Compassionate Lighting

Calming Infusion Rooms

These solutions range from the practical to the advanced. For example, deploying sound absorbing materials and replacing open bays with three-walled designs in infusion and consultation rooms to reduce stressful noises and increase privacy.

Outdoor Spaces for Restoration

Incorporating nature—from outdoor patios and views of green plants to immersive nature photographs—is proven to speed the healing process and provide a calming moment for patients and staff.

Randy Fisher, IALD, MIES, CLD Principal, Studio Lead RFisher@nbbj.com 206.223.5019

Let’s discuss how we can help you create a lighting approach that meets the wants and needs of tomorrow's healthcare environments.

Joseph Montange, IALD, CLD Senior Associate, Light and Health Lead JMontange@nbbj.com 206.621.2264

Jonas Kuo, IALD, CLD Senior Associate, Design Lead JKuo@nbbj.com 206.621.2342

Circadian Lighting for the Patient Floor

Compassionate Lighting for Behavioral Health

Hospitality Reimagined

A growing body of research shows that lighting isn't just about visibility — it has a profound impact on our wellness, productivity, and mental health.

Bloomberg: A Prototype for Behavioral Health Facilities, Ohana's Nature- and Light-Filled Design Helps Promote Healing

NBBJ: Research Spotlights Need to Focus on Healthcare Workforce

NBBJ Lighting: The Night Shift is Bad for Providers’ Health

NBBJ Lighting: A Healthy Building Starts with Light

further reading

Circadian rhythms are natural, internal processes that regulate the sleep-wake cycle and repeat roughly every 24 hours. Disruptions to these rhythms, often caused by inadequate or improperly timed lighting, can lead to various health issues, including sleep disorders, depression, and metabolic problems. In healthcare settings, implementing circadian lighting—lighting systems designed to align with the body's natural rhythms—can significantly enhance patient recovery and staff performance. By mimicking natural light patterns, these systems help regulate hormone production, improve sleep quality, and boost overall mood. Incorporating circadian lighting into healthcare environments is not just a matter of comfort but a crucial component of holistic patient care and staff wellness. By aligning artificial lighting with natural biological rhythms, healthcare facilities can create environments that support healing, reduce stress, and enhance overall health outcomes. Color Temperature in Healthcare Environments The color temperature of light significantly impacts human physiology and behavior, particularly in regulating circadian rhythms and influencing mood, energy, and sleep quality. Here's how different color temperatures—measured in Kelvins (K)—affect humans: Cooler Light, 5000-6500K Boosts alertness and cognitive function Stimulates the production of cortisol, the body's natural "wake-up" hormone Suppresses melatonin production, signaling the body that it's time to wake up Enhances focus and productivity by mimicking the bright, blue-rich light of a clear morning sky Ideal for morning lighting in healthcare worker stations or areas requiring high-focus Helps shift workers adapt to morning routines after night shifts Neutral Light, 3500-5000K Supports ongoing alertness and maintains steady energy levels Balances stimulation without overstimulating, allowing for productive and comfortable working conditions Mimics natural daylight, promoting a sense of well-being and reducing fatigue Suitable for treatment rooms, administrative offices, and shared spaces Helps healthcare workers sustain energy throughout long shifts Warmer Light, 2700-3000K Reduces stimulation of the circadian system, allowing the body to prepare for sleep Encourages melatonin production, promoting relaxation and sleep readiness Creates a calming atmosphere that reduces stress and promotes healing Ideal for patient rooms, recovery areas, and staff relaxation zones Helps patients fall asleep more quickly and aids healthcare workers transitioning off-shift In healthcare environments, a dynamic lighting system that adjusts color temperature throughout the day can support patients' and staff's health and performance. Proper lighting design can enhance recovery rates, improve mood, and prevent the health complications associated with circadian disruption.

