Healing light, less medication

The condition of most patients in intensive care is critical. As such, suitable surroundings are all the more important for their recovery. To date, however, this has hardly been taken into consideration at all in traditional intensive care units – a matter-of-fact design and any amount of technical equipment often have a disconcerting effect on patients and create a sense of dependence and helplessness. Other important factors include the unfamiliar daily rhythm, too few relaxing deep sleep phases, and an increased lack of natural light. Yet precisely ambiance and natural daylight are important factors that can play a pivotal role in a patient’s healing process. For this reason the Charité in Berlin is currently conducting research into these connections and is using Ward 8i at the Campus Virchow-Klinikum for a pilot project.

The project was initiated by Professor Claudia Spies, a consultant anesthesiologist and head of the Charité Department of Anesthesiology and Operative Intensive Care Medicine, who is researching intensive therapy and narcosis methods for delirium and cognitive dysfunction. Delirium, a condition of mental confusion frequently caused by stress, can occur in intensive care patients and lead to comorbidities. The research project “Parametric Spatial Design”, for which Charité CFM Facility Management GmbH has joined forces with the Berlin firm of architects Graft and the media designers at Art+Com, aims to reveal how deliriums of this nature can be avoided. For the study they are designing an intensive care ward with two rooms and a total of four beds from scratch: Architects, medics, and media designers conceived the interior together, availing themselves in the process of the services of language researchers, as well as light and acoustics experts.

Less stress due to controlled light and better acoustics: Graft architects designed in cooperation with the Charité at the Campus-Virchow-Klinikum two new rooms for the intensive care unit. The technology, which causes often fear on the patient, is hidden behind a modular wall system at the bed-head of the bed.
Photo © Tobias Hein

The intensive care ward – new territory for the architects

Controlling and orchestrating light and its impact is what architects do. As far as the Graft team was concerned, what was new about this very special assignment was having to deal with the requirements of patients and doctors in an intensive care unit and taking the complex technical equipment as well as daily routines and work processes into account in the design. Yet according to Thomas Willemeit, founding partner at Graft, precisely their impartial view of things was an advantage for the architects when they were developing the concept, as this way the team did not take its cue from something that already existed, but was able to pursue a new vision.

For this reason they designed the intensive care unit from the perspective of the patients, such that it fully met the latter’s needs. All the technical features and medical equipment disappeared, for example, behind a modular wall system at the end of the bed. In some cases it was relocated to an adjoining observation room to avoid annoying noises that cause stress. Measuring 2.5 by 7 meters, a specially developed screen above the bed is the core element in the new ward. The interface, which can be used for media purposes, curves downwards at the end such that it accommodates a large part of a patient’s field of vision. The peculiarity of this new product is in the technical detail: Behind a taut piece of film are two offset LED grids that perform different tasks. Whereas one, by means of synchronized LEDS, delivers light that is similar in quality to natural daylight, the other features individually controllable LEDs that can create moving images and colors.

A wide LED-screen is an important element of the room architecture. Images, which change slowly and the simulation of daylight should take an effect on the physical recovery of the patient. Photo © Tobias Hein

A special sky full of lights for patients

The ceiling screen is intended to simulate an artificial sky, which creates a natural daylight mood and thus aids the patient’s recovery. The technical features exploit those processes in the human body that are influenced by daylight. By way of example, it lowers the level of the hormone melatonin, a process which makes people more alert. Simulating daylight causes patients in intensive care units, who as a rule just lie in bed without moving during the day, to be more alert, such that they can sleep better at night. Individual control of the intensity and temperature of the light assists this natural sleep-wake rhythm. There are hopes that thanks to relaxing REM sleep phases the dose of medication and, as such, deliriums can be reduced. The screen can also be used to diagnose patients’ waking condition following surgery or to stimulate their motor function and concentration by their being able to follow moving points of light via a tablet computer.

The ceiling screen is curved and goes seamless into the wall design – to cover up the visual field of the patient. Photo © Tobias Hein

Comforting scenarios

With a view to increasing patients’ well-being and reducing stress and fear, the screens show calming natural scenarios, for example a roof of green leaves penetrated by sunlight, passing clouds, or a starry sky with a shooting star darting across it. Depending on the patient’s mood and condition, the scenes can be individually adapted. The architects describe the effect of this artificial sky as a spatial extension. The distance to the interface can no longer be estimated, and as such the screen no longer perceived as a ceiling element, they maintain.

With funding from the Federal Ministry for Economic Affairs and Technology, the project has been running since 2013, since when medical professionals, psychologists, and sleep researchers have been monitoring the impact of the redesigned intensive care unit on patients. The response has so far been positive, and the official research results of the study are expected to be presented in the early summer of this year.

Calm for the patient: The architects removed all technical instruments, which are causing disturbing noises like alerts, at the observation room. Photo © Tobias Hein
The right partner for the important technology was Philips. The LED media screen generates biologically active light and also creates a warm atmosphere.
Photo © Tobias Hein

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