Designing for the Smallest Customers

By Steve Munn
Five rules for lighting pediatric healthcare environments
Throughout my career, I have had the opportunity to design for many distinct types of spaces. The most challenging and rewarding, hands down, would be pediatric healthcare. Unlike typical adult hospital environments, pediatrics involves patients filled with curiosity, apprehension and anxiety far beyond that of most adult patients. In addition to the patient, you must consider the emotions and needs of the parents, siblings who would prefer to be elsewhere, and the staff providing care to the patient. I have five rules I follow while designing these spaces. These rules can be used in any design, but are even more relevant when dealing with Peds.

1 DESIGN FOR ALL
The customer is the utmost priority for any design. The challenge in Peds is that your customers are patients (up to age 18), families, doctors, healthcare providers and hospital administration. Unlike adult facilities where the patient can control their anxieties, children have a much more challenging time with this. As a result, lighting should mimic the healthcare philosophy of treating the entire family. When designing, color is always a nice element to include in a space design. A plain white room, by contrast, can add to a child’s anxiety.

One of the most important things I’ve learned over the years is that letting the patient have some type of control over the area helps on many fronts. Remember, these are patients that have no say in the illness, course of treatment or much of anything else. Giving them the ability to control something (i.e., the lighting) can provide a distraction and help ease their anxiety, which can lead to a much smoother exam. A solution I found that works well is having interactive lighting the patient can control either before or during the exam. Nearly all children can work a tablet these days, and something as simple as an app that controls a small light above the bed can serve as a distraction for a short period of time.

Finally, don’t forget the staff. The staff should have simple controls for the room and enough white light to conduct an exam when that time comes. I find simple scene selections, predetermined by the staff and clearly identified, often work better than a bank of six switches in which the healthcare provider must guess which switch controls which light. Controls should be simple from an end user’s standpoint.

2 UNDERSTAND THE HOSPITAL’S CHALLENGES AND GOALS
It’s important when designing to know of and initiatives the hospital is trying to accomplish. Once you have that information, your lighting design, if possible, should aid the design team in accomplishing this goal. For example, if the administration’s goal is to reduce anesthesia rates for a particular area or exam, then that should be taken into consideration by all members of the design team. In healthcare, each patient-care area will have unique needs. It is important to approach each of these on a case-by-case basis to design the best solution for each space.

One of the biggest mistakes designers make is thinking that the lighting concept should have an overall theme. In pediatric healthcare, the theme should always be the patient’s well-being; the lighting, therefore, should be designed to meet that need. This is not to say the lighting should not be cohesive, but putting the customer’s need first should always be the number one goal.

3 SPEND WISELY
Designing in ways that incorporate RGB lighting, control interfaces, antimicrobial lighting, etc. comes at a premium cost. The last thing any lighting designer wants to do is craft an amazing design that the owner can’t afford. When it comes to antimicrobial lights, make sure they will benefit the institution. If you are designing clinic rooms that see 15 patients a day, maybe an antimicrobial light isn’t the best solution due to the high turn-around rate and the time it takes the antimicrobial lighting to eliminate bacteria in a space.

Use RGB lighting in rooms that make sense. Using RGB in a room that has a 90 percent rate of patients under anesthesia doesn’t make a lot of sense when simple bright paint on the walls could brighten the room for the staff and those patients that are awake for the exams.

Back-of-house lighting should include inexpensive fixtures. Normally these areas are designated for staff, so lower cost luminaires should be used to simply light the area per IES recommendations. Communication with your design team is essential to ensure that finishes in certain areas help to enhance your lighting design. Using highly reflective finishes can often eliminate the need for fixtures in certain spaces. A useful yet superior design is dependent on a clear vision established by the design team and hospital staff, and the ability to work within the budgetary allocation.

4 COMMUNICATE THE DESIGN ELEMENTS
Provide effective and true renderings of the spaces you are designing. While paper and pen designs are still necessary, a true 3D rendering provides a more elaborate visualization of the design. Renderings bring your vision to life and can encourage the customer to consider out-ofthe-box thinking.

A mock-up room allows the customer to get a real “touch and feel” of the space design. Have patients and families give feedback on the mockup. As adults, we sometimes fail to see things through the eyes of a child. I have found the most common issue is glare. We often plan spaces for adults and forget that these patients are usually not adult size. They have different viewing angles when it comes to televisions, windows and nearly everything in the room. If you have been hired to design a 200-bed facility, it is better to build one room and correct any mistakes than it is to build 200 rooms incorrectly. The return on investment for mock-up rooms is invaluable for both the owner and design team. If you are designing with LED luminaires, always include dimmable options. The option not only provides the owner with energy savings, but also visual comfort for the occupants whether they are staff or patients. Since many LEDs come with a dimming option at no additional charge, incorporate this when possible.

We have already discussed controls, but it bears mentioning again. Controls should be extremely easy for hospital personnel, patients and families to utilize and understand. The more complex the controls are for your lighting, the less people will use them. The primary purpose of the lighting is to be used and enjoyed by all and not to be feared as something that they could damage or break. Always use proven technologies in your design. I often tell my clients it’s okay to be on the cutting edge of technology, just not the bleeding edge. Using controls and luminaires that are proven to work will save you callbacks and help prevent a dissatisfied customer. In the end, your design needs to work as promised to the customer.

5 BE OPEN-MINDED
Innovation comes from an open mind. When I give this presentation to owners, I always tell them to watch out for the phrase, “this is how we’ve always done it.” If the design team is using the same lights and technology it used 10 years ago, then when the building opens it will immediately look 10 years old. Be open-minded to new and innovative technologies and lighting strategies. Think like a child. With today’s technology, their imaginations can become a reality. Owners are spending a lot of money on healthcare facilities; it is imperative to give them the most bang for the buck. Use your ability to listen. I always try to go to the initial design meetings during the concept phase. It’s during this phase that you can truly understand the needs of everyone involved. Listening is probably the best skill any designer can have. And you, as the lighting designer, can take what you learn from the customer and start to shape your design. Don’t let your ego get the best of you. Just because you have always used certain lighting in certain rooms, doesn’t mean it meets the customer’s criteria. The one thing constant about pediatric healthcare is change. No two facilities are the same; no two customers are the same. The ability to listen will set your design apart from anything else.

Contributor(s)

Steve Munn

Steve Munn, LC, MIES

Steve Munn, LC, Member IES (2013), is a lighting design consultant with Perkins-Everitt Lighting and Controls in... More info »