Rethinking Healthcare Lighting Hospitals and clinics are places of healing, but are challenged by staff retention and burnout, rising costs, increasing behavioral and mental health challenges, and the enduring challenge of improving patient outcomes. We believe that lighting can help address these issues by creating environments more conducive to staff productivity and wellness while nurturing patient outcomes.

Lighting is an untapped environmental tool that can improve staff wellness, mental health, and performance, while supporting and nurturing patient outcomes.

Circadian Lighting for the Patient Floor Traditional lighting, based on guidelines for the visual system, provides insufficient light during the day and too much at night, creating a biologically murky environment. Studies examining increased light level exposure interventions have shown improvements in sleep quality, mood, alertness, productivity, and even depression.1-5

Compassionate Lighting for Behavioral Health The future of behavioral healthcare design emphasizes creating welcoming, homelike environments that prioritize privacy and security with softness and compassion. With thoughtful detailing, the durability required for behavioral health environments can be masked to create a comfortable space for healing and fostering social interactions. Thoughtful lighting engenders an atmosphere of respect and empathy, necessary environmental cues to facilitate calm and healing.

Compassionate Lighting:

Rethinking Lighting for Healthcare

From supporting circadian rhythms to creating a calming environment, a compassionate lighting approach nurtures patient outcomes and staff wellness.

Hospitality Reimagined Hospitals and clinics are our temples of healing, but inevitably can be places of tremendous stress, fear, and grief. We believe lighting can help alleviate these emotions by helping express the care and compassion these temples stand for. Borrowing lighting techniques from hospitality and adapting them to the healthcare setting engenders a comforting and restorative environment, embracing patients under duress with compassion. Regardless of the project's budget and scope, from lighter renovations to full-fledged new buildings, this philosophy underpins our approach to all our healthcare projects.

Numerous research studies studies show that lighting affects our physiology and mental health, not just vision. Proper lighting for the circadian system requires more light during the day and less at night, impacting brain pathways differently than visual lighting. This science is a powerful, underutilized tool in healthcare to improve staff alertness, productivity, health, and mood.

Hospitals and clinics can benefit from science-based circadian lighting systems. Care teams often work in non-daylit environments that are biologically murky for the circadian system and mental health. Night shifts, especially the commonly used rapid-rotation schedules, prevent the circadian system from adapting, leading to chronic disruption. This disruption is linked to an increased risk of depression, metabolic syndrome, diabetes, hypertension, and cancer in long-term night shift workers.10-12

Designing lighting to support staff circadian rhythms and mental health is an environmental tool that reduces staff burnout and improves retention by nurturing wellness and providing a custom-design workplace that's design just for them.

Day Shift 7 AM to 7 PM

Night Shift 7 PM to 7 AM

Uplift Podcast: To Take Care of Us, We Must Take Care of Them. Designs to Support the Healthcare Workforce

Since the discovery of the ipRGC receptor around 2001, researchers have mapped its signals to various centers of the brain that regulate circadian rhythms and mood, highlighting the significant impact of light on physical and mental health.6-9 The ipRGC requires higher light levels than visual receptors to activate, and the circadian system is adapted to bright light during the day and darkness at night.

Light levels and spectrum are enhanced to meet science-based light levels at the care team station while simultaneously improving light exposure in corridors to support staff on rotations.13, 14

Here, we explore how this can look in an inpatient floor setting. Leveraging deep research into the science, expert consensus recommendations, and available technologies, we demonstrate a circadian lighting solution based on 12-hour shifts and rapid 3-day night shift rotations.

Exploring Science-Based Circadian Lighting for the Patient Floors

Lighting dims and shifts spectrum to eliminate blue-wavelength content in corridors and minimize it at care team stations, reducing impacts to patient sleep and staff melatonin suppression while maintaining visual lux levels for the care team’s visual tasks.15-18

Montage Health's Ohana Center for Child and Adolescent Behavioral Health has won many design accolades for its compassionate design and connection to nature while adhering to strict behavioral health standards.

