Hospital Lighting

Calm patients,
reduced sedation

Philips’ innovative Ambient Experience Cath Lab has recently been installed at Sheikh Khalifa Medical City in Abu Dhabi. Callan Emery speaks to cardiologists at the hospital to find out more about this novel catheterisation laboratory and how it is impacting patients and staff.

Dutch company Royal Philips Electronics has stepped out the box to combine aspects from two separate areas of its business – lighting and healthcare. They have taken their knowledge of how ambient lighting can calm people and cleverly transferred it to the healthcare setting where it is being used to soothe patients undergoing stressful procedures. And the results are proving quite remarkable.

Specifically, they have developed what they call the Ambient Experience Catheterisation Laboratory – a specially designed cath lab that uses a combination of coloured lighting, sound and projection to create a relaxing, soothing atmosphere for the patient and cath lab staff. In the Middle East Sheikh Khalifa Medical City (SKMC) in Abu Dhabi, UAE, is the most recent facility to have one of these labs installed. The first one in the region was installed earlier this year at King Faisal Specialist Hospital & Research Center (KFSH) in Riyadh, Saudi Arabia. Philips says they are expecting orders from several other hospitals in the region.

SKMC is a cluster of stateowned medical care facilities, which is being managed by United States-based Cleveland Clinic. It boasts an advanced cardiac sciences department. This centre of excellence provides non-invasive cardiology, interventional cardiology, electrophysiology and cardiac surgery. The department also provides round the clock primary angioplasty. So it comes as no surprise that the cardiology department opted to install Philips’ Ambient Experience Cath Llab. Not only does this cath lab provide innovative lighting effects and architectural design but it is equipped with one of the most advanced cath lab systems – the Philips Allura Xper FD 20/10 bi-plane imaging system provides 3D and real-time anatomical insight in one view enabling easy navigation through intricate and complex vasculature.

The doctors who work at the lab say it has enhanced their capabilities considerably.

“I’ve found the unique ‘stent boost’ feature very useful,” says Dr Nazar Al Bustani, Director of Invasive Cardiology and Deputy Head of Adult Cardiology at SKMC. “It is software that magnifies the position of the stent in the vasculature.

“The new cardiac catheterisation suite is enhancing our abilities to perform more complex and technically challenging procedures with the newly installed stent enhancing tools. The 3D imaging of the coronary arteries enables precise positioning of coronary stents,” he explains.

“It is the whole package that makes it so good,” says Dr Wael Almahmeed, Head of Cardiology at SKMC. “It’s the equipment, the design and the lighting. The architectural design of the lab has been very carefully planned.”

Stepping into the cath lab you’ll find there is no equipment blocking access to the patient. The floor around the patient table is padded for the comfort of cath lab staff who are on the feet for long periods. Waste bins are colour coded, each for a particular type of trash. The result is an environment that is clean, minimalist and befitting of 21st Century medicine.

The pathway

“The pathway for the cath lab patient begins in the holding area,” explains Dr Al Bustani.

The ambient lighting effects begin here, too. SKMC has two types of holding areas. In one the patient can control the lighting effects, in the other moving images are projected on the ceiling with background sound.

“This is a pretty scary procedure,” says Dr Al Bustani. So it is important to calm the patient at the earliest possible opportunity and the holding area where the patient is prepped for the procedure is a good place to begin.

The patient is presented with a wireless Touch Pad – a touch-sensitive laptop-sized screen – which the patient uses to choose their preferred ambient lighting theme. Currently four themes are available (more are in development at Philips Research in Eindhoven in the Netherlands). They depict peaceful landscapes, relaxing tropical beach scenery and abstract, almost psychedelic, flowing patterns, which is proving to be the most popular option, according to Dr Al Bustani.

“By giving the patient control over their environment you also empower them, which helps reduce their fear,” Dr Al Bustani adds.

From the holding area the patient is wheeled into the cath lab. The ambient lighting theme they chose in the holding area continues in the lab.

“There are many components of the ambient experience,” explains Dr Al Bustani.

During this phase coloured LED lights, tucked away in a rim around the edge of the ceiling, bathe the lab in soothing, coloured light – hues of either blue, pink, purple, red, green and other colour combinations, which correspond to the patient’s chosen theme. Moving coloured lights on the sides of the ceiling help distract and calm the patient. Adjacent to the overhead spotlights directly above the patient a moving image is projected with accompanying ambient sound in the background.

“If the patient wants to play their own CD this can be done as well,” Dr Al Bustani says.

Step two

The physician presses the “Preparation” button on the Touch Pad which transforms the glass window between the control room and the lab from transparent to translucent or one-way glass. The physicians can see into the cath lab, but the patients cannot see into the control room, which gives them a sense of privacy and security – another reason to feel calm.

The “Procedure” phase is next. During this phase the physician has control of the lighting and can highlight specific areas of the body in white light – from an overhead spotlight – without interfering with the ambient coloured lighting effects for the patient.

Following this is the “Post Procedure” phase. The procedure is complete, the theme music still plays in the background, but the lights change to bright white in anticipation of moving the patient out of the cath lab.

And then there is the “Cleaning” phase where the cath lab is returned to a normal state – no ambient lighting or sound – for cleaning.

No sedation

It is still early days for the Ambient Experience Cath Lab at SKMC. The lab only opened in September and by early October had seen about 100 patients. (SKMC has two cath labs – a standard cath lab and the Ambient Experience cath lab)

“Although we haven’t done any clinical studies, we’ve noticed some remarkable differences with patients using the new lab compared to the standard cath lab,” says Dr Al Bustani.

“Most importantly patients are much calmer. Most of them do not now need to be sedated.

“All our cath lab patients are sedated in the standard cath lab.”

Dr Almahmeed adds that this has knock-on effects. “If the patient is not sedated they do not have to be admitted to a ward for several hours following the procedure. They can return to the holding area and be discharged” – making this a relatively easy outpatient procedure.

This enables the hospital to accommodate more patients and saves money for the patient and the hospital. Not using sedation also improves recovery time and avoids any possible sideeffects for the patient.

“We consult with the nursing staff and only sedate patients who are really edgy or nervous. But this is not often. In fact the lighting effects are so soothing that some patients fall asleep during the procedure,” says Dr Al Bustani.

The procedure also seems to pass quicker for the patient.

“In the old cath lab, the patients were generally more restless and would ask you a lot of questions. They would ask repeatedly ‘are we done yet?’ Time passed much slower for them in that situation.” The ambient lighting also helps physicians. As well as it assisting the physician by calming the patient, Dr Al Bustani says he finds the ambient lighting environment soothing and more pleasant to work in.

“And the staff,” he says, “prefer to work in this lab compared to the other cath lab at SKMC, which does not have ambient lighting..”

SKMC’s advanced Cardiac Sciences Department is a regional reference site for Philips Ambient Experience Cath Lab, echocardiography and cardiovascular information solutions.

ate of upload: 16th November 2008

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