lighting and patient outcomes -...
TRANSCRIPT
Lighting and Patient Outcomes
Lighting and Controls in Healthcare Facilities
About Us!
Robert Blakey• CBRE ~ Group Health Co‐op• Sr. Manager, Operations
– Energy, Engineering, etc.
• CEM, CFM, CHFM, LEED AP• MS, Engineering Mgmt.• Instructor for U of W
Facilities Management Certificate Program
Joe Schuler• Prime Electric • Sr. Project Manager • Washington State Master
Electrician certificate • Member IBEW with 30
years in the field
About Our Companies
CBRE• Worldwide leader in real
estate services• 70,000 professionals in 60+
countries• 6 billion+ square feet under
management worldwide“As the world’s largest manager of commercial buildings, CBRE has both a responsibility and an opportunity to influence the way buildings are built, sourced, managed, occupied and sold.”
Prime Electric• Size & Resources
– 28 Years in Business– Annual Sales Volume: $80‐
100 million– 18 Project Managers + 50
Support Staff– 220 Field Employees– Awards
• Washington’s Best Workplaces 2012‐2015
• Fastest Growing Company in 2009
Lighting & Controls in Healthcare Facilities• Key Points
– Facility Manager View• T‐8 Fluorescent vs LED • Standards & Recommended lighting levels• Occupant considerations• Control Strategies & Opportunities• Operational Savings & Other Benefits
– Contractor View• Control cost/device• Installation strategy & issues• Commissioning
Case Study: Northshore
Case Study: Veradale
FMView
T‐8 Fluorescent vs LED
• Incremental cost for LEDs only about 10%• Significant benefits in technology
– Lower maintenance (20 year bulb life?)– Light quality and color– Dim ability
• Luminaire and ballast life
FMView
Standards & Recommended lighting levels
Space Type OSHA / ANSI Minimum Recommended
Exam Room 30 FC 37 FC
Office/Conf. Room 20 FC 30 FC
Corridor 10 FC 20 FC
Waiting Area 10 FC 23 FC
* Measured at floor in center of room
The opportunity: Fixtures installed have to be capable of producing the recommendedlighting level, yet it is rare that the use in the space actually requiresthat level of light output.
FMView
Occupant Considerations
Consider an Exam Room– Unoccupied for a significant amount of time– Nurse brings patient to room and performs standards tests that require only modest lighting
– Lighting should adjust for daylighting– Patient waits (reads magazine or rests)– Doctor arrives– Doctor may require high lighting level for specific exams, or may not.
RECOMMENDED LIGHTING LEVEL ONLY A SMALL %
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Occupant Considerations
Consider a Doctor’s Office– Unoccupied for a significant amount of time– Doctor in space working primarily on computer most comfortable in modest lighting, no glare
– Lighting should adjust for daylighting– Doctor may require high lighting level for specific tasks, or may not.
RECOMMENDED LIGHTING LEVEL ONLY A SMALL % “Task Tuning”
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Code Requirements
• Washington State Energy Code 2012– Occupancy Sensors– Daylight Harvesting– Dimming/Power Reduction to 50%
• Exemption for “medical and dental” procedures appears to be omitted (2009 Code)
• Compliance required at 60% of luminaires
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Control Strategies & Opportunities
Task Tuning
DaylightHarvesting
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Control Strategies & Opportunities
• Exceeds Code
• User Friendly
• Wireless• Programmable
Up to 4 programmable modes
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Operational Savings & Other Benefits
• Energy Savings (Building Total)– LEDs and Advanced Controls (Northshore) = 30%– LEDs and “Code Required (2009?)” = 18%
• Improved Occupant Control• Reduced Workspace Glare• Adjustment is on computer not at switch
(07 Electrician not required)
• Flexible programming of Lighting Zones
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SavingsYear Over Year
ContractorView
Lighting Control Design Build Considerations
• Request for Proposal– Meet specified Return on Investment (ROI)– We were already installing LED lights so the new system had to be very efficient to pay off.
– We weighed the advantages of wireless versus traditional hardwired control
• The wireless system was more expensive• Labor savings were significant.
ContractorView
Lighting Control Design Build Considerations
• Factors that pushed us toward a wireless system– Hard lids, Atriums, exposed construction, etc. make traditional systems more difficult and more costly to install.
– Occupancies like healthcare facilities, labs and pharmacies increase labor costs because of infection control measures
– Occupied facilities require after hours shift work putting a premium on finding ways to reduce labor
– There was a possibility of extending the system in the future to add dimmable LED parking lot lighting which would be cost prohibitive to hardwire controls to.
ContractorView Riser Wiring
ContractorView Installation strategy & issues
• The System selected, by design required a wireless sensor and control unit (CU) for eachfixture.– While this gave the end user greater flexibility for pinpoint lighting control, at nearly $100 per unit it also was driving us over budget.
– Needed a strategy to reduce the number of CUs• Identify fixtures that didn’t need dimming or daylight harvesting
• Identify areas where we could reduce the number of sensors without leaving blind spots
ContractorView Installation strategy & issues
• Once we realized that we could manipulate the system we employed the following strategies.– Corridors were all interior and didn’t need dimming or daylight harvesting. We installed a single wireless sensor combined with a relay to control the entire corridor.
– Exam rooms had two fixtures but were small enough to get by with only one sensor. We mounted the CU in a separate housing and tied both lights to this single point.
ContractorView Controlling cost/device
• With the number of control units squeezed to the minimum we now targeted labor savings.– Prefabrication was the answer
• All fixtures were delivered directly to our warehouse• On straight time, JWs and lighting techs installed CUs in fixtures and packaged for just in time delivery to the jobsite.
• Relay units for corridor lights were prefabricated with whips that were field ready to install.
• All prepared fixtures and relay packages were delivered to the crew twice a week to reduce handling and on site storage.
ContractorView Commissioning
• The customer identified optimum settings for each type of occupancy. Both for cost saving and usability. Prior to commissioning, “user groups” were programmed into the system to reflect each type of occupancy.– Exam rooms. 70‐80% output with the ability to dim or go to full intensity with the push of a button.
– Offices. Set to a predetermined fractional output. Daylight harvesting applied.
– Corridors. On/off with override for housekeeping.– All groups also had off hours and marginal hours programmed to reduce and then completely shut off lights.
ContractorView Commissioning
• One challenge of conversion to this new system was to limit commissioning time. The commissioning tech was coming in from out of town and had limited time so we needed to start up the new wireless system overnight.
• When the tech arrived we needed to have all of the components in place including the new wireless switches.
• Commissioning was done with a laser pointer and a laptop. They simply move from room to room until all sensors are identified and accounted for.
• Each fixture was dropped into a “user group” by occupancy that we had preprogrammed. By morning we had a functioning system.
Outcomes
• LEDs about 10% more than T8 replacements– 50% less energy– 2 year payback or less
• Controls about double in price– 50% savings on remaining energy– About a 5 year payback
• LEDs a 20 year investment– Right time to do controls or missed opportunity
• High occupant satisfaction• Learning curve for our Maintenance Staff
