Environmentally Friendly Construction and Operations
The construction industry in United States consumes 3 billion tons of raw materials annually and generates a significant amount of waste. This brings into focus the need for use of sustainable environmentally friendly products and energy-efficient equipment in construction and renovation projects. The U.S. Green Building Council launched its Leadership in Energy and Environmental Design (LEED) rating system for commercial construction and renovation projects in 2000 and helps in promoting this noble cause.
Given the amount of new construction and renovation projects in health care, the American Society for Healthcare Engineering (ASHE) recognized the need for a similar tool for the industry. A task force subsequently developed and was headed by Robin Guenther, a principal with New York City-based Guenther 5 Architects and Gail Vittori, co-director of the Austin, Texas-based Center for Maximum Potential Building Systems (CMPBS).
The Green Healthcare Construction Statement was published in January 2002. This 11-page statement designed to support an ASHE Vista Award and raise awareness of sustainable design. It is also applied to renovation and expansion projects, and includes a complete section focused on operations. A key component is the use of multidisciplinary teams, which can include clinicians, administrators, plant operators, engineering staff, support services and housekeeping to work together throughout the project.
In March 2003, CMPBS convened a multidisciplinary steering committee to extend the statement into a detailed guidance document on green construction. By year’s end, the first draft of the Green Guide was released for public comment. Between March and November 2004, the committee used public comments to fine-tune the document and launched version 2.0 at the end of November.
While the Green Guide parallels the LEED model, it was developed specifically for health care facilities and addresses issues that are unique to those structures, such as infection control and around-the-clock occupancy. The Guide even extends to the kitchen in hospitals Those who employ the Guide earn a “point” for each of the 96 construction credits and 72 operations credits. Health facilities can earn credits for everything from the elimination of mercury-containing thermostats and switches to designing private areas where staff can bond to the natural environment.
An important feature of the Guide based on feedback collected after the release of the first draft is that it is voluntary and self-certifying. Also, because the Guide is voluntary, the steering committee has tremendous flexibility when it comes to making changes and upgrades and don’t have to go through the truly rigorous process that a national standard would require. It’s just a tool for you to use. You can be as green as you want to be. The Green Guide provides a wonderful incentive to pick up the green challenge.
Any compliance with LEED could adversely affect compliance in other areas, such as the Life Safety Code and JCAHO’s Environment of Care standards. LEED was considered a costly endeavor.
The first health care facility to register for LEED certification, and the second to certify behind Boulder (Colo.) Community Foothills Hospital, was a 30,000-square-foot diagnosis and treatment facility built in an agricultural community in upstate New York. At the time, health care facilities were listed in the “other” category. The building consumed 40 percent less energy than a comparable conventional building, thanks to increased insulation, ground-source heat pumps and a combination of natural light and energy-efficient lighting.
However, the facility had difficulty complying with LEED’s water-reduction targets. The problem: LEED addresses only water that comes out of fixtures (i.e., toilets, sinks and spigots). But typically only 30 percent of the water used at a health facility comes out of a fixture. Lab equipment, sterilizers and laundry account for much of the remaining 70 percent. Because none of those things are in office buildings, LEED doesn’t give credit for reductions in water use.
Many of the facilities were inefficient energy users. Part of the problem was simply the result of poor commissioning. It’s important to ensure that equipment throughout a facility is in harmony. Facilities directors should look beyond the energy efficiency of their control systems and building materials.
Most hospital administrators think of energy as a fixed cost and see it as the cost of doing business. But hospitals, the second largest consumers of energy next to food service facilities, waste as much as 30 percent of the energy they use. While hospitals spend tens of millions of dollars on energy each year, it accounts for a mere 1 percent to 2 percent of a hospital’s total annual operating budget.
Energy is such a small piece cut requires consideration. Because of the small amount of margin that a hospital makes from each dollar earned, each dollar of expense that is reduced is like $20 that they don’t have to earn. Facilities directors can earn easy credits by plucking some of the low-hanging fruit in their buildings. One easy target is lighting. Switching from magnetic ballasts to fluorescent T-8 lamps and electronic ballasts. Other energy-saving features include light meters and occupancy sensors. Sometimes corridors are under lit, while other parts of a building use far too much light.
Beyond cost-saving best practices, the Guide also focuses on the sustainability of various materials.