ANSI IESNA RP-29-2016 Lighting for Hospitals and Healthcare Facilities《医院和康复设备照明》.pdf

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1、ANSI/IES RP-29-16Lighting for Hospitals and Healthcare Facilities ANSI/IES RP-29-16Lighting for Hospitals and Healthcare FacilitiesPublication of this Standardhas been approved by IES.Suggestions for revisionsshould be directed to IES.Prepared by:The IES Healthcare Facilities CommitteeCopyright 2016

2、 by the Illuminating Engineering Society of North America.Approved by the IES Board of Directors, October 23, 2016, as a Transaction of the Illuminating Engineering Society of North America.Approved by the American National Standards Institute, December 1, 2016, as an American National Standard All

3、rights reserved. No part of this publication may be reproduced in any form, in any electronic retrieval system or otherwise, without prior written permission of the IES.Published by the Illuminating Engineering Society of North America, 120 Wall Street, New York, New York 10005.IES Standards and Gui

4、des are developed through committee consensus and produced by the IES Office in New York. Careful attention is given to style and accuracy. If any errors are noted in this document, please forward them to Brian Liebel, Director of Standards and Research, bliebelies.org, at the above address for veri

5、fication and correction. The IES welcomes and urges feedback and comments.Printed in the United States of America.ISBN # 978-0-87995-338-6DISCLAIMERIES publications are developed through the consensus standards development process approved by the American National Standards Institute. This process b

6、rings together volunteers representing varied viewpoints and interests to achieve consensus on lighting recommendations. While the IES administers the process and establishes policies and procedures to promote fairness in the development of consensus, it makes no guaranty or warranty as to the accur

7、acy or completeness of any information published herein. The IES disclaims liability for any injury to persons or property or other damages of any nature whatsoever, whether special, indirect, consequential or compensatory, directly or indirectly resulting from the publication, use of, or reliance o

8、n this document. In issuing and making this document available, the IES is not undertaking to render professional or other services for or on behalf of any person or entity. Nor is the IES undertaking to perform any duty owed by any person or entity to someone else. Anyone using this document should

9、 rely on his or her own independent judgment or, as appropriate, seek the advice of a competent professional in determining the exercise of reasonable care in any given circumstances. The IES has no power, nor does it undertake, to police or enforce compliance with the contents of this document. Nor

10、 does the IES list, certify, test or inspect products, designs, or installations for compliance with this document. Any certification or statement of compliance with the requirements of this document shall not be attributable to the IES and is solely the responsibility of the certifier or maker of t

11、he statement.AMERICAN NATIONAL STANDARDApproval of an American National Standard requires verification by ANSI that the requirements for due process, consensus, and other criteria for approval have been met by the standards developer.Consensus is established when, in the judgment of the ANSI Board o

12、f Standards Review, substantial agreement has been reached by directly and materially affected interests. Substantial agreement means much more than a simple majority, but not necessarily unanimity. Consensus requires that all views and objections be considered and that a concerted effort is made to

13、ward their resolution.The use of American National Standards is completely voluntary; their existence does not in any respect preclude anyone, whether that person has approved the standards or not, from manufacturing, marketing, purchasing, or using products, processes, or procedures not conforming

14、to the standards.The American National Standards Institute does not develop standards and will in no circumstances give an interpretation to any American National Standard. Moreover, no person shall have the right or authority to issue an interpretation of an American National Standard in the name o

15、f the American National Standards Institute. Requests for interpretations should be addressed to the secretariat or sponsor whose name appears on the title page of this standard.CAUTION NOTICE: This American National Standard may be revised at any time. The procedures of the American National Standa

16、rds Institute require that action is taken to reaffirm, revise, or withdraw this standard no later than five years from the date of approval. Purchasers of American National Standards may receive current information on all standards by calling or writing the American National Standards Institute.Pre

17、pared by the IES Healthcare CommitteePaul Mustone, ChairRichard Kassouf, Vice ChairCover Image - Nemours Childrens HospitalArchitect of Record / Design Architect: Stanley Beaman those that affect lighting design are Table 1. Primary Consumer Concerns in Healthcare FacilitiesANSI/IES RP-29-16 ANSI/IE