1. Boubekri M, Cheung I, Reid K, Wang CH, Zee P. Impact of Windows and Daylight Exposure on Overall Health and Sleep Quality of Office Workers: A Case-Control Pilot Study. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine. 2014;10:603-611. doi:10.5664/jcsm.3780 2. Boubekri M, Lee J, MacNaughton P, et al. The Impact of Optimized Daylight and Views on the Sleep Duration and Cognitive Performance of Office Workers. International Journal of Environmental Research and Public Health. 2020;17(9):3219. doi:10.3390/ijerph17093219 3. Figueiro MG, Steverson B, Heerwagen J, et al. The impact of daytime light exposures on sleep and mood in office workers. Sleep Health: Journal of the National Sleep Foundation. 2017;3(3):204-215. doi:10.1016/j.sleh.2017.03.005 4. Grant LK, Crosthwaite PC, Mayer MD, et al. Supplementation of ambient lighting with a task lamp improves daytime alertness and cognitive performance in sleep-restricted individuals. Sleep. 2023;46(8):zsad096. doi:10.1093/sleep/zsad096 5. Figueiro M, Kalsher M, Steverson B, Heerwagen J, Kampschroer K, Rea M. Circadian-effective light and its impact on alertness in office workers. Lighting Research & Technology. 2018;51(2):171-183. doi:10.1177/1477153517750006 6. Mure LS. Intrinsically Photosensitive Retinal Ganglion Cells of the Human Retina. Frontiers in Neurology. 2021;12. Accessed May 6, 2022. https://www.frontiersin.org/article/10.3389/fneur.2021.636330 7. Logan RW, McClung CA. Rhythms of life: circadian disruption and brain disorders across the lifespan. Nat Rev Neurosci. 2019;20(1):49-65. doi:10.1038/s41583-018-0088-y 8. Fernandez DC, Fogerson PM, Ospri LL, et al. Light affects mood and learning through distinct retina-brain pathways. Cell. 2018;175(1):71-84.e18. doi:10.1016/j.cell.2018.08.004 9. Bedrosian TA, Nelson RJ. Timing of light exposure affects mood and brain circuits. Transl Psychiatry. 2017;7(1):e1017-e1017. doi:10.1038/tp.2016.262 10. Boivin DB, Boudreau P, Kosmadopoulos A. Disturbance of the Circadian System in Shift Work and Its Health Impact. J Biol Rhythms. 2022;37(1):3-28. doi:10.1177/07487304211064218 11. Lee A, Myung SK, Cho JJ, Jung YJ, Yoon JL, Kim MY. Night Shift Work and Risk of Depression: Meta-analysis of Observational Studies. J Korean Med Sci. 2017;32(7):1091-1096. doi:10.3346/jkms.2017.32.7.1091 12. ESMO. Night Shift Work Classified as Probably Carcinogenic to Humans. Accessed February 7, 2022. https://www.esmo.org/oncology-news/Night-Shift-Work-Classified-as-Probably-Carcinogenic-to-Humans 13. Brown TM, Brainard GC, Cajochen C, et al. Recommendations for daytime, evening, and nighttime indoor light exposure to best support physiology, sleep, and wakefulness in healthy adults. PLOS Biology. 2022;20(3):e3001571. doi:10.1371/journal.pbio.3001571 14. UL 24480 | UL Standards & Engagement | UL Design Guideline. Accessed September 19, 2024. https://www.shopulstandards.com/ProductDetail.aspx?productId=UL24480_1_D_20191219 15. Lowden A, Kecklund G. Considerations on how to light the night-shift. Lighting Research & Technology. 2021;53(5):437-452. doi:10.1177/14771535211012251 16. Nagare R, Rea MS, Plitnick B, Figueiro MG. Effect of White Light Devoid of “Cyan” Spectrum Radiation on Nighttime Melatonin Suppression Over a 1-h Exposure Duration. J Biol Rhythms. 2019;34(2):195-204. doi:10.1177/0748730419830013 17. Regente J, de Zeeuw J, Bes F, et al. Can short-wavelength depleted bright light during single simulated night shifts prevent circadian phase shifts? Applied Ergonomics. 2017;61:22-30. doi:10.1016/j.apergo.2016.12.014 18. RPI Lighting Research Center. Lighting for Shift Workers.; 2018. https://www.youtube.com/watch?v=U3lKLPimF-o&list=PL_X9RKGy9RIZmgzoJwHZsQmpPW6O1fLu3&index=6

Over 7 million square feet of healthcare spaces illuminated.

