trends in healthcare lighting & upgrade opportunities · 2019. 12. 7. · private payer, 33.3%...

Trends in Healthcare Lighting

& Upgrade Opportunities

Karen Lee, LC, LEED AP

28 July 2015

www.osram-americas.com

© 2012 Jonathan Hillyer

Trends in Healthcare Lighting & Upgrade Opportunities | KL

RES/JCI/RTS Meeting | 07.28.2015

2

Agenda

1. Healthcare Segment Overview

2. Trends and Priorities for Healthcare Facilities

3. The Business Case for Good Quality Design

4. Healthcare Design Trends

5. Lighting for Healthcare Facilities

6. Lighting Upgrade Opportunities for Healthcare Facilities

7. Q&A


Healthcare

Segment Overview



4

Healthcare Market Segment

Business Types

Inpatient Facilities

• General hospitals

• Small primary care hospitals

• Psychiatric hospitals

• Rehabilitation facilities

Outpatient Ambulatory Care Facilities

• Primary care outpatient

• Freestanding diagnostic and treatment

• Freestanding urgent care

• Cancer treatment

• Outpatient surgical

• Office surgical

• Gastrointestinal endoscopy

• Dental

Residential Care Facilities

Laboratories

© 2010 Halkin Architectural Photography, LLC



5

Healthcare Facility Definitions (US DOE CBECS)

Inpatient FacilityBuildings used as diagnostic and treatment

facilities for inpatient care.

• hospital

• inpatient rehabilitation

Buildings used to offer multiple accommodations

for short-term or long-term residents, including

skilled nursing and other residential care buildings

are classified as lodging buildings.

Outpatient FacilityBuildings used as diagnostic and treatment

facilities for outpatient care.

• medical office

• clinic or other outpatient health care

• outpatient rehabilitation

• veterinarian

Medical offices are included here if they use any

type of diagnostic medical equipment (if they do

not, they are categorized as an office building).

Laboratories are categorized as “other” buildings.

Source: U.S. Energy Information Administration, Commercial Buildings Energy Consumption Survey (CBECS)

© 2010 DuPont. All rights reserved.



6

U.S. Hospitals (AHA Hospital Statistics, 2015 Edition)

Federal Government Hospitals

213

Nonfederal Psychiatric Hospitals

406

Nonfederal Long Term

Care Hospitals81

Hospital Units of Institutions (Prisons, Colleges, etc.)

12

Nongovernment Not-for-Profit

2,904

Investor-Owned (For-Profit)

1,060

State and Local Government

1,010

Community Hospitals60% Urban / 40% Rural

U.S. Registered Hospitals5,686 Total – 914,513 Beds

$859,419,233,000 in Expenses

Source: American Hospital Association (AHA) Fast Facts on U.S. Hospitals (2015); data from 2013 AHA Annual Survey


Trends and Priorities

for Healthcare Facilities

© Todd Mason/Halkin Photography



8

Challenges for Today’s Healthcare Facilities

Trends threaten already low profit margins

Very Competitive Market

Patients

• Most communities have many options

- Other inpatient and outpatient facilities

- “Retail” outlets (e.g., walk-in, etc.)

• Emphasis on community relations

- Wellness; preventative care

- Farmers markets

Staff

• Physicians, nurses, other caregivers

- Working environment

- Amenities (e.g., shops, wellness, etc.)

Transparency via Hospital Compare web site

Financial Well-Being

Shifting reimbursement models

• From volume-based to value-based

- Patient outcome

- Patient experience (HCAHPS)

• From inpatient to outpatient procedures

• No payment for “Never Ever” events

• Decreasing payment-to-cost ratio

Aging population

• Less private payer, more Medicaid/Medicare

Total Margin

Operating Margin

0%

2%

4%

6%

8%

10%

93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13



9

Healthcare "Never Events" (2011 Revision)

Surgical events

Surgery or other invasive procedure performed

• on the wrong body part

• on the wrong patient

Wrong surgical or other invasive procedure

performed on a patient

Unintended retention of a foreign object in a

patient after surgery or other procedure

Intraoperative or immediately post-operative/

post-procedure death in an ASA Class I patient

Product or device events

Patient death or serious injury associated with

• use of contaminated drugs, devices, or

biologics provided by the health care setting

• use or function of a device in patient care, in

which the device is used for functions other

than as intended

• intravascular air embolism that occurs while

being cared for in a health care setting

Patient protection events

Discharge or release of a patient/resident of any

age, who is unable to make decisions, to other

than an authorized person

Patient death or serious disability associated

with patient elopement (disappearance)

