Natural light is a fundamental aspect of all life on earth. But due to a highly urban-influenced living, we humans often ignore its significance. Daylight can have a profound impact on our overall well-being, especially in situations where we may be feeling unwell or in need of recovery. This is particularly true for patients inside hospitals, where access to natural light can significantly improve their recovery process. In this article, we will explore the role of natural light in patient recovery inside a hospital.
Data on daylight
There is a lot of research data on the importance of natural light. Early research trials show that patients placed near the window have a shorter hospital stay than those away from windows. Access to natural light in patient areas can expedite healing and recovery rates due to several benefits. These include better sleep and circadian rhythm, pain management, reduced stress, and improved satisfaction and mood. Studies show that patients exposed to at least three hours of natural light daily have lower stress levels and higher satisfaction compared to those in windowless rooms. Analgesic use decreases in patients undergoing elective cervical and lumbar spinal surgeries or post-labor recoveries.
According to researchers Choul-Gyun Chai and Man Young Park from Kwangwoon University, South Korea, and Korea Institute of Oriental Medicine, South Korea, respectively, natural daylight has a positive effect on the process of recovery of hospitalized patients. It also helps shorten the duration of their hospital stay.
In another study, published by the National Library of Medicine, the researchers Jeffrey M Walch, Bruce S Rabin, and others found that the amount of sunlight in a hospital room helps improve the psychosocial health, reduces the quantity of analgesic medication used, and the pain medication cost for patients who have undergone spinal surgery.
“Patients staying on the bright side of the hospital unit were exposed to 46 percent higher-intensity sunlight on average (p = .005). Patients exposed to an increased intensity of sunlight experienced less perceived stress (p = .035), marginally less pain (p = .058), took 22 percent less analgesic medication per hour (p = .047), and had 21 percent less pain medication costs (p = .047). The age quartile was the only other variable found to be a predictor of analgesic use, with a significant negative correlation (p <.001). However, patients housed on the bright side of the hospital consistently used less analgesic medications in all age quartiles,” the researchers note in their study results.
Benefits of natural light
Natural light is essential for creating a healing environment in hospitals as it can boost the mental and physical well-being of patients, caregivers, and visitors. It enhances staff efficiency, cleanliness, and patient well-being. Hospital design should prioritize patient well-being, and natural light should be considered while designing to prevent stress, sick-building syndrome, and drug-resistant infections. Patients in windowless rooms experience increased stress levels, while poorly ventilated spaces can cause fatal infections for critically ill patients.
Natural daylight is crucial for maintaining circadian rhythms in humans, so a lack of natural daylight seriously disrupts our bodies, explains Dr Subramanian Swaminathan, Director of Infectious Disease, Gleneagles Global Hospitals, Bengaluru. Even healthy shift workers, he says, suffer greatly with maintaining bodily homeostasis due to lack of exposure to daylight. “Also, because people won’t see any sunlight throughout the winter, their levels of depression rise, as we know from the western globe where winters are quite harsh and days are relatively brief,” Dr Subramanian says.
Ar Manu Malhotra, Founder Partner and Director at RSMS Architects, says, “While promoting the healing process, it also helps the physicians & the nurses to provide better healthcare. Ambient Natural lighting tends to provide a sense of well-being in healthcare facilities. Evidence-based study shows that Natural light significantly reduces the length of in-patient stays by speeding up the post-operative recovery as well as contributing to greater pain relief.”
“Full spectrum light is known to reduce viral and staphylococcus infections and aid in reducing heart rate. It also helps lower blood pressure and increases oxygen uptake. Inadequate light can lead to addictions, suicides, depression, and fatigue,” says Dr Nikhil Mathur, Group Chief of Medical Services, CARE Hospitals Group.
Daylight drawbacks?
From an architectural perspective, one of the drawbacks of abundant daylight, especially in a tropical country like India, is said to be its impact in terms of rise in temperature inside a hospital building. So, the challenge lies in balancing the benefits of increased natural light with the potential for reciprocal heat gain inside hospital rooms.
That’s where a good hospital design comes into the picture. According to Alpana Gupta, Partner at Vijay Gupta Architects (VGA), a well-designed hospital incorporates sufficient natural light along with proper ventilation to avoid overheating and ensure fresh air circulation at the same time.
Director of Edifice Consultants, Manoj Chaudhury, suggests that one effective strategy to reduce heat absorption in buildings is to optimize the hospital’s climatic orientation, with the shorter face of the building oriented towards the east and west directions.
Creating a sustainable hospital design that promotes patient well-being involves implementing tools such as energy management through smart BMS, utilizing local materials, and providing access to natural light and improved indoor air quality. In addition to these practical considerations, the patient-centric design also requires compassionate and functional spatial configurations that facilitate interaction. These elements ultimately contribute to a hospital environment that supports the needs of both patients and clients, Manoj Chaudhury says.
