Green Strategies of Healthcare Design: Case Studies of Medical Centers
Green Strategies of Healthcare Design: Case Studies of Medical Centers
Green Strategies of Healthcare Design: Case Studies of Medical Centers
Abstract
Our Common Future begins by stating that "The Earth is one but the world is
not." This simple statement means that we all live here and we all need to share
our resources. Whatever affects the world affects us all. The problem is that most
communities only think of themselves. They consume their resources in vast
quantities which would leave a void for future generations. Sustainable
architecture focuses on environmentally-conscious design techniques. lt seeks to
minimize negative environmental impact by enhancing efficiency and
moderation in the use of materials, energy, and development space. It challenges
the design to have a healthy process and to utilize renewable energies and site
specific resources. Sustainable architecture has proven that people who live
andlor work in such buildings are happier, healthier, and have higher work
productivity. The same affect applies to patients in hospitals. Recognizing the
connection between health care and the building designs has help health care
leaders/providers, designers, and architects engage in sustainable design and
construction for healthy 'green' buildings. One could even label it healthy
architecture. Healthy architecture has made the role of architects and designers to
very important one for future development on healing centers.
To meet patient needs healthcare facilities consume tremendous amount of
energy and resources; hospitals use twice energy per square foot as office
buildings. So, the necessity of having sustainable hospitals is obvious.
In conclusion, it would be impossible to have healthy people on a sick planet. In
order to keep people healthy and provide proper medical treatment and to reduce
the negative effect on the surrounding environment, a sustainable "healthy"
architecture must be considered.
1 Introduction
Environmental benefits:
Enhance and protect ecosystems and biodiversity
Improve air and water quality
Reduce solid waste
Conserve natural resources
Economic benefits:
2 Case Studies
Parents may remain ovemight during their child's hospital stay and a state-of
the-art Special Care Nursery provides both a private room for newboms
requiring prolonged medical attention and an adjoining room for the infant's
parents. In addition to labor and delivery, neo-natal intensive care and pediatrics.
the facility also hauses an emergency roOfl1. a surgery department and a full
imaging department. Native Colorado materials were llsed for the structure as
Sustainable Architecture and Urban 435
weil as the building facade, and wherever practical, products and manufacturers
were selected within a 500-mile radius. Many of the products incorporated
recycled material, and 64% of jobsite construction waste was recycled. The
hospital achieved a Silver Rating under thc LEED 2.0 Program. becoming the
first hospital in the country to receive LEED certification from the U.S. Green
Building Council.
2.1.1.1 Energy
Efficient daylighting and electric Iighting; daylight and occupancy sensors
In this hospital, daylighting is used primarily to light the central, two stories,
and entry space. Lighting does not affect adjacent neighborhoods. Up
lighting, bleeding and light pollution is non-existent. Day-lighting is
maximized in occupied space. Sensors in rooms shut off lights when no one
is present. Also, BCFH complements the benefits of daylighting with
dramatic views of the Flatirons and natural ventilation. When a patient
opens a window for fresh air, a sensor notifies the HVAC system to shut off
room's air conditioning (Jones, 2008).
Energy Star reflective roof, with high R-value (R-30)
A reflective roof was instalIed and insulation in the roof and exterior walls
was increased to minimize heat gain in the building, which also minimizes
energy usage. To have minimum annual heating and cooling cost, it is
recommended to use a minimum R-30 roof insulation.
Energy-efficient glazing
There is a low E (short for emittance) glass that contains an invisible metal
coating that sandwich between the layers of glazing, which causes the glass
to be reflective. They keep the building warmer in the winter and cooler in
the summer.
Exterior sun shading on west and south
In addition, to capture as much natural light as possible, one wing of the
hospital constructed at apreeise angle to maximize the Colorado sunshine.
Some of the windows are quite large with dimensions sometimes greater
than 46x66-inches.
Highly efficient Central Utility Plant (CUP)
The Hospital made a large capital investment in a central utility plant to
provide a 12 year payback through energy savings. Such an investment as
weil as adhering to the LEED requirements throughout the design and
construction process, c1early demonstrate the hospital's commitment to a
long-term, sustainable approach to building design and operation, and to
first-class patient care. Multiple sustainable design awards and national and
international recognition have followed.
