Hospitals designed with fresh air and sunlight. Cancer treatment centers built without materials linked to cancer. Pediatric clinics free of asthma-triggering chemicals. Today more healthcare facilities are turning these scenarios into reality by incorporating environmentally friendly solutions into every aspect of their building design from floors and lighting to restroom fixtures.
Although the healthcare industry is increasingly interested in constructing and maintaining green buildings, not many have registered for certification from the Leadership of Energy and Environmental Design Initiative, a voluntary, consensus-based national standard for developing high-performance, sustainable buildings developed by the U.S. Green Building Council.
LEED identifies six primary areas required for certification, including: sustainable sites; water efficiency, energy and atmosphere; materials and resources; indoor environmental quality; and innovation and design.
One reason for the lack of interest may be the lack of standards. While LEED standards currently are available for new construction, commercial interiors and existing building operations, there had been no specific LEED guidelines to address healthcare facilities' special needs including, 24/7 operation, infection control, air changes and building code regulations.
The USGBC, however, is expected to release its LEED Application Guide for Healthcare before the end of this year.
In the meantime, healthcare organizations can look to another source for guidelines to building green, “The Green Guide for Healthcare,” released in November 2004. (For more information on The Green Guide, see sidebar.)
Certainly one way healthcare organizations can make a positive environmental impact is in plumbing fixture selection. Because space is at a premium, especially in critical and intensive care units, more hospitals today are choosing to install modular patient care units that combine a lavatory and water closet module. These units take up minimal space, are easy to install and cost-effective to maintain.
Wake Forest University Baptist Medical Center in Winston-Salem, N. C., also has found that installing these patient care units in ICUs allows them to conserve water and provide a convenient hand-washing station with solid-surface countertops that reduce the spread of germs.
Multiheight lavatory systems that are ADA-compliant also provide more flexibility for children, parents and the physically disabled.
There also are new environmentally-friendly technologies to consider for healthcare public restrooms such as light-powered hand-washing fixtures that integrate photovoltaic cells into the top of the lavatory to convert light into energy. Using light-activated fixtures instead of typical battery power, for example, also helps reduce the 2.5 billion pounds of batteries that are sent to landfills each year.
More facilities also are choosing auto flush valves, low-flow aeration faucets, as well as touch-free faucets. Manufacturers have been working aggressively to refine and push the performance levels of tank-type toilets through the use of pressure-assist technology. Incorporating these types of high-efficiency fixtures may help organizations earn Green Guide and LEED points by reducing water usage to 20 percent or even 30 percent below the baseline calculated for the building.
But as healthcare organizations explore all these options, one major question they face is how they will afford the overall cost of going green. Though in some case incorporating environmentally sound design may cost more initially, healthcare facilities are finding that the investment is a good one as the durability, higher quality, lower maintenance and reduced operating costs (energy, water, etc.) over the life of the building ultimately will result in cost savings.
Using light-powered hand-washing fixtures, for example, in public restrooms eliminates the cost of diagnosing and replacing dead batteries, which can cost upwards of $400, even up to $1,600 per fixture annually for some systems.
Forced-air hand dryers are another good source of savings in healthcare restrooms. The energy to operate the new generation of hand dryers is generally less than 10 percent of the cost of paper towels, including the elimination of associated labor costs for ordering, storing, replenishing dispensers, collecting and disposing of paper towels.
“We see more hospitals and other healthcare facilities fitting environmental solutions into the master plans of both their exterior construction and interior design,” said Dick Pearson, principal of Pearson Engineering in Madison, Wis. “The bottom line is that going green does produce long-term cost savings.”
Pearson notes green initiatives can also serve as an effective part of an organization's internal and external marketing activities. Environmentally sound facility design also can help improve the health and productivity of employees that will result in better staff recruitment and retention.
Ultimately, a healthy building protects the local environment resulting in a healthier community overall. That's a win-win scenario for any healthcare facility.
Guidelines For Going GreenThe Green Guide for Healthcare provides modifications specifically related to healthcare, including structural, usage and regulatory challenges of healthcare buildings; considers health issues as an explicit component of each credit; and incorporates design elements that enhance the healing process.
The Green Guide is modeled with permission after LEED, and borrows the credit numbering scheme and credit outline structure with some modifications.
While following the Green Guide does not guarantee an organization will meet LEED requirements, it does give facilities a leg-up for ultimately obtaining certification because both guidelines are similar. Anyone can download the Green Guide at no charge by visiting www.gghc.org.
One helpful feature of the Green Guide is a best practices section that spotlights innovative technologies that specifically address the healthcare industry's significant energy and water consumption and elimination of materials that contain or produce persistent, bio-accumulative, toxic (PBT) chemicals. For example, Kaiser Permanente, the nation's largest nonprofit health system, wanted an alternative to products containing formaldehyde, mercury and PCV (vinyl). The solution was to work with manufacturers to develop a durable, low emission PVC-free carpet.
In addition to considering green products, looking at the building's overall design is critical for developing environmentally sound healthcare facilities. Adding a healing garden, outdoor walking spaces and staff break rooms with views provides a creative solution, as well as implements green housekeeping and landscaping protocols.
Beyond environmental benefits, healthcare organizations can see long-term cost benefits from these changes. One study indicates that patients with views of nature went home sooner, had $500 lower cost per case, used fewer heavy medications and exhibited better emotional well-being than patients without such views. Creative use of natural or solar light to build a strong connection between indoor and outdoor environments can also help earn LEED points for de-lighting.