Light Impact Health Care Environment of the Future Group 7 Geetanjali Ningappa, Jeff Jopling, Adriana Fuentes, Luxmi Saha, Lars Christensen

Light is very critical in Health Care settings  Visually  Emotionally  Biologically

Importance of Light in Hospitals Affects Patients well-being Increases visual performance of the staff resulting in enhanced work performance Healing Property; Light therapy is used as treatment to cure many diseases Induces alertness in staff Errors by staff is reduced Reduces number of falls by patients

Visual Impacts of light Enabling Performance of Visual tasks Light enables us to see things ahead of us Higher levels of light helps reduce staff error Age related performance errors are reduced Day lighting is preferred for fine color discrimination

Visual Impacts of Light Sleep quality of residents and number of fall incidents during night time Patient falls reported inspite of wall mounted luminaire over the bed o can not reach the switch or can not see the switch in the dark Light near the head disrupted the sleep of the patient at night

Emotional Impacts of Light Affecting Moods and perceptions affects behavior and performance at work Daylight has better impact in a work environment than the artificial lighting Patients exposed to bright daylight experienced lesser perception of light

Emotional Impacts of Light Exposure to Colored light long exposure to a particular color is not advised o Causes over saturation creates an emotional state of mind

Biological Impacts of Light Controlling body's Circadian System Higher levels of light suppress Melatonin causing alertness Daylight is a better source as it provides higher levels of light at eye level Very important to staffs as they work in night shifts Controlling the Circadian system helps combat o depression o sleep o circadian rest activity rhythms o length of stay

Biological Impacts of Light Facilitating direct absorption for critical chemical reactions within the body Light radiation is directly absorbed by body stimulating chemical reactions in the blood and other tissue o Vitamin D metabolism o Jaundice prevention

Right selection of light critical Factors important in selection of light: o Technical needs o Soft lighting for relaxing o Night lighting o Location, Intensity and Controllability of light Natural light is the best preference due to its natural healing properties and economy.

Family and Communication

Family 'a group of persons with close familial, social or emotional relationship to the patient.' religious, cultural and social factors influence who is considered family, and how those family members understand illness. family members are more than just visitors - they, too, experience the processes of care......and can suffer from anxiety, PTSD and/or depression as a result

Effective Communication Communication o 'As a result of treatment and the seriousness of the illness, the ICU patient's body sends signals that the next of kin neither recognize or understand.' (Eriksson 2010) Aspects of good communication o appropriate timing, style, and wording o message effectively received and understood o allow family to stay during times of crisis o support and appreciate family's contributions in caring for the patient.

Role of Communication in Family Satisfaction Satisfaction - influenced by gap between needs and expectations and perceived fulfillment of those expectations. Need to make health professionals aware of the needs and expectations of patients and their families.

End of Life Communication Why is needed? One out of five or 22% of Americans die in an ICU Need for clinicians and families to make decisions about withdrawing or withholding life supporting therapies has become standard 54% of family/patients may misunderstood patients diagnosis or treatment if meetings last less than 10 minutes Perceived to lack hospitality towards dying patients and their family members Doctor communication is not taught in an ICU

Good Communication Advantages Good communication makes a difference. improved clinical outcomes: o Reducing psychological trauma symptoms o Reducing depression and anxiety o Decreased length of stay o More frequent referral to hospice o earlier orders for DNR and withdrawal of life support  Improving quality of death and dying Critical care training may also change significantly if there is some data that demonstrates improvement of patient/family outcome as a result of communication skill training

Assessing Communication in the ICU Validated tools primarily based on questionnaires can assess communication and satisfaction: o critical care family needs inventory (CC-FNI) o critical care family satisfaction survey (CC-FSS) o family satisfaction in the ICU (FS-ICU) Results from individual ICU used to drive improvements in that same ICU Next steps: o develop means of tracking effective communication over time. o further develop tools for NICU and PICU settings

Electronic Communication What is the need? Advances in information technology have led to an increase in the options for mode of communication Increasing need for patients to read doctors' notes which can help on: o Understanding their health o Foster communication o Ease and promote shared decision making process o Lead to better health patients' outcomes

Electronic Communication Results Positive: Communication improvement through: o internet portals with secure electronic messages o display medications, tests results, problems lists and facilitate communication refills o ease on appointment scheduling Efficiency in relating laboratory findings and doctors notes Helps remind patients what happened during visits Negative: More questions raised about doctors' writing Doctor's concerned about patients reactions from notes Conclusion: Current literature suggests positive results may be greater than negative

Things to Consider Role that the built environment plays in facilitating or hindering communication o Make patient rooms less obviously dominated by loud, mechanical medical devices o Allow for 'open access' to the unit Effective discussion of prognosis and goals of care o Family members use various types of information from a wide array of sources for prognostication Shared decision making based on patient's and family's values and preferences o Develop patient-specific triggers for palliative care consults