Additional comrnissioning extensive third party
30% savings over LEED baseline
436 Farshin Salehi & Sima Vaez Eslami
2.1.2.1 SitelWater
1. Maintain wildlife corridor and sensitive to floodplain
To remove the building site from the 500-year floodplain, fill excavated for a
downtown underground parking garage was trucked to the site at no cost to
BCH. And as part of its development agreement with the city, BCH agreed to
make improvements to a flood wall that protects a neighborhood located south of
BCFH (Yudelson, 2006).
Erosion control
Restoring wetlands for filtering storm water (with oil interceptors first)
Permeable pavers for fire lane
To reduce the amount of pavement further, the fire lane on the site has grass
pavers. These pavers allows you 10 park, drive, walk, ride, or lounge on a
beautiful grass surface. It performs, but with the aesthetic of a lawn-all while
enhancing the environment.
Near transit, added bus shelter
Bicyc\e facilities, showers
Reducing parking 25% beyond zoning via variance, preferred parking for
carpools
As a long time proponent of alternative transportation modes, BCFH received
four LEED points for the site's proximity to high-frequency transit service and
the provision of employee transit passes, providing bicyc\e storage and easy
access to showers and changing rooms for employees, as weH as offering
dedicated parking spaces for carpools. Beeause of its policy of providing
employees with free transit passes, the hospital was able to vary the city's
building code requirements and build 25 percent fewer parking spaces than
required. The hospital has reserved on-sire space to build more parking in the
future if necessary.
hornes or 1.9 million people per year. This vast amount of outflow to the sewer
and septic systems can be eliminated and will not run into our natural waterways
and oceans. On your local level this could mean: A typical office building rest
room with three urinals and 120 men equals a yearly water use of 237,600
gallons of potable water flushed down the drain. This assurnes three uses per
person per day and only 220 working days (Waterless, 2009).
2.1.3.1 Materials/IEQ:
438 Farshin Salehi & Sima Vaez Eslami
2.1.3.2 Operations
programs in place and designed for in new (Guenther & Vittori, 2007)
2.1.3.3 Innovative
Credits for encouragement of alternative transportation, and extremely high
amounts of local and recyc\ed content materials. (updated September 2005)
distinctive garden response based on native plants from the seven eco-regions
(forty-two counties) served by the children's hospital. The diverse palette results
in unique, bioregionally focused experiences connecting children to the familiar
while educating them about broader regional differences (Guenther& Vittori,
2007).
Within the parking areas, trees are positioned to reduce heat island impacts.
The perimeter site landscaping is based on native, drought-tolerant plants. Where
required, drip landscape irrigation 1S provided by the municipal rec1aimed water
system.
Parking lot trees and refleetive surfaee pavement and roof materials reduee
the heat-island effect
Energy Onsite Austin Energy system is eompleting an onsite 4.6 megawatt
heating/eooling plant that will produce steam and ehilled water effieiently, as
we1\ as generate seven to eight LEED energy points. "rt would take a eatastrophe
to lose power at this faeility," said Bell (Durio, 2006).
Healfhy Inferior - The hospital gained LEED points for healthy interior
selections, such as paints and adhesives with low or no volatile organic content.
For example, most of the flooring is natural linoleum applied with green label
adhesives. In carpeted areas, flooring contractor Intenech Flooring chose carpet
with recycled content and backing made ofrecycled soda bottles (Durio, 2006).
Job Sitc Recycling -- Approximately 70 percent of construction waste is being
recycled through the projecfs aggressive recycling program, which designatcs
different types of dumpsters for drywaJl, stone, woodlpaper, general trash and so
on. "This is something thafs gaining momentum, but is still relatively new in the
building trades," said White Construction Senior Project Manager Alan Harbert.
'There are some additional costs that you don 't traditionally have, but there also
are some rebates for recycling" (Durio, 2006).
Natural linoleum t100ring that is biodegradable. formaldehyde-free and nontoxic
is among the 'green' materials used.