Patient suicide, attempted suicide, or self-harm

resulting in serious disability, while being cared

for in a health care facility

Care management events

Patient death or serious injury associated with

• medication error (e.g., wrong drug, dose,

patient, time, rate, preparation, or route of

administration)

• unsafe administration of blood products

• labor or delivery in a low-risk pregnancy while


• a fall while being cared for in a health care

setting

Maternal or neonate death or serious injury

associated with

• labor or delivery in a low-risk pregnancy while


Artificial insemination with wrong sperm/egg

Any stage 3, stage 4, or unstageable pressure

ulcers acquired after admission/presentation to a

health care facility

Patient death or serious disability/injury resulting

from

• irretrievable loss of an irreplaceable

biological specimen

• failure to follow up or communicate

laboratory, pathology, or radiology test

results

Environmental events

Patient or staff death or serious disability/injury

associated with

• an electric shock in the course of a patient

care process in a health care setting

• a burn incurred from any source in the course

of a patient care process in a health care

setting

• the use of restraints or bedrails while being

cared for in a health care setting

Any incident in which a line designated for

oxygen or other gas to be delivered to a patient

contains no gas, the wrong gas, or is

contaminated by toxic substances

Radiologic events

Death or serious injury of a patient or staff

associated with introduction of a metallic object

into the MRI area

Criminal events

Any instance of care ordered by or provided by

someone impersonating a physician, nurse,

pharmacist, or other licensed health care

provider

Abduction of a patient/resident of any age

Sexual abuse/assault on a patient within or on

the grounds of a health care setting

Death or significant injury of a patient or staff

member resulting from a physical assault (i.e.,

battery) that occurs within or on the grounds of a

health care setting

Source: National Quality Forum (NQF)



10

10 Most Concerning Issues for Hospital CEOs

1. Financial challenges– Medicaid reimbursement

– Bad debt

– Decreasing inpatient volume

– Medicare reimbursement

– Competition from other providers (of any type)

2. Healthcare reform implementation – Reduce operating costs

– Shift to value-based purchasing

– Alignment of provider and payer incentives

– Align with physicians more closely

– Develop information systems integrated with primary care physicians

3. Governmental mandates– CMS audits, implementation of ICD-10, CMS regulations, state regulations, increased govt. scrutiny, etc.

4. Patient safety and quality

5. Care for the uninsured/underinsured

6. Patient satisfaction

7. Physician-hospital relations

8. Population health management

9. Technology

10. Personnel shortages

Source: Becker’s Hospital Review, Jan. 2015; American College of Healthcare Executives (ACHE) 2014 Survey (n=338)



11

Changing Reimbursement Model:Value-Based Purchasing (VBP)

Issues now greatly co-dependent• Financial challenges

– Medicaid reimbursement

– Bad debt

– Decreasing inpatient volume

Medicare reimbursement

– Competition from other providers (of any type)

• Healthcare reform implementation Reduce operating costs

Shift to value-based purchasing

– Alignment of provider and payer incentives

– Align with physicians more closely

– Develop information systems integrated with primary care

physicians

• Governmental mandates CMS audits, implementation of ICD-10, CMS regulations,

state regulations, increased govt. scrutiny, etc.

