Have you ever been in a hospital or medical clinic, observed the humming machinery, the constant overhead lights, the busy staff, the patients in varying degrees of distress, the human drama, but your first thought is “How much energy is this place consuming?” Congratulations, you are a building science geek. Welcome, you are among friends.
Pacific Northwest Health Care Provider Leaps Forward: I worked in healthcare, clinics and hospitals for many years as a Registered Nurse, then a Nurse Practitioner. My career change to Green Building Consultant felt pretty natural to me as I was always renovating houses on the side. And I have watched with special interest the emergence of LEED© for Healthcare (LEED-HC). So I was delighted to start work on a local LEED-HC project for a great organization where I used to work as a Nurse Practitioner. Group Health Cooperative has committed to LEED-HC Certification for two new or replacement clinics in Washington — one in Puyallup (see rendering) and one in Burien. These will be among the first in the country to certify under this new Rating System. Along with the owner, CollinsWoerman, University Mechanical, and GLY Construction, are enthusiastically committed to the projects' sustainability goals, and in particular achieving the target for LEED-HC Gold and achieving a 30% energy efficiency improvement over a similar baseline building.
A Little History on LEED-HC: It grew from the Green Guide for Healthcare (GGHC), a sustainable design “Toolkit” that integrates environmental and health principles into the planning, design, construction, operations and maintenance of healthcare facilities. GGHC originated in 2004 as a joint venture between the Center for Maximum Potential Building systems and Health Care Without Harm, aligning itself with the structure of LEED for New Construction. GGHC piloted 100 facilities, enabling LEED-HC to bypass the US Green Building Council's LEED pilot process. The first draft for LEED-HC was released in November 2007, and projects began registering in November 2010. To date, there are 26 registered projects in the US ranging from medical clinics and Veterans homes to hospitals and cancer centers.
The Problem: Hospitals, open 24/7, use enormous amounts of energy. There are rigorous ventilation and pressurization needs; heating and cooling demands that vary from the OR to the ER and contribute significant mechanical loads; and intensive water needs. According to Energy Star, the average EUI of a hospital is 468 kBtu/ft2 while the average EUI of an office building is 193 kBtu/ft2. The healthcare sector is reported to contribute 8% of total US Green House Gas Emissions (JAMA, Nov 11, 2009). How can hospitals and medical clinics become high performance buildings, better neighbors and a healthy part of the community where they are located?
A Problem-Solving Tool: Despite the fact that LEED for Healthcare requires a mere 10% energy performance improvement over the baseline (like LEED NC, but its not enough), it addresses several key aspects of the problem, with several new Prerequisites and Credits that make sense for these massively consumptive facilities, such as:
- Integrated Design: Integrated Project Planning and Design is a Prerequisite.
- Energy: In Energy & Atmosphere there is a credit for buildings that limit products of combustion, a sure way to become a better member of the community and the planet.
- Daylight: Articulated floor plates that allow more daylight and views for patients and staff earn credit.
- Water: Medical equipment process water must be non-potable — it's a Prerequisite. New credits for water use measurement and verification (you can’t manage what you can’t measure); and water use reduction for medical equipment, cooling towers and food waste systems.
- IEQ: In Materials & Resources there is a credit for medical furnishings and mattresses that do not contain harmful chemicals or VOC’s.
- IEQ: While sustainably sourced materials garner credit, they are also required to meet the low emitting requirements in IEQ.
- IEQ: The bar for the low emitting materials credit is raised with the addition of carcinogenic limits for adhesives and sealants; and credit for limiting VOC content for exterior applied products safeguards construction workers and the community.
Respite Care: In addition there are credits for Places of Respite for patients and visitors, a place to heal and recuperate from ongoing treatment. Don’t you feel better already? For in-patients or patients with long wait times, for families waiting even longer for their loved ones, this is a place to rest the eyes, have a view, appreciate some nature and smell some flowers. This is evidence-based design, referencing research indicating improved outcomes for patients with a view of nature rather than a brick wall. Additionally this LEED-HC credit has a requirement for a private outdoor area for staff to take a break, away from patient care. This allows hard working medical staff some time and space to find balance in a stressful workplace. Group Health’s Puyallup Clinic has a green roof and rooftop staff area planned, incorporating shelter, access to nature and privacy. The project design also incorporates a respite area for patients and families adjacent to the ground floor clinics.
Existing Buildings, When a Problem is an Opportunity: Retrofitting existing hospitals and clinics offers tremendous opportunity for reducing energy use, greenhouse gas emissions and CO2. The Community Power Works program is working with all the major local hospitals in the Seattle area to conduct energy upgrades as part of $20 million in federal stimulus grant funding to energy retrofit hospitals, municipal and large commercial buildings. Puget Sound Energy offers customized grants to hospitals for energy retrofits and existing building commissioning. Environmental Purchasing Policies for hospitals such as mercury-free purchasing; buying products with recycled content; requesting reduced packaging; and purchasing reusable products help reduce their environmental impact. Remember the old days when that bedpan was metal and cold? It was cleaned in an autoclave and reused for years. This is much more sustainable than the plastic ones that are often single use in emergency rooms. But I digress. Stay tuned for more postings on Hospitals and Sustainability.
Colleen Groll, CSBA and Senior Project Associate for O'Brien & Company, Inc. is consulting on GHC's Puyallup and Burien Projects . In addition to her green building expertise, she brings more than 15 years experience in the health care services sector. She is a regular contributor to the Building Capacity Blog. Colleen recommends additional resources including Practice Green Health, The Healthier Hospitals Initiative, and The Department of Energy’s Hospital Energy Alliance.