Lighting – because it usually costs no more to specify or install, minimizes energy waste, and creates benefits whose value can be many times greater than the annual cost of lighting system ownership and operation.
High-Benefit Lighting is not a brand, nor does it even relate to one given method or another. Hundreds of methods are typically available to optimize lighting. The one constant, however, is having an experienced designer work with you. A number of experienced hospital lighting designers are available, and some may even be able to provide their services without charge, via a manufacturer, contractor, utility, or other entity. Many also are available through the National Council for Qualifications in the Lighting Professions (NCQLP) and the International Association of Lighting Designers (IALD).
More assistance is available without charge from the National Lighting Bureau and its sponsors.
John Philip Bachner has many years’ experience in the field of facility and property management, and was for several years involved with nursing homes groups and hospitals. He is the author of The Guide to Practical Property Management (McGraw-Hill) and Public Relations for Nursing Homes (Charles C. Thomas). He served as Executive Vice President of the Property Management Association for almost a quarter century, and has authored or coauthored literally dozens of guides, manuals, and texts on the subject of energy conservation in buildings.