Patient safety and quality

• Care for the uninsured/underinsured

Patient satisfaction

• Physician-hospital relations

• Population health management

• Technology

Personnel shortages

Patient Experience of

Care25%

Safety20%

Efficiency25%

Outcomes25%

Process5%

FY 2017 View2% Medicare Reimbursement Withheld

Clinical Care

30%

Source: www.stratishealth.org/documents/FY2017-VBP-fact-sheet.pdf

HCAHPS SurveyFlu Immunization

Mortality Rates

Medicare Spending

per Beneficiary

Hospital Acquired

Infections



12

Hospital Costs and Payments by Payer Types

Payment-to-Cost Ratios

• Medicaid & Medicare reimbursements do

not cover hospital costs

• Private payers critical to hospital operation

• Impact worsened by decreasing inpatient

revenue

Hospital Cost by Payer Type

• Balance shifting to costs for Medicaid &

Medicare patients

• 20% of community hospitals operating with

negative margin

Hospital Payment-to-cost Ratios by Payer Type, 1993 – 2013

Distribution of Hospital Cost by Payer Type, 1980, 2000 and 2013

70%

80%

90%

100%

110%

120%

130%

140%

150%

93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13

Private Payer

Medicare

Medicaid

Medicare, 34.6% Medicare, 38.3% Medicare, 40.2%

Medicaid, 9.6%Medicaid, 12.8%

Medicaid, 16.5%

Other Government,6.1%

Other Government, 1.4%

Other Government, 1.8%

Private Payer, 41.8% Private Payer, 38.7% Private Payer, 33.3%

Uncompensated Care, 5.1%



Non-patient, 2.7% Non-patient, 2.8% Non-patient, 2.2%

1980 2000 2013

Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2013, for community hospitals



13

Percent of Hospital Costs by Type of Expense (2013)

Only ~2% of operating expenses is energy, but $1 saved ≈ $50 revenue

Source: American Hospital Association (AHA) analysis of Centers for Medicare and Medicaid Services data, using base year 2010 weights.(1) Does not include capital.(2) Includes postage and telephone expenses.(3) Percentages were rounded, so they do not add to 20 percent.

Prescription Drugs, 6.3%

Other Services, 20.0%(3)Wages and

Benefits,

59.2%

Other Products

(e.g., Food, Medical

Instruments),

14.4%

All Other: Non-Labor

Intensive, 3.7%(2)

Professional Fees, 9.1%

Utilities, 2.3%

All Other: Labor Intensive, 3.7%

Professional Liability Insurance, 1.2%

Although only 2.3%,

most hospitals spend several

million $ on energy


The Business Case

for Good Quality Design




15

Creating an Improved Environment of Care

Washington Hospital Center

Washington, DC

Patient

Outcome

Evidence-Based DesignReduce anxiety & stress

Reduce staff turnover

Improve wayfinding

SustainabilityLEED for Healthcare

Daylighting & views

Energy savings

ReliabilityError reduction

Systems compatibility

Safety & security

Operational CostsImprove HCAHPS

Reduce maintenance

Infection control

Reduce liability




16

HCAHPS Survey and Medicare Reimbursement

Hospital Consumer Assessment of Healthcare Providers and Systems

Some of the 29 survey questions:

Never – Sometimes – Usually – Always

• During this hospital stay, how often did nurses or doctors– Treat you with courtesy and respect

– Listen carefully to you

• During this hospital stay, how often – Were your room and bathroom kept clean

– Was the area around your room quiet at night

• During this hospital stay, – Did you need medicine for pain

– How often was your pain well controlled

– How often did the hospital staff do everything they could

to help you with your pain

• Rate this hospital

• Would you recommend this hospital to your friends and family?

Source: Centers for Medicare & Medicaid Services (CMS)

CMS Timeline for HCAHPS Impact

• 2006 – survey implemented

• 2007 – hospitals penalized 2% for not

submitting data

• 2008 – 1st public reporting of results

• 2012 – 1% Medicare payments withheld to

create value-based incentive fund

• FY 2015 – 1.5% Medicare payments at

risk

• FY 2017 – 2% Medicare reimbursement

dollars at risk



17

Medicare.gov Web Site and Hospital Compare

Hospital statistics database• Searchable by location

• Survey of patients’ experience (HCAHPS)

– Publishes scores by question

– Explains each survey topic and potential

impact on quality of care

– Compares to state and national average

• HCAHPS scores linked to Hospital Value-

Based Purchasing (VBP) program

– Effort to improve healthcare quality

• Also publishes information and statistics re:

– General information

– Timely and effective care

– Readmissions, complications and deaths

– Use of medical imaging

– Number of Medicare patients

– Payment and value of care



18

2017 HCAHPS Composites 25% Weight – Patient Experience of Care

Category (Composite) Summary of Questions Lighting Opportunities

1 Communication – Nurse • Courtesy and respect

• Listening skills

• Clear explanation

• Human-scale design

• Create “circle of intimacy”

2 Communication – Doctor • Courtesy and respect

• Listening skills


• Human-scale design

• Create “circle of intimacy”

3 Responsiveness of Staff • Help getting to bathroom

• Assistance in bathroom

• Response to patient call

• Visual alerts

• Pathway lighting

4 Pain Management • Timely medication

• Pain control

• Staff assistance

• Patient control of environment

• Calming design

5 Communication of

Medications


• Side effects described

6 Discharge Information • Clear discharge explanation

• Written information

7 Environment –

Cleanliness and Quietness

• Noise level at night

• Cleanliness of room and bathroom

• Quality & quantity of illumination

• Well-located lighting

• Day/night illumination

8 Overall Rating • Overall experience

• Would you recommend this hospital?

