A common trend in the design of patient care facilities is the integration of pillow speakers, bedside rail buttons or other nurse call devices with the lighting in order to give patients the ability to control some or all of the room lighting from their bed.
Generally speaking, all nurse call equipment is designed to operate using normally open, low voltage momentary contact switches. A momentary button press on a pillow speaker for example allows low voltage to pass through, creating a “pulse” which can be used to signal equipment downstream to perform a specific function, such as calling a care provider for help, controlling the television, or in our design case, turning lighting on and off.
Turning lights on and off is easy to solve, as a simple device such as a switch pack can be used to accept the momentary pulses of the pillow speaker button and toggle the lighting load accordingly. Switching with 3-way scenarios are also easily accommodated by simply adding additional momentary switches. For example, you may want to add a switch to the head wall next to the patient bed so the care provider can turn different lighting zones on or off as necessary.
But what if you want to add the ability for the patient or care provider to dim the lighting?
Combining dimming with switching functions can become surprisingly difficult, and the exact solution depends on where you want the dimming control to originate from – the patient or the care provider. At first glance, you may think a simple wall box dimmer on the head wall would do the trick. But remember that pillow speakers operate using normally open momentary buttons, and as of yet, there are currently no available 0-10v dimmers with momentary switches on the market. If a standard wall box dimmer is used, the maintained line voltage relay can certainly kill the power feed to the lighting, but the patient controls will be subsequently locked out.
I have been asked for solutions to this design dilemma on a few occasions, and am happy to share my research here. Keep in mind that these solutions assume you are specifying LED lighting (which you should be) are are dimmed using 0-10v control. While 0-10v dimming comes standard on many LED fixtures, make sure you specifically call out “0-10v 4-wire dimming” on the fixture schedule to ensure it is provided that way on your project.
In order to arrive at the correct solution, you first need to answer a few questions:
- Do you want the patient, the care provider, or both to be able to dim the lighting?
- How many zones of lighting do you want the patient to have control of? Many times this will be 1 or 2 zones, such as ambient lighting and a reading light. Typically I find that if exam lights are present, providers prefer they be controlled from the head wall only and no pillow speaker integration is required.
- How big of a factor is cost? If you have an owner that values design and function over price (which does actually happen in medical facilities given their often sizable pocket book!), there are a greater number of options available to you at the “high-end”. If you are looking for ways to lower your cost-per-room factor, you may find some of the latter solutions to be a good compromise.
We’ll start at the top in terms of highly functional levels of control & higher cost and work our way down to less functional but more cost effective solutions.
Solution #1 – Patient and Care Provider both have on/off and full range dimming control of up to 3 zones of lighting.
BUDGET COST: $320 per room for controller + 1 wall station (cost of patient controls not included).
A Room Controller product such as the EATON Lighting Solutions Healthcare Room Controller (model RC3DEHC) offers the most advanced level of control, giving you a wide range of options for patient and healthcare provider control.
In a nutshell, the RC3DEHC model Room Controller is capable of switching and dimming up to 3 independent zones of lighting. It’s wall stations offer 1 to 6 buttons in a single gang, decora/GFCI form factor. Buttons can include on/off toggles, raise/lower commands and even customization scenes are possible (with added IR receiver and handheld remote). The Healthcare model specifically contains low voltage inputs to allow wiring of a pillow speaker in order to toggle each zone of lighting for independent switching and dimming.
Additionally, EATON offers a pillow speaker model which gives you the necessary buttons to allow the patient to both switch and raise/lower the lighting levels. The sequence of operation for control from the pillow speaker is as follows (number of zones controlled is dependent upon the model pillow speaker you are using):
- Press any of the 1, 2 or 3 lighting buttons to toggle that zone on or off
- Press the Raise or Lower arrow to raise or lower the light level of the last zone that was turned on
- Press the All Lighting Off button to turn everything off at once
The pillow speaker is actually manufactured by Curbell so you can be sure you are getting a proven, quality pillow speaker that will be compatible with standard nurse call systems and meets all required healthcare facility regulations.
ADVANTAGES: The ultimate solution offering the most flexible control you can offer both a patient and care provider while remaining simple to use with dedicated raise/lower/on/off buttons; minimal wiring for the contractor in spite of how many zones it handles.
DISADVANTAGES: Most expensive integration option per room.
Solution #2 – Both Patient and Care Provider has on/off control of up to 3 zones and simplistic dimming control of up to 2 zones
BUDGET COST: $185 for Curbell LVC-2000-004 in-fixture low voltage controller + momentary switch on head wall (cost of patient controls not included).
This solution gives you slightly less functionality than the EATON Room Controller with only 2 zones of dimming and 1 zone of switching, but at a lower cost per room. The reason we say basic dimming control is because the dimming is done with a momentary switch to perform press-and-hold actions to cycle through different dimming functions, which is not as intuitive as a slider or dedicated raise/lower buttons would be. The press and hold sequence for the Curbell unit operates as follows:
- Quick press and release turns lighting on at 25%
- Press and hold raises 25% to 100%
- Release and press dims 100% to 10%
- Release, press and hold to change dimming direction between 10% and 100%
- Quick press and release turns lighting off
Note: there are a couple versions of the Curbell low voltage controller. The functions outlined here are from the 004 model. The 001 model, while identical in terms of hardware, is programmed with a different sequence of operation. Visit the Curbell website for more information on their LVC relays.
ADVANTAGES: Mid range solution offering some control of switching and dimming without the high cost; module can be installed in light fixture or in ceiling cavity.
DISADVANTAGES: Press-and-Hold control method can be confusing to patients and care providers.
Solution #3 – Patient has On/Off control of 1 zone, Care Provider has On/Off and Full Range Dimming control of same zone
BUDGET COST: $125 for (1) 0-10v wall box dimmers + (1) Switch Pack + (1) Low Voltage Momentary Contact Switch (cost of patient controls not included).
If you want the patient to be able to turn lights on/off only, but want to give the care provider the ability to dim them, you might think it would be as simple as adding a 0-10v dimmer to the head wall and calling it done. Unfortunately, due to the design of wall box dimmers found on the market today, none currently offer a momentary contact switch as all are maintained relays, which would not be compatible in a 3-way configuration with the patient controls.
The work-around is to separate the dimming and switching entirely. By placing a momentary switch beside a slide-only wall box dimmer in a 2-gang box in the head wall, you can toggle the lighting on/off via the patient controls and momentary switch, while dimming the lighting using the wall box slide dimmer. The key is specifying a dimmer which does not have a dedicated on/off rocker or push button in order to give the appearance of dimming-only control. A slide-to-off dimmer works just fine, you’ll just have a “click” at the end when the dimmer slides to it’s lowest range and the lights will remain on. The Lutron Nova 0-10v Slide-to-Off dimmer is an example of this.
ADVANTAGES: Least expensive option if dimming 1 zone of lighting
DISADVANTAGES: Only staff or non-patients have access to dim levels, and lighting level is set by the position the slider gets left; Slide to off “click” may cause slight confusion to care staff; Adding additional zones of control cause cost to approach other solutions.
Hopefully this article has helped give you a few options to work with when deciding how much control to design into your patient care rooms. If you know of any solutions I have overlooked, feel free to let me know!