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1

2 Welcome

3 How LED Lighting is Impacting Healthcare E69

4 Speakers Marjorie Sobylak New York Presbyterian Sr. Project Manager Karen Murphy LC, IALD, LEED AP HDR Sr. Lighting Designer Lam Vu PE, CEM US Department of Veterans Affairs Office of Construction & Facilities Management

5 Session Description 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.

6 Session Objectives 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.

7 LEDs Save Energy LEDs Eliminate the Need for Maintenance This is better) it s LED LEDs Have Better Color Quality LEDs Last Forever

8 FLUORESCENT LIGHT EMITTING DIODE

9 LED fixtures use different methods to produce white light: Color mixed LED modules RGB RGBW Blue LED modules with yellow phosphors Blue Pump White LED RGBA

10 FLUORESCENT Ballasts Instant Start Rapid Start Program Rapid Start LIGHT EMITTING DIODE Drivers Forward Phase Reverse Phase 0-10V Dali Very recently: Tunable Integrated

11 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

12 FLUORESCENT LIFE Lamp Life is the time is takes for 50% of fluorescent lamps to fail. LED LIFE 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?

13 Lumen Depreciation 120% Lamp Lumen Depreciation 100% LED XL T8 Fluor Compact Fluor Percentage of Initial Lumens 80% 60% 40% 20% 0%

14 Maintenance: Group Replace LEDs Maintenance 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.

15 Energy Efficiency LED Linear Fluorescent Compact Fluorescent Projected Average Best Average Incandescent EFFICACY (lumens/watt)

16 Operating Characteristics Heat LEDs transfer heat through conduction Fluorescent lamps don t like cold; LED modules don t like hot

17 Operating Characteristics Flicker LED Driver Control Device compatibility can create flicker problems IEEE (establishes threshold limits <200Hz) Negative effects can occur with frequencies <120Hz eye strain / headaches Negative effects typically occur with frequencies <70Hz photosensitive epilepsy

18 COLOR METRICS Color Temperature ( Kelvin) Color Rendering Index (CRI)

19 Color Quality Correlated Color Temperature (CCT) Measured in ºKelvin 2700ºK 4000ºK 6500ºK

20 Color Quality Color Rendering Index (CRI - Ra)

21 Color Quality Color Rendering Index (Ra) Color Fidelity (Rf)

22 Color Quality Color Gamut (Rg) saturation Rg range is when Rf >60

23 Clinical Applications where Color Rendering is Important Burn Units / Wound Healing NICUs Select Laboratories ER Surgical Lights

24 Common use for LED today Fall Prevention

25 Common use for LED today Decrease Patient Anxiety Pediatric Hyperbaric Chambers MRI / PET Scan Psychiatric

26 Current Trends with LED today Support Circadian Entrainment

27 New Possibilities with LED Luminaires double as Access Panels

28 Future Possibilities with LED Enhance Infection Control 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.

29 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.

30 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

31 VA Technical Information Library (TIL)

32 VA Technical Information Library (TIL) (cont.) PG 18-1 Master Construction Specifications - PG Design Manuals - PG Design Guides - PG 18-4 Standards Details and CAD Standards - PG 18-5 Equipment Guide List - PG 18-9 Space Planning Criteria - PG Room Finishes, Doors, and Hardware Schedules - (And many more construction & engineering standards)

33 Current VA Lighting Design Guidance: Design - Currently shown as part of the Electrical Design Manual (EDM) Construction Currently shown in VA Master Lighting specifications (Interior) & (Exterior) Before 2012: LED task focused lighting (only) Surgical Lights, U/C Lights, Exam Lights Since 2012: LED ambient lighting allowed

34 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

35 Positive Impacts of LED: Energy saving Sustainable Ease in control and dimming Ease in automated color adapting Ease in maintenance

36 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)

37 Challenging impacts of LED: (continued): Installation hiccups (i.e. incompatible dimension, color, glare etc.) Maintenance hiccups (i.e. light loss, part replacement etc.)

38 Going Forward: Keep embracing LED technology Keep monitoring continued development and advancement of LED

39 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.

40 Lighting Challenges Case Studies 1. Maintainability 2. Energy and Efficiency 3. Color, Illumination Level and Controls

41 CASE STUDY 1: Maintainability New 750K SF Ambulatory Building with over 160 different fixtures/luminaires 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.

42 CASE STUDY 2 : Energy + Efficiency 1.5M sf of corridors

43 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

44 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 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.

45 CASE STUDY 3 : Color, Illumination Level and Controls

46 CASE STUDY 3 : Color, Illumination Level and Controls

47 Lighting Lessons Learned

48 Lighting Lessons Learned

49 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

50 What you do matters) do it well!

51 2015 HDR, Inc., all rights reserved.