• Wayfinding

• Safety, security



19

Ability of Lighting to Improve Patient Experience

Good quality lighting design can:• Create human scale intimacy and areas of

privacy

• Enhance colors and surroundings

– Prevent furnishings & surfaces from looking

dingy

– Highlight sparkling clean

• Encourage soft speaking and overall quiet

with lower light levels

– Minimize disturbance due to noise

• Create soothing, relaxing environments

– Lower stress reduces need for pain

medication

• Welcome and put people at ease

– Improve wayfinding

– Enhance safety and security

– Create positive brand position

Source: The Center for Health Affairs

http://www.chanet.org/en/CommunityInitiatives/PatientExperience/HCAHPStraining.aspx



20

Priorities of the Healthcare AdministrationFacilities Management



21

Top Priorities for Facility Management Directors



22

Convince Stakeholders to Prioritize Lighting

• Patient outcomes

– Administrators – circadian rhythms

Accelerate healing

– Nurses – HAI

– Physicians – consistent visual perception

– Surgeons – comfort in OR (heat)

– Millenials – carcinogens, asthma

• Patient safety

– Slips & falls

Orientation

Visibility

Aging population

• Budget, infrastructure, capital expenses

– Reduce lighting load to allow additional

equipment to be added with other systems

Generator capacity

Audience-dependent message



23

Energy Use in Healthcare 2nd Highest Energy Use Intensity (EUI)

0 50 100 150 200 250 300

Vacant

Religious Worship

Warehouse and Storage

Service

Education

Retail

Office

Public Assembly

Healthcare - Outpatient

Lodging

Public Order and Safety

Other

Food Sales

Healthcare - Inpatient

Food Service

EUI in 1000 Btu per square foot

Energy Use Intensity by Principal Building Activity

Source: US DOE EIA, 2003 CBECS Data

Hospital Characteristics

• 24/7 operation

• Thousands of employees, patients, visitors

• Sophisticated HVAC systems to control

temperature and air flow

• Energy intensive activities:

- Laundry, medical and lab equipment

use, sterilization, computer and server

use, food service, refrigeration

• Large hospitals (>200,000 s.f.):

- <1% of all commercial buildings

- 2% of commercial floor space

- Consumed 4.3% of the total delivered

energy used by the commercial sector



24

Energy Use in Healthcare Consumption by End Use – All Fuel Types (2.3% of operating expenses)

Space Heating37%

Cooling7%

Ventilation8%

Water Heating19%

Lighting16%

Cooking2%

Refrigeration1%

Office Equipment1%

Computers2%

Other7%

Inpatient Facilities249.2 kBtu/sf

Space Heating41%

Cooling8%

Ventilation3%

Water Heating2%

Lighting24%

Refrigeration3%

Office Equipment2%

Computers3%

Other14%

Outpatient Facilities94.6 kBtu/sf




25

Energy Use in Healthcare Electricity Consumption by End Use

Space Heating2%

Cooling13%

Ventilation21%

Water Heating2%

Lighting42%

Refrigeration2%

Office Equipment2%

Computers4%

Other12%

Inpatient Facilities52 billion kWh

Space Heating6%

Cooling16%

Ventilation5%

Lighting42%

Refrigeration5%

Computers5%

Other21%

Outpatient Facilities20 billion kWh




26

Healthcare Facilities

Age by Floorspace (CBECS 2012)

0

100

200

300

400

500

600

700

Before1946

1946 to1959

1960 to1969

1970 to1979

1980 to1989

1990 to1999

2000 to2007

2008 to2012

Tota

l F

loo

rspa

ce

, m

illio

n s

.f.

Inpatient Outpatient

Source: US DOE EIA, CBECS 2012 Survey

• Hospitals build “for life”

• High renovation potential



27

Window and Interior Lighting

Features of Large Hospitals (>200,000 s.f.)