18、S RP-29 Healthcare Draft for Typeset - Page 13 of 182 D:PatRPRP-29 Hospitals emergency call systems Sense of Well-Being Facilitates healing, areas of respite, and positive distraction Facilitates relaxation while fostering a sense of quality Sense of home and independence Convenient, Accessible Park

19、ing, drop-off areas, wayfinding Anything that gets the patient in and out quickly Emergency egress; bathroom access Confidentiality, Privacy Private patient rooms and bathrooms; quiet places for families to “get away“ Intake interview not audible in the waiting room; i.e., occupants not able to hear

20、 through exam room walls Single-occupancy rooms when possible; partitions that enable visual and acoustic privacy for semi-private rooms Family Support Space utilization that accommodates periodic and overnight visitors Sufficient seating in waiting areas; accommodations for children Encourages dail

21、y interactions between family members and residents Accommodates Physical Impairments Ambulation with equipment or cognitive impairment; traversing distances Diversity of furnishings in waiting area; signage Designed not just for ADA compliance, but for staff assistance with hygiene facilities; maxi

22、mize mobility Connection to Nature Access to outdoor areas; indoor nature; windows in patient rooms with outside views Waiting rooms: windows to outside; indoor nature; fresh air Outdoor activities; outside views from patient rooms; indoor gardens 1.2 Trends in Healthcare Design There are many trend

23、s in healthcare design and operations; those that affect lighting design are incorporated into this document. Some trends may still be considered controversial or in need of more definitive research at the time of this writing. Rather than ignore these topics, this document attempts to provide guida

24、nce where possible and to identify those areas where further knowledge is needed. 3ANSI/IES RP-29-16incorporated into this document. Some trends may still be considered controversial or in need of more definitive research at the time of this writing. Rather than ignore these topics, this document at

25、tempts to provide guidance where possible and to identify those areas where further knowledge is needed. Where there is doubt as to proper practice, lighting professionals are encouraged to follow the medical professions mantra of “First, do no harm.” Three prevalent design principles are: Sustainab

26、ility. Healthcare facilities are the second highest consumer of energy per area of any building type, just behind food services, and therefore there is a heightened interest in reducing energy consumption and operational expenses. The 24-hour critical-use nature of operations means that lighting in

27、several areas of a facility will remain operational, and therefore consuming electricity, at all times. Hospitality-inspired designs. Envisioning hospitals as hospitality environments to reduce stress by communicating a welcoming, non-threatening environment has become a common design approach. Conc

28、eptually, this project approach requires variations to illumination levels (typically higher in hospitals than in hospitality) and material selections (understanding the need for cleanliness and disinfection) in several room types. Evidence-based design. This is the process of basing decisions about

29、 the built environment on credible research in order to improve outcomes.Evidence-Based Design (EBD) is a tool that designers can use to test measurable benefits associated with design trends, as well as a resource for design inspiration and innovation. A large and growing body of evidence attests t

30、o the fact that the physical environment affects patient stress, patient and staff safety, staff effectiveness, and the quality of care provided in hospitals and other healthcare settings.3This body of knowledge allows designers to learn from each others experiences and improve future facility plann

31、ing and design decisions in order to achieve the best possible patient, staff, and operational outcomes. Lessons learned and knowledge acquired through experience are valuable tools to be shared and utilized by design professionals. The Center for Health Design has spearheaded this movement, creatin

32、g and administering an evidence-based design accreditation and certification (EDAC) credential. Evidence-Based Design utilizes research methodology to collect measurable data to evaluate the effectiveness of design decisions. This quantifiable data is used to better fiscally analyze the impact of de

33、sign decisions. The process follows eight steps:1. Define evidence-based goals and objectives2. Find sources for relevant evidence3. Critically interpret relevant evidence4. Create and innovate evidence-based design concepts5. Develop a hypothesis6. Collect baseline performance measures7. Monitor im

34、plementation of design and construction8. Measure post-occupancy performance resultsOrganizations such as the Center for Integration of Medicine and Innovative Technology (CIMIT) seek to accelerate the healthcare innovation cycle through creative collaboration between product developers, designers,

35、and healthcare professionals. Collaborative innovation provides a cross-pollination of ideas and leads to procedural efficiency enhancements or new product offerings. These innovative products often are developed in response to a specific need and have been shown to be useful in multiple situations.

