April 19, 2007
Hospitals slowly warming to green design
By MICHAEL L. SMITH
For institutions pledged to improve health, hospitals have been surprisingly slow, compared with corporations, to adopt “green” design and operating principles.
Reasons for this lag are many: hospitals are heavily regulated, they have severe cost constraints, they use great amounts of energy, they need a controlled environment for infection control, and they produce significant amounts of waste.
A national body that tracks new green projects, the U.S. Green Building Council, says that of the 5,562 new projects currently registered in its eco-friendly Leadership in Energy and Environmental Design program, only 117, or 2.1 percent, are in health care. A mitigating factor has been that the LEED certification process, designed initially for office buildings and schools, is not sensitive to the specific needs of hospitals. The council is currently developing a LEED guideline for health care.
Even without a LEED health care road map, a few hospital administrations across the country have moved ahead with projects that meet the rigorous LEED guidelines. And a new Green Guide for Health Care, influenced by LEED and sponsored by private and nonprofit organizations, is being used for more than 100 projects around the United State, Canada and elsewhere. A third organization, Hospitals for a Healthy Environment, focuses on mercury and waste management.
Here in the Pacific Northwest we are fortunate to have one of the nation’s greenest hospitals: Providence Newberg Medical Center, in Newberg, Ore., which received a LEED gold certification last year the first hospital in nation to earn this designation. Earlier this year, the First Street Building at SMDC Health System in Duluth, Minn., became the second to earn a LEED gold.
Providence Newberg incorporated a number of sustainability elements that contributed to its certification. The mechanical system operates entirely with outside air that is not recirculated in the building. Eighty percent of the construction waste was recycled or salvaged. More than 25 percent of the material used in construction had recycled content, and over 30 percent of the material was manufactured locally.
The hospital is believed to be the only one in the country to purchase all of its power from green sources 50 percent wind, 25 percent geothermal and 25 percent low-impact hydro. Moreover, it has arranged to sell power to Portland General Electric produced by the hospital’s two 750-kilowatt emergency generators in times of peak demand for the utility. That is enough energy to power up to 3,000 homes.
Of the nearly 60-acre site, only 19 acres are developed. The site includes walking paths and a healing and wellness garden. Stormwater runoff in parking areas is managed with bioswales, and landscaping relies on native and drought-resistant plants, reducing the use of potable water for irrigation by more than 50 percent.
In Duluth, the First Street Building at 236,000 square feet, probably the largest green health care facility in the country has achieved a 25 percent reduction in energy and a 30 percent reduction in water.
Boulder (Colo.) Community Hospital Foothills Campus, which earned a LEED silver, reduced water use with waterless urinals, electric eye faucets and plants that require little or no irrigation. It also used renewable, recycled low-VOC emitting and resource-efficient building materials.
Kaiser Permanente has required that its flooring supplier create a PVC-free carpet for most of the 20 new buildings it plans to build over the next decade.
Traditionally, a major barrier for hospital administrators who want to go green has been the fear of expensive up-front costs.
Civic partnerships, foundation grants and rebates can often, however, mitigate initial costs. Portland General Electric, for example, provided the emergency generators to Providence Newberg in return for their use to feed back into its power grid. SMDC received rebates from Minnesota Power for replacing old mechanical systems with energy-efficient units. The city of Duluth also subsidized the construction of a clinic parking garage.
Creating a successful green project requires early planning, acceptance of a common vision and understanding of reasonable payback periods.
Dell Children’s Medical Center in Austin, Texas, set a seven-year return goal. Kaiser wants a payback of three to five years. Providence Newberg expects that it will have repaid its initial investment within 14 months of construction, later this year.
As the general public begins to recognize the value of green design, hospitals will increasingly incorporate sustainability principles not only in new structures but in daily operations. New York-Presbyterian Hospital in New York City has switched to nontoxic cleaning products, dry hand-washing stations and high-efficiency air filters. Providence Newberg uses only green maintenance products, and it also gives tours to promote the design and performance aspects of the building.
Hospitals may never come to the point that they can throw open their windows, but they are already moving toward adopting sustainability elements more natural daylighting, nontoxic paints and adhesives, greater use of recycled materials, formaldehyde-free furniture, healing gardens, roof gardens, partnerships that encourage carpooling and the use of public transport.
Sustainability can be achieved. More important, however, is that by incorporating green practices hospitals can deliver improved care to patients speedier recovery, improved nursing and lower infection rates. This leads to greater staff retention and increased patient satisfaction, not inconsequential issues for hospitals competing for business.
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