Ten healthcare projects recognized with illumination design awards.

Incorporating light fixtures tailored for Behavioral Health into clean, architectural designs cost effectively elevates the overall experience for patients, creating calming and compassionate spaces.

Cove pocket hides industrial ligature resistant linear recessed light, reducing glare and softening the effect for a more hospitality-like experience.

Whether a full-service lighting system for a new building, circadian-focused lighting upgrade for an interiors renovation or a pilot project to test effectiveness for your clinics... We are here to help.

Touch-sensitive wall task light gives users a safe way to customize their space and offer a non-destructive distraction to calm patients.

Lounges build community, fostering healing through shared experiences and connections.

We offer a full suite of services:

Architectural Lighting Design

Circadian Lighting Consulting and Design

Daylight Consulting and Design

Lighting Master Planning

Site and Landscape Lighting Design

Horticulture Lighting Consulting and Design

Custom Light Fixture Design

Patient Room Lighting Design

Operating Room Lighting Design

Circadian Lighting Consulting and Design

Daylight Consulting and Design

Lighting Master Planning

Compassionate Lighting

Research Citations

10. Boivin DB, Boudreau P, Kosmadopoulos A. Disturbance of the Circadian System in Shift Work and Its Health Impact. J Biol Rhythms. 2022;37(1):3-28. doi:10.1177/07487304211064218 11. Lee A, Myung SK, Cho JJ, Jung YJ, Yoon JL, Kim MY. Night Shift Work and Risk of Depression: Meta-analysis of Observational Studies. J Korean Med Sci. 2017;32(7):1091-1096. doi:10.3346/jkms.2017.32.7.1091 12. ESMO. Night Shift Work Classified as Probably Carcinogenic to Humans. Accessed February 7, 2022. https://www.esmo.org/oncology-news/Night-Shift-Work-Classified-as-Probably-Carcinogenic-to-Humans 13. Brown TM, Brainard GC, Cajochen C, et al. Recommendations for daytime, evening, and nighttime indoor light exposure to best support physiology, sleep, and wakefulness in healthy adults. PLOS Biology. 2022;20(3):e3001571. doi:10.1371/journal.pbio.3001571 14. UL 24480 | UL Standards & Engagement | UL Design Guideline. Accessed September 19, 2024. https://www.shopulstandards.com/ProductDetail.aspx?productId=UL24480_1_D_20191219 15. Lowden A, Kecklund G. Considerations on how to light the night-shift. Lighting Research & Technology. 2021;53(5):437-452. doi:10.1177/14771535211012251 16. Nagare R, Rea MS, Plitnick B, Figueiro MG. Effect of White Light Devoid of “Cyan” Spectrum Radiation on Nighttime Melatonin Suppression Over a 1-h Exposure Duration. J Biol Rhythms. 2019;34(2):195-204. doi:10.1177/0748730419830013 17. Regente J, de Zeeuw J, Bes F, et al. Can short-wavelength depleted bright light during single simulated night shifts prevent circadian phase shifts? Applied Ergonomics. 2017;61:22-30. doi:10.1016/j.apergo.2016.12.014 18. RPI Lighting Research Center. Lighting for Shift Workers.; 2018. https://www.youtube.com/watch?v=U3lKLPimF-o&list=PL_X9RKGy9RIZmgzoJwHZsQmpPW6O1fLu3&index=6