The Visual Environment

The quality of the visual environment has a positive effect on the occupant’s feeling of well-being and in the case of hospitals and healthcare buildings this can affect staff performance and patient recovery. The cost of hospital staff and patient treatment is considerable; therefore, measures to maximise performance through improved environments will generally be cost-effective.  For these reasons, it is essential to consider lighting and colour design at the early stages of specifying and designing a building. Only then can a truly integrated approach to the visual environment be undertaken. It may be difficult, disruptive or costly to make changes once a hospital is in use.

An electric lighting installation serves a number of needs; some are obvious, such as being able to see to move around safely or to carry out tasks, which might be easy or complex. 

Lighting has a considerable effect on the appearance of a space.  The visual appearance of the lit space also applies to the way lighting equipment integrates with the architectural design and the physical elements of the building.  It is equally important to ensure that electric light integrates with daylight. 

For both lighting and colour design, a proper maintenance plan needs to be drawn up at the design stage, and carried out at regular intervals, to ensure that the quality of the visual environment remains high following installation or refurbishment. 

Energy efficiency has a direct influence on running costs.  The use of efficient lamps, ballasts and luminaires, coupled with appropriate lighting controls, can be highly cost-effective and help to meet energy targets for the NHS. 

During the planning stage, it is essential to consider the running costs over the life of the installation as well as its capital cost. Lighting installation costs, even those involving high quality equipment, will be tiny compared with the cost of staff and medical equipment. If high quality lighting makes just a small improvement on the performance of the hospital, in terms of either staff productivity or patient recovery rates, then it will be a price worth paying.

For general areas and circulation areas there are two priorities: to provide a pleasant environment for all hospital users, and to help and guide them as they move through the hospital.

Lighting design will concentrate on the appearance of spaces with enough light on walls and ceilings.  Spaces will be more pleasant if daylight and views out are available. 

Even in general areas, there is a surprising range of visual tasks; staff and users will need to be able to see to perform these tasks and to move around the building. 

Hospitals must have emergency escape lighting to switch on automatically in a power failure.  In some areas of a hospital, it will be necessary to provide stand-by lighting to enable procedures to be continued or shutdown safely.

Sometimes a relatively minor change to the colour design or lighting of spaces can solve an ongoing, apparently insurmountable, problem (for example, extra lighting on walls with accent colour to brighten up a gloomy area).  Colour design and lighting consultants can often pinpoint the reason why a place does not “feel” right.  For example, a change of floor colour from light to dark or vice-versa can affect a whole area dramatically.

Lighting design covers a range of issues

  • Task illumination: being able to see to move around safely and carryout tasks which may be simple or complex
  • Lighting appearance: providing a good-quality visual environment
  • Architectural integration with the design and the physical elements of the building, and particularly with daylight where it is available
  • Energy efficiency: including the specification of appropriate lighting controls as well as efficient lamps and luminaires
  • Lighting maintenance
  • Lighting costs, not just the capital cost of the installation but the running costs over its life

The importance of each of the elements will vary, as will the solutions, depending on the particular application. For example, the requirements for a reception desk in an entrance area will be different from that of a nurse’s station in a ward complex.  It is essential for the designer to have a clear understanding of what goes on in each of the spaces for which the lighting is being designed.

The quality of the visual environment has a positive effect on the occupant’s feeling of well-being and in the case of hospitals and healthcare buildings this can affect staff performance and patient recovery.  For example, harsh lighting has been identified as one of a series of stressors that can lead to episodes of delirium in a critical care unit.  In the neonatal ward, appropriate lighting can result in improved development of sleep patterns and reduced retinal damage.  The elderly and partially sighted particularly benefit from good quality, low-glare lighting. 

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