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Total LitFloorspace

TintedWindowGlass

ReflectiveWindowGlass

ExternalOverhangsor Awnings

Skylights orAtriums

DaylightingSensors

OccupancySensors

14%of buildings

46%of buildings

Lit F

loo

rspa

ce

in m

illio

n s

qu

are

fe

et

Hospital Architecture

• High degree of fenestration

• Low penetration of daylighting

harvesting and occupant detection

• Opportunity for energy savings

and increased occupant comfort

Source: US DOE EIA, Large Hospital Report, CBECS 2007 Survey


Healthcare Design Trends

© Tom Powel Imaging



29

Evidence-Based Healthcare DesignThe process of basing decisions about the built environment on credible research to

achieve the best possible outcomes.

Non-Visual Benefits: Natural Light, Views of Nature, Positive Distraction, Circadian Entrainment

Source: Cama Incorporated: The Experience of Light for Health and Wellbeing

Patient Satisfaction“There is strong evidence that design changes that make the

environment more comfortable, aesthetically pleasing, and informative

relieve patient stress and increase satisfaction with the quality of care.”(Leather, et al., 2003)

Sunlight & Pain

Effect of sunlight on pain medication usage of

patients recovering from spinal surgery.

• 46% greater sunlight

• 22% less pain medication

• 21% reduction in medication cost

Distraction Theory

Patients diverted by a pleasant distraction

have less attention to direct to their pain.

NICU Lighting

Infants exposed to day/night lighting cycles

experienced deeper sleep and a greater rate

of weight gain.

Better View or Better Light?

“...patients assigned to rooms with windows

looking out on a natural scene had shorter

postoperative hospital stays and took fewer

pain killers than patients in similar rooms with

windows facing a brick building wall.”(Ulrich, 1984)

© Karen Lee



30

Color Critical Observations in Healthcare



31


• Daylight views

• Increased fenestration

• Landscaped exteriors

• Natural materials

• Neutral & warm colors

create calming

environments

Project details:

• Architect: Stantec / Anshen+Allen

• Project: Mills Peninsula Medical Center

• Location: Burlingame, Calif.Source: Health Facilities Management designView



32


• Dynamic color

• Color for wayfinding

• Whimsy to relax

children & families

Project details:

• Architects: Stanley Beaman Sears

Perkins + Will

• Lighting : Anjan Sarkar, CD+M

• Project: Nemours Children’s Hospital (video) (video)

• Location: Orlando, FL

Images © 2012 Jonathan Hillyer

http://youtu.be/s5Hmk7PKmoA

http://youtu.be/4F4bTLev6LE



33

Creating a Healing Environment: Light as Art

St. Joseph’s Regional Medical Center

Paterson, NJ

Lighting Designer: Rachel Calemmo

University of Tennessee Medical Center

Knoxville, TN

Interior Designer: Heather King

Anyone Who Has A Heart

Manchester, UK

Lighting Designers: Andrew Small, Steve Almond

© Todd Mason/Halkin Photography © Chris Foster© University of Tennessee Medical Center


Lighting for




35

Quality Lighting

For your staff…

For your visitors…

For your patients…

For your bottom line…




36

Recommended Practices

for Lighting Healthcare Facilities

ANSI/IES RP-29: Lighting for Hospitals and Health Care Facilities• Last revision published in 2006 (RP-29-06)

• Being overhauled by IES Health Facilities Lighting Committee

– Will better reflect current state of healthcare delivery

– Terminology and organization will mirror Facilities Guidelines Institute (FGI)

Guidelines for Design and Construction of Hospitals and Outpatient Facilities

(2014 revision)

– Sidebar commentary on current areas of related research

• Currently in committee review

– Will be released for public comment in compliance with ANSI process

IES The Lighting Handbook, 10th Edition• Published in 2011 supersedes RP-29-06

• Chapter 27 – Lighting for Health Care

– Illuminance tables by space and application

– Brief design narrative by space

• Incorporates new design recommendations:

– Day/night light levels to promote more restful sleep and noise reduction

– Night lighting using low CCT or amber-colored light



37


Upgrade Opportunities by Area

• Patient rooms

• Nursing stations

• Surgical areas

• Examination and treatment

• Laboratory and pharmacy

• Helipad

• Signage and wayfinding

• Healing gardens

• Parking facility

• Public accommodation

– Food service

– Retail shops

– Meeting spaces

1

2

3

4

5

6

7

8

9

10

101 2

3 4

5

67 8

9

Patient experience begins upon arrival at the hospital



38

Patient Rooms

Design Elements• Distinct zones: patient, care-giver, family

• Unobstructed path to toilet area

Lighting Opportunities• Controls

– Multiple task-appropriate light levels

Exam, TV, reading, sleeping

– Patient control over environment can reduce

need for pain medication

• Task lighting

– Limit disturbance of sleeping patient

• Day/night light levels

– Noise reduction

• Night lighting for safe wayfinding

– Low CCT or amber color




39

Nursing Stations and Corridors

Design Elements• Focal point of care unit

• Private communication

• May have decentralized nurse stations


– Day/night light levels to promote quiet

• Task lighting

– Charting

– Medication dispensing

– Handwashing

• Wayfinding

– Clear identification of information areas

– Patient door locations

– Alarms

• Accent lighting

– Artwork



40

Surgical Areas

Design Elements• 3 layers of light

– Ambient, surgical overhead, task

• Comfort of surgical team

– Low heat, low glare


– Effective scene setting and remote access

for improved infection control procedures

• Energy-efficient lighting systems

– Reduce emitted heat for staff comfort

– Reduce conducted heat for better

outcomes

• Excellent color quality for accurate

observation

• Long-life sources for reduced downtime



41

Examination and Treatment

Design Elements• Layers of light

– Ambient, exam, instruments

• Supports compassionate discussion


– Ability to change scene for stage of visit

• Excellent color quality for accurate

observation

• Task lighting

– Examination

– Test preparation, injection, etc.

– Note-taking

• Equipment selection may be restricted by

medical equipment



42

Laboratory and Pharmacy

Design Elements• Glare-free, shadowless lighting

• High visual acuity tasks

• High vertical illumination


– Occupancy sensors

– Motion sensors on bench task lighting may

qualify for LPD exemption

• Task lighting

– Allows for lower ambient light level

– May be tied to occupancy sensors for

increased energy savings

• Diffuse vertical illumination

– Reduce medication errors



43

Helipad

Design Elements• Heliport identification beacon

• Touchdown and lift-off area (TLOF)

• Final approach and takeoff area (FATO)

• Taxiways and taxi routes

• Windsock

• Obstruction lighting

• Floodlights

Lighting Opportunities• Long life sources for increased reliability

• FAA-approved designs

• Well-controlled luminaire optics



44

Signage and Wayfinding

Design Elements• Information may be conveyed in a variety of

ways

– Text

– Color

– Artistic features

• Art


– Dynamic features

– Energy-saving schedules

– Motion sensors

• Match corporate colors or interior design

palette

• Accent lighting


© 2010 Halkin Architectural Photography, LLC



45

Healing Gardens

Design Elements• Human-scale lighting

• Long views of nature

• Calm respite


– Dim for curfew hours

– Limit light trespass and sky glow

• Well-controlled luminaire optics

• Safe navigation

• Encourage peaceful thought

York Hospital in York, ME



46

Parking Facilities

Design Elements• Transition zone

• Parking decks and lots

• Cashier

• Elevator lobbies

• Wayfinding


– Day/night levels

– Occupancy sensing

– Scheduling

• Often the patient’s first & last impression

– Safety

– Security

– Stress-free navigation



47

Public Accommodation

Design Elements• Food service

• Retail shops

• Meeting spaces

• Lounges

• Chapels


– Daylight harvesting

– Time scheduling

• Welcoming, inviting design

– Reduce stress

– Offer distraction for visitors and staff

• Lighting design appropriate for function

– Merchandising in retail shops

– Hospitality in food service

– Education in meeting spaces



Lighting Upgrade

Opportunities

for Healthcare Facilities




49

SAFELINE® Shatter-Resistant Lamps HBO® Mercury Short Arc XBO® Xenon Short Arc

Specialty Halogen Types

HALOTHERM, HLX, XIR

LINEARlight FLEX® LED

LINEARlight FLEX® Protect LED PURITEC® Germicidal ITOS LED Modules DULUX® S BLUE Fluorescent

Illumination

• Surgical procedures– Overhead, headlights

– Endoscopy

• Microscopy

• Special environments– Wellness

– Cold storage

– Clean room

• Helipad lighting

Therapeutic & Diagnostic Procedures

• Therapeutic applications– Bilirubin

– Dermatological treatment

• Laboratory diagnostics

• UV applications– Purification / Germicidal (UV-C)

– Fluorescent dyes (UV-A)

– UV curing & inspection

• Dental whitening and curing

• Heating (air & infrared)