The Fletcher Allen Health Care. located in the heart of Vermont. incllldes new
bllildings and renovations 01' existing bllildings designed to integrate healthcare.
education and research into one cohesive campus environment. Almost the first
thing we noticed was that the project team deserved special credi! for placing the
442 Farshin Salehi & Sima Vaez Eslami
parking for this facility underground, thus preserving the beautiful landscape and
eliminating the dreaded parking-lot deserts common to too many facilities. The
connections of the medical school to the hospital are very nicely done in this
durable, solid, 100-year building. The planning is weil done and the architectural
design is strong and convincing (see figure 3).
In 2009, Fletcher Allen has reduce consumption by another 2.5 million
kilowatt hours and saved an estimated $250,000 in utiIity costs in the first seven
months of the year.
The eITorts also carry over into nutrition services. In 2006, Fletcher Allen
adopted the Healthy Food in Health Care Pledge, which contends that the
methods used to produce and distribute foods often are not aligned with dietary
guidelines and rely too heavily on practices that adversely affect publie health
and the environment. Signing the pledge "solidified" efforts to buy goods from
local farms to cut down on transportation and reduce pollution, says Diane lmrie,
direetor of nutrition services. Managers and supervisors also identified ways to
reduce waste, so everything a person "eats on, in, or with is either recyclable or
compostable," Imrie says (Leiser, 2009).
The hospital stopped using foam and plastic cups and plates, instead
choosing products made from 100% reclaimed fibers that fully degrade into
water, carbon dioxide, and organic material when composted. They replaced
disposable catering trays with reusable trays, a move that saves about $1,000 a
year (Leiser, 2009).
Laer in May, the medical center unveiled its new Harvest Cate. The facility is
designed to be "the most sustainable cafe in healthcare" across the country. Imrie
says. The menu at the cafe---referred to by some in-house as "the starship"~~
incorporates such Iocally grown organic fare as soy milk and squash. It serves
turkey and chicken raised without nontherapeutic antibioties or arsenical
compounds, and it also offers fair-trade coffee, which is produced without
pesticides (Leiser, 2009).
3 Comparison
Green hospitals are creating sustainability councils or "green teams" that involve
many specialties rather than hiring one sustainability coordinator. The groups
usually meet monthly or quarterly. Conversations range from how to reduce
waste and promote alternative transportation, to how to utilize alternative energy
sources, conserve water, and purchase environmentally friendly products. Such
panels are the prominent parameter which is similar among three cases that
provide an excellent opportunity to take an active role in the greening of their
facilities.
Making general comparison between above cases, results listed points:
Among these three hospitals, BCFH and Deli made innovative strategies to
get a "sustainable site". BCFH is more sensitive on the aspect of natural
features and also site's facilities and transportation, while DelI considered
economic aspects more.
By various techniques BCFH saved energy 30% above LEED. But in
comparison with on-site natural gas turbine, supplies all electricity, DelI is
more successful in "energy saving"
Among these case studies, BCHI is the only one in which light pollution has
been considered. Outdoor lighting was carefully designed to reduce light
pollution in the night sky.
In order to reduce water usage, Deli Medical Centre, used dual flush toilet
valves and motion sensors. While BCFH considered waterless urinals, and
Fletcher Allen replaced aging air handler with a more efficient water-chilled.
In comparison ofthese three ways, BCFH and Fletcher Allen's methods are
more efficient.
Fletcher Allen created a distinctive hospital by integrating medical,
educational and research spaces. This integration cause operation of the
latest research results into medical performances.
The unique strategy in Fletcher Allen is green nutrition services, by usage of
local farm and green materials for dishes. This consideration bolds Fletcher
Allen healthcare among the others.
4 Conclusion
Despite the challenges, today's health care institutions are tinding new ways to
incorporate green design strategies into new construction to speed healing, not
only of patients, but also of the planet. The first challenge involves finding
meaningful ways to identify appropriate strategies and measure their
effeetiveness.
More than an optimization of any single component, sustainable design and
construction represents the integration of materials and methods that, together,
create the physical manifestation of a building. The entire life cycle of building
materials and products, as weIl as the building as a whole relative to its physical,
Sustainable Architecture and Urban Development 445
environmental and human contexts on the local, regional and global scales, must
be evaluated for environmental and health considerations.
According to case studies investigation, we could conclude that a project
checklist for a sustainable design will include:
References