Sustainability in healthcare design gains in importance.

The typical commercial building--fluorescent lights, boxy floor plans, and static work environment--is slowly being phased out. Today's traditional building has become costly, and inefficient, by wasting energy, depleting natural resources, and endangering the environment. The solution to these problems is designing more efficient "green buildings," especially for use in healthcare facilities. Green buildings are designed specifically to reduce the impact of their construction and operation on the natural environment and for the comfort and health of its occupants. This philosophy of sustainability adheres to meeting the needs of the present without compromising the ability of future generations to meet their own natural resource needs. To accomplish this, a balance between environmental inputs and outputs is needed so that environmental burdens can be severely diminished. These green healthcare facilities are extremely energy efficient, which drives operating costs down, and also creates a safer environment for employees and patients.

There are three components to a green building: the design of the building, the materials selected for the construction, and the methods of heating and cooling used.

The design of the building is critical in developing a productive physical setting for the building's occupants and their psycho-physiological state.

People currently spend 80% of their time indoors, especially in the cities. As we have essentially become interior creatures, modern buildings will have to reflect this change in habitat to accommodate our physical and mental health.

These sustainable, healthier environments are especially essential in the healthcare industry, as these subtle changes can aid in a patient's recovery.

Green buildings are designed to create a more natural environment, via natural ventilation, daylight, and the use of organic materials to increase air quality and subsequent well-being. Current facilities are seen as being environmentally sealed off from the world. Fluorescent lighting, fixed heating controls, and locked windows allow little opportunity for the occupant to adjust their surroundings to a personal comfort level.

The ability to do so can also alleviate mental stress. Being able to open a window, sit in sunlight, or admire plants can have a calming effect on a stressed employee or patient. In addition, a hospital with a more natural work environment will have more potential to retain employees, increasing productivity and employee morale.

Another core component of sustainable design is the choice of materials that can be used to construct the building itself.

Natural reserves such as gas, timber, energy, raw materials, and water are consistently used in construction with little thought on how to replenish reserves for future use.

The downsides of using virgin materials are numerous: deforestation, air and water pollution, toxic runoff from mines, damming of rivers, global warming, gas emissions, disposal of waste, health complaints and illness. There is also the issue of the bottom line. The current method of constructing buildings with scarce resources is expensive, with higher costs for energy, water, labor, raw materials, environmental "fiixes," labor, plus any additional costs to maintain an unsustainable quality of life. A survey conducted by Commercial Buildings Characteristics in 1995 found that three types of buildings--health care, food service, and food sales--were found to have the highest energy consumption and dispose of more waste than other building types. According to the Environmental Protection Agency, American hospitals produce approximately 6,000 tons of waste per day alone. Green construction and sustainable design is an alternative to this traditional, yet wasteful, building process and will prove more beneficial and profitable in the long run.

Instead of depleting our natural reserves, there are numerous near-inexhaustible materials that can be used. Mud, concrete, plastic, aluminum, clay (for bricks), and sand (for glass) can all be used to construct much of the building.

The energy typically required to extract, manufacture, and transport building materials as well as the energy needed to assemble and finish construction is immeasurable. And while not inexhaustible, wood is a material that is harvested using the least amount of embodied energy. Recyclable rainwater could be used to flush toilets and water plants, and graywater from washbasins and showers can be re-purified through reed beds on the building grounds.

Sustainability can also be used as a marketing strategy to show a green hospital as a destination hospital.

When patients go into a hospital, they want the best care. A sustainable hospital can use the money that is saved on operating costs to spend on patient services.

Green buildings may be difficult to begin, as the upstart costs are greater than current traditional construction. However, lower long-term operational costs have already been demonstrated at facilities that