36、 The Center for Health Design has published a table showing the relationship between facility features and healthcare outcomes (see Figure 2). While the term “appropriate lighting” used in the table is vague at best, it does underscore the important role that lighting plays in healthcare facilities.

37、 It also reinforces the need for the lighting design community to become involved and actively participate in building the growing body of Evidence-Based Design reports in order to enhance technical accuracy.1.3 Financial ImplicationsThe healthcare industry is a very competitive one. In most communi

38、ties, the options for seeking medical care are several, often with multiple medical systems, outpatient clinics, and retail outlets from which to choose. The competition exists not only for patients, but also for physicians, caregivers, and staff, so differentiation and well-designed facilities beco

39、me a business advantage for healthcare facilities. Healthcare providers are consistently faced with the financial struggle to provide medical care for pre-negotiated rates with insurance companies and Medicare, while also providing medical care to the uninsured. This financial pressure causes health

40、care providers to look favorably on designs that reduce hospital-acquired infections, reduce operational costs, and improve medical outcomes.4ANSI/IES RP-29-16There are two types of financial structures for hospitals: for-profit and not-for-profit. For-profit hospitals have a private board of direct

41、ors, pay taxes, and have greater abilities to raise capital. Not-for-profit hospitals do not pay taxes but must annually report on the community benefits they provide, and must invest all profits back into the institution. Within Canada, and growing in popularity in other areas, Public-Private Partn

42、ership (PPP or P3) is a common method of project delivery and funding. In this system, a government service or private business venture is funded and operated through a partnership of government and one or more private sector companies. This type of development leverages the expertise and innovation

43、 of the private sector for the development of public assets. The government entity occupies the completed building while purchasing it in installments over the term of the project, typically 20 to 30 years. This long-term approach entrusts the private sector to have a greater role in the design, bui

44、lding, financing and, in some cases, the operation of the public infrastructure. The designer is part of the private sector team assigned to deliver a building that will Within the United States, the Affordable Care Act has linked medical reimbursements to quality of care. The Hospital Consumer Asse

45、ssment of Healthcare Providers and Systems (HCAHPS) survey is provided to patients with the intent to capture consumer satisfaction in a transparent and consistent manner across all hospitals. Survey results provide insight into patients experiences and are a useful tool for facilities to determine

46、what is working well and what needs improvement. In the spirit of transparency, these HCAHPS scores are published on the Medicare website via their Hospital Compare tool, which is a strong incentive for healthcare facilities to strive for high performance. In 2016, 1 percent of all Medicare reimburs

47、ements to hospitals are being withheld. By 2017, that number will increase to 2 percent. A hospitals Total Performance Score (TPS) is derived 70 percent from measurable performance outcomes and 30 percent from HCAHPS survey results and determines whether a hospital will receive more, less or the amo

48、unt originally withheld as reimbursement for the medical care that was delivered. Linking consumer satisfaction and medical outcomes to medical reimbursements has created a financial incentive to support innovative and evidence-based design solutions. ANSI/IES RP-29-16 ANSI/IES RP-29 Healthcare Draf

49、t for Typeset - Page 15 of 182 D:PatRPRP-29 Hospitals many hospitals have a diverse demographic. Art elicits individual reactions and can evoke the patients inherent resources for healing. Studies show that music can mitigate nausea and emesis in chemotherapy patients, decrease preoperative anxiety in infants, improve physiological and behavioral measures of premature infants, and reduce the stress of visitors in waiting rooms. It has also been shown that music “administered” at times of high stress has an anxiolytic (anti-panic or anti-anxiety) effect, resulting in increas