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Welcome


How LED Lighting is Impacting Healthcare

E69


Marjorie SobylakNew York Presbyterian

Sr. Project Manager

Karen Murphy LC, IALD, LEED APHDR

Sr. Lighting Designer

Lam Vu PE, CEMUS Department of Veterans AffairsOffice of Construction & Facilities

Management

Speakers


A heightened awareness of energy

conservation and a desire to improve

sustainability has caused many people to

utilize LED lighting without really

understanding the technology.

Our goal is to have an open and honest

discussion about the application of Light

Emitting Diode technology.

Session Description

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCN_C4bKigcgCFYiODQodJSYLTg&url=http://www.armacostlighting.com/store/shop/white-led-ribbonflex-pro-60-leds-per-meter/&psig=AFQjCNF4y5R-NFNoqzur7hNZvwQ_vXfKvg&ust=1442689247567101


� Learn how LED technology differs from

Fluorescent (strengths and challenges)

� Recognize why lighting specifiers must also

specify the lighting controls

� Explore maintenance protocols necessary for

LED products

� Understand color rendering metrics and discuss

appropriate metrics for clinical spaces.

Session Objectives


“LEDs Eliminate the Need for Maintenance”

“LEDs Save Energy”

“LEDs Have Better Color Quality”

“LEDs Last Forever”

“This is better) it’s LED”


FLUORESCENT LIGHT EMITTING DIODE

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCNjq2f-9gcgCFULUgAodWsMEAg&url=http://www.newenergyco-op.co.uk/LP07113.html&psig=AFQjCNGNnFbRcJjb7AJBx2P74zpHqYddBw&ust=1442696645641462


LED fixtures use different methods to produce white light:

Color mixed LED modules

“RGB”

“RGBW”

“RGBA”

Blue LED modules with yellow phosphors

“Blue Pump”

“White LED”


FLUORESCENT LIGHT EMITTING DIODE

Ballasts

• Instant Start

• Rapid Start

• Program Rapid Start

Drivers

• Forward Phase

• Reverse Phase

• 0-10V

• Dali

Very recently:

• Tunable

• Integrated

http://ul.com/wp-content/uploads/2014/04/ul_markshub_north-america_UL-Listing-Mark.gif


Maintenance Protocols Change

LED replacement parts come from the light

fixture manufacturer:

� Difficult to stock replacement parts

� Lead time

� Replacements available in future may not

operate identically

� Disconnect fixture before replacing LED

modules

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCJupjPz-08gCFYqegAod7pQAeQ&url=https://www.jeremykc.com/electrician-overland-park-ks/&psig=AFQjCNEVnHV5Hfjxu4ctwHTLHL9BkhM7uw&ust=1445531580498780


FLUORESCENT LIFE LED LIFE

Lamp Life is the time is takes for 50% of

fluorescent lamps to fail.

IES Standard LM 80 defines lifetime

(lumen depreciation) for LEDs

• For general illumination, life is defined

as time until 30% decrease in output

• For decorative lighting, life is defined as

time until 50% decrease in output

• Testing through 6,000 hrs6.. Reliable

prediction of useful light?


Lumen Depreciation

0%

20%

40%

60%

80%

100%

120%

Per

cen

tag

e o

f In

itia

l Lu

men

s

Lamp Lumen Depreciation

LED

XL T8 Fluor

Compact Fluor


Maintenance: Group Replace LEDsMaintenance schedule can be determined by:

• Calculation based on published life and

estimated hours of operation

• Lighting control systems that track and log

hours of operation can be used to determine

maintenance schedule

• Some fixtures offer built-in end-of-life detection

• If driver life is approximately the same as LED

life, replace both when driver fails.