Specialty ApplicationsLighting and processes in special environments



50

Easy Lighting Upgrade Strategies

Sustainable Lamp Replacements

• Simple exchange

• No extra effort

System Component Replacements

• Lamp and ballast upgrades

Luminaire Retrofit Kits

• Convert existing fixtures to LED technology

• Conserve installed housing

“No New Wires” Controls

• Add local controls and sensors for energy savings

strategies

• Use of existing wiring minimizes labor



51

Upgrade Strategy #1:

Sustainable Lamp Replacements

SUPERSAVER® Reduced Wattage

• Up to 22% energy savings– OCTRON® T8 Fluorescent

XV, XP, XP XL, linear and CURVALUME®

– PENTRON® T5 Fluorescent Standard and HO

– METALARC® Metal Halide

– DULUX® EL Self-Ballasted CFL

– DULUX® D/E, T/E/IN, & L Pin-Based CFL

XL eXtended Life

• Up to 100% longer life– OCTRON® XP® XL ECOLOGIC®3 T8 Fluorescent

Standard and SUPERSAVER®

– PENTRON® HO XL ECOLOGIC® T5 Fluorescent

– DULUX® T/E/IN XL ECOLOGIC® Pin-Based CFL Standard and SUPERSAVER®

– LUMALUX PLUS® XL ECOLOGIC® High Pressure Sodium

Solid State Lighting

• Mercury-free, long life, energy savings– ULTRA LED

A-line, PAR, MR, wet rated PAR; premium ULTRA SE™ and PRO HD™

– SubstiTUBE® IPS T8 LED



52


System Component Replacements

Magnetic Electronic Ballasts

• Improve efficiency and reduce visual strobing

vs. magnetic ballasts– T12 T8 fluorescent

– HID magnetic electronic QUICKTRONIC® Electronic Ballasts

Fluorescent High Efficiency Systems

• QUICKTRONIC® High Efficiency Electronic Ballasts– Instant start for greatest energy savings

– PROStart® programmed rapid start for use

with occupancy sensors

– Select ballast factor to optimize performance

T8 Fluorescent LED Systems

• ULTRA HE™ High Efficiency LED T8 Retrofit Kits

Extended Warranty Coverage

• QUICK 60+® System Warranty

• QUICK 7XL+™ System Warranty



53


Luminaire Retrofit Kits

• Convert existing fixtures to LED technology

• UL Classified retrofit kits

• Re-use installed housing

• Significant energy & maintenance savings

– ULTRA RT5/6 Downlight Kit For 5” or 6” housings

Gimbal option for 6” housings

700, 900, 1200 lumens

120V, dimmable to 10%

– ULTRA RT6 HO LED Downlight Kit High output option for 6” housings

120-277V (UNV)

1500 lumens

– ULTRA RT8 Downlight Kit For 8” housings

120-277V (UNV)

2000 lumens

– ModuSYS™ Troffer Conversion Kit For 2x2 troffers; 7-year warranty

120-277V (UNV), 0-10V dimming interface

Up to 4450 lumens; 3000, 3500, 4000K



54


“No New Wires” Controls

Use of existing wiring minimizes labor

• Add local controls and sensors for energy

savings strategies– ENCELIUM® Wall Switch Occupancy Sensors

• Add dimming capabilities without rewiring– QUICKTRONIC® POWERSENSE® Controllable

Fluorescent Ballasts

T8, T5, T5HO systems

Power line dimming

– OSRAM Slide Dimmers

• Implement daylight harvesting strategies with

RetroFriendly™ products– QUICKTRONIC® POWERSENSE® Controllable

Fluorescent Ballasts

T8, T5, T5HO systems

Simultaneous power line and 0-10V control

– ELOGIC® Sensor and Control for Daylight Harvesting

Clips to T5/T8 lamp or mounts to any flat surface

Wires feed into 0-10V control port of ballast



55

References

Design• IES The Lighting Handbook, 10th Edition

• ANSI/IES RP-29-06 Lighting for Hospitals and Health Care Facilities

– Currently being revised by IES committee

• LEED for Healthcare

• Green Guide for Healthcare (GGHC)

• Facilities Guidelines Institute (FGI)

• The Center for Health Design

Energy• ASHRAE Advanced Energy Design Guides (AEDG)

– 30% Energy Savings for Small Hospitals and Healthcare Facilities

– 50% Energy Savings for Large Hospitals


Many Thanks.

Questions?

For additional information, please contact:

Karen Lee, LC, LEED AP

[email protected]

trends in healthcare lighting & upgrade opportunities · 2019. 12. 7. · private payer, 33.3%...

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