Ravideep Singh, Associate Director, Creative Designer Architects, informs that the new glazing systems available today provide high levels of heat insulation with double- or triple-glazed units and a visible light transmittance (VLT) of 40-50 percent, allowing for usable daylight while avoiding heat gain and glare. “Striking a golden mean is a pure rationale of carefully understanding the space, end-user dynamics and strategically employing the best available technology. A holistic design approach towards patient areas and the building envelope helps to ensure natural light and identify the zones of minimal heat gain for better orientation,” he explains.
Ar Manu of RSMS Architects informs that his organization follows the ‘Salutogenic Model’, to design efficient curative spaces. RSM, he informs, fuses the human desire for a connection with nature and other life forms with its design approach. This approach, he says, allows for the integration of green spaces and the maximization of natural light in medical buildings while minimizing heat gain.
A changing scenario
Making a critical comment on the current situation, Dr Nikhil Mathur of CARE Hospitals says that it is fashionable in India today to use air-conditioning systems instead of natural air and light. He says that our ancestors knew the importance of daylight and that can be seen through traditional practices that Indians followed. “Our ancestors used to work in the open and the sick and the elderly were made to sit in sunlight for some time daily. Traditional practices did have a lot of scientific advantages. While a well-ventilated and aired room with good light is a principle of Vastu, we have forgotten these aspects.”
Accedes Ravideep of CDA: “The traditional Indian medicine relied heavily on the importance of sunlight in healing and its impact on overall health. This aspect, somehow, didn’t percolate well in the contemporary Indian healthcare landscape as it grew, mainly intending to imitate the big-box western hospitals.”
However, the global trends in this space have begun to reflect on the fundamentals, especially during the past decade. “There is an acknowledgment about the importance of natural light and its positive impact on patients and caregivers alike.”
Stating that not many hospitals currently prioritize sustainability, Manoj of Edifice Consultants says that hospitals are generally perceived to be function-oriented and focus on end-user operations only. There also exist misconceptions about cost escalations in implementing sustainable, environment-friendly designs. But in reality, he says, “cost efficiency can be achieved if sustainable practices and strategies are conceived during the design stages itself.”
According to Ar Manu of RSM, there has been a definite shift to a value-based service model, where outcomes and satisfaction drive reimbursements. The patient experience, he says, is taking on a whole new level of importance for providers today. Agreeing with this, Dr Subramanian of Gleneagles Global Hospitals observes that many hospitals are investing in this approach simply because it looks nice. “Every patient wants to have a window through which she/he can see the outside world. Therefore, hospitals accommodate this in the case of patient rooms and windows. I suspect, many hospital rooms end up with natural lighting without really intending to, but it has helped the patients’ symptoms,” he says.
Seeing is believing
Dr Subramanian informs that at both the locations of Gleneagles Global Hospitals–in Bengaluru and Chennai—the single, as well as double-sharing rooms, have been designed to allow entry of sunlight and natural ventilation. In addition, as a good practice, the hospital staff also occasionally takes its patients out in wheelchairs to see the world outside. “The patients consistently report that this has had a positive impact on their capacity to heal and to start feeling better,” informs Dr Subramanian.
In Varanasi’s Ashirvad Hospital, all the patient rooms have a view of the outdoors with a large window filling the space with natural light, informs Alpana Gupta of VGA. “The concerns regarding external street noise and heat gain have been mitigated by using double-glazed windows with high-performance glass. The large windows ensure optimum daylight and regulate indoor air quality,” she says.
Kolkata’s Peerless Hospital uses a Biophilic design approach and includes green areas of respite, informs Manoj of Edifice. “The glass and terracotta façade, along with the foliage and wave-like brise soleil presents an earthy and vernacular look to the built form, while also reducing HVAC loads.”
Ensuring seamless visual access to daylighting, hospitals such as Max Nirogi in Patparganj, Max Nanavati in Mumbai, and Yashoda Medicity in Indirapuram comprise large elevated landscaped gardens accessible to patients and their relatives to exemplify the visual and physical access to natural light, informs Ravideep of CDA. “Raipur’s Rama Krishna Care Hospital incorporates a vast central courtyard that functions as crucial respite space for patients, relatives, and caregivers, minimizes stress, and promotes well-being,” he says. Centrally located courtyards or garden areas are being incorporated by many hospitals today to provide visual relief besides profuse daylight.
The LEED Gold certified Apollomedics Super Specialty Hospital, Lucknow, presents a curvilinear form to gather the range of views on the eastern side of the site from the patient areas, while making use of maximum daylight in the building, especially in the patient rooms, ICUs and circulation areas, informs Ar Manu of RSM. In the case of Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), the patient areas have been designed in such a way that every bed gets optimum natural light along with a view of the outside world, thus, reducing the risk of ICU psychosis and ensuring a faster patient recovery, Ar Manu says.
Light-speed adoption
Although traditional hospital designs rarely paid attention to natural light, the scenario is changing fast. Even the organizations such as India Green Building Council place tremendous emphasis on natural elements such as open spaces, sunlight, fresh air, and visual relief for patients as well as care provides inside a hospital building. With both, healthcare professionals and designers becoming aware of the importance of natural light in healing spaces, there will be many more new hospitals designed with patients’ overall wellness in mind, going forward.
Source: https://www.healthcareradius.in/