Energy Efficiency

0 50 100 150 200

Incandescent

Compact Fluorescent

Linear Fluorescent

LED

Projected Average

Best

Average

EFFICACY (lumens/watt)


Heat

• LEDs transfer heat through conduction

Operating Characteristics

• Fluorescent lamps don’t like cold; LED modules don’t like hot


Flicker

• LED – Driver – Control Device compatibility can create flicker problems

Operating Characteristics

IEEE 1789-2015 (establishes threshold limits <200Hz)

Negative effects can occur with frequencies <120Hz

eye strain / headaches

Negative effects typically occur with frequencies <70Hz

photosensitive epilepsy

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCPL58bmO0MgCFQPJPgodz0cB1w&url=http://www.100candles.com/i-6323/Blue-Floating-LED-Light-Non-Flicker&psig=AFQjCNGqQv6vBH4AymvFIZ56e05ASxqgiA&ust=1445398192232804


COLOR METRICS

Color Temperature

Color Rendering Index

(°Kelvin)

(CRI)


Color Quality

Correlated Color Temperature (CCT) –Measured in ºKelvin

2700ºK 6500ºK4000ºK


Color Quality

Color Rendering Index (CRI - Ra)


Color Quality

Color Rendering Index (Ra)…

… Color Fidelity (Rf)


Color Quality

Color Gamut (Rg)

… saturation

Rg range is 60-140 when Rf >60


Clinical Applications where Color Rendering is Important

Burn Units / Wound Healing

NICUs

Select Laboratories

ER

Surgical Lights


Fall Prevention

Common use for LED today

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCJ_K1OmygcgCFcjVgAodr6oLAw&url=http://www.lrc.rpi.edu/programs/solidstate/cr_innovativeSolutions.asp&psig=AFQjCNE11AjBS92af-9S1bCPlCc5WS9UvQ&ust=1442693648032936

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCMPmuvWygcgCFRHqgAodO0QLzg&url=http://www.ltlmagazine.com/article/hot-technologies-advanced-lighting-technologies-enhance-resident-care&psig=AFQjCNE11AjBS92af-9S1bCPlCc5WS9UvQ&ust=1442693648032936

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCPTZio-zgcgCFcOcgAodgqgCRw&url=http://www.sleepreviewmag.com/2015/05/light-therapy-better-sleep/&psig=AFQjCNE11AjBS92af-9S1bCPlCc5WS9UvQ&ust=1442693648032936

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCNuDm56zgcgCFYaVDQod5M8A1w&url=http://www.lrc.rpi.edu/programs/solidstate/cr_innovativeSolutions.asp&psig=AFQjCNE11AjBS92af-9S1bCPlCc5WS9UvQ&ust=1442693648032936


Decrease Patient Anxiety

Pediatric

Hyperbaric Chambers

MRI / PET Scan

Psychiatric

Common use for LED today


Support Circadian Entrainment

Current Trends with LED today


New Possibilities with LED

Luminaires double as Access Panels


Enhance Infection Control

Future Possibilities with LED

Patient Room 2020 Handwashing Demo:

Proximity sensor triggers red light

and timer…

After 1 minute light turns green

signaling that time spent washing

hands complies with protocols.


Department of Veterans Affairs (VA)

Mission: To fulfill President Lincoln's promise

“To care for him who shall have borne the

battle, and for his widow, and his orphan” by

serving and honoring the men and women who

are America’s veterans.

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCJTQ7rC9gcgCFYGKDQodx9cI0w&url=http://www.gig.com/blog/2014/01/01/disabled-veterans-swindled-by-own-kith-and-kin/&psig=AFQjCNEvBASngrlW8x4wjoQ3W1PI71mBYg&ust=1442696472570958


VA operates and manages:

• 150 Medical Centers

• 229 National and State Cemeteries

• 6 Independent Outpatient Clinics

• 104 Dormiciliary Residential

Rehabilitation Centers

• 820 Community-Based Outpatient Clinics

(CBOC)

• 300 VET Centers

• 135 VA Community Living Centers

• 56 Regional Admin Offices



VA Technical Information Library (TIL) –

http://www.cfm.va.gov/TIL



VA Technical Information Library (TIL) – http://www.cfm.va.gov/TIL (cont.)

• PG 18-1 Master Construction Specifications - http://www.cfm.va.gov/TIL/spec.asp

• PG 18-10 Design Manuals - http://www.cfm.va.gov/til/dManual.asp

• PG 18 -12 Design Guides - http://www.cfm.va.gov/til/dGuide.asp

• PG 18-4 Standards Details and CAD Standards - http://www.cfm.va.gov/TIL/sDetail.asp

• PG 18 -5 Equipment Guide List - http://www.cfm.va.gov/TIL/equip.asp

• PG 18-9 Space Planning Criteria - http://www.cfm.va.gov/TIL/planning.asp

• PG 18-14 Room Finishes, Doors, and Hardware Schedules -

http://www.cfm.va.gov/til/room/RoomFinishes.pdf

• (And many more construction & engineering standards)

http://www.cfm.va.gov/TIL

http://www.cfm.va.gov/TIL/spec.asp

http://www.cfm.va.gov/til/dManual.asp

http://www.cfm.va.gov/til/dGuide.asp

http://www.cfm.va.gov/TIL/sDetail.asp

http://www.cfm.va.gov/TIL/equip.asp

http://www.cfm.va.gov/TIL/planning.asp

http://www.cfm.va.gov/til/room/RoomFinishes.pdf



Current VA Lighting Design Guidance:

• Design - Currently shown as part of the

Electrical Design Manual (EDM)

• Construction – Currently shown in VA Master

Lighting specifications 26 51 00 (Interior) &

26 56 00 (Exterior)

• Before 2012: LED task focused lighting (only) –

Surgical Lights, U/C Lights, Exam Lights

• Since 2012: LED ambient lighting allowed



Near-future VA Lighting Design Guidance:

• Lighting Design Manual - under

development with HDR

• Tentative schedule to be published on

TIL – December 2015

• Lighting design parameters - inclusive

of LED and Fluorescent

• Lighting equipment - inclusive of LED

and Fluorescent



Positive Impacts of LED:

• Energy saving

• Sustainable

• Ease in control and dimming

• Ease in automated color adapting

• Ease in maintenance



Challenging impacts of LED:

• Design burden for renovation projects

• Open specification challenge on

uniformity for facility

• Lack of standardizations (i.e.

interchangeability, compatibility & color

rendering)



Challenging impacts of LED:

(continued):

• Installation hiccups (i.e. incompatible

dimension, color, glare etc.)

• Maintenance hiccups (i.e. light loss, part

replacement etc.)



Going Forward:

• Keep embracing LED technology

• Keep monitoring continued

development and advancement of

LED



New York Presbyterian Healthcare System is comprised of 2 academic medical centers, 4

regional hospitals, multiple ambulatory centers and physician practices, serving NYC and the

region as world-class Healthcare providers, ranked #1 in NY for the last 15 years.

http://nyp.org/


Lighting Challenges Case Studies

1. Maintainability

2. Energy and Efficiency

3. Color, Illumination Level and Controls

http://nyp.org/


Report: The LED tray was difficult to remove, the safety cable

was too short, reflector tray screws had no stopping point

and screws were not captive. The manufacturer agreed to

adjust safety cable length and modify screw issues and LED

tray accessibility. The manufacturer provided a video showing

modifications.

CASE STUDY 1: Maintainability

New 750K SF Ambulatory Building with over 160 different fixtures/luminaires

http://nyp.org/


CASE STUDY 2 : Energy + Efficiency

1.5M sf of corridors

http://nyp.org/


CASE STUDY 2 : Energy + Efficiency

1. LM 79 and 80 (manufacturers test reports)

• Photometric Performance

• Chromaticity

• Lumen Maintenance

2. In-house campus electricians hands on review

3. Mock-up in situ review (patients, visitor, staff)

• Glare

• Color

• Brightness

• General appearance

4. Initial Cost v. Maintenance Costs

http://nyp.org/


CASE STUDY 3 : Color, Illumination Level and Controls

Mock-up luminaire and dimmer within a patient room.

Target illuminance was 100 footcandles.

Actual illuminance was 115.6 footcandles.

CRI measured at 93 CCT.

Color temperature measured at 3300K.

22 different clinicians including nurses and doctors

reviewed at a variety of different times of the day.

http://nyp.org/


CASE STUDY 3 : Color, Illumination Level and Controls

http://nyp.org/


Lighting Lessons Learned

http://nyp.org/


WHAT DO WE KNOW ABOUT LED LIGHTING:

Presents opportunities to enhance patient and staff satisfaction through far reaching controllability

Increases the reliance on lighting design professionals due to inherent complexities

Creates a need for facility managers and electricians to re-evaluate maintenance protocols

Not going away anytime soon, but for sure, tomorrow will not be the same as today

http://nyp.org/



What you do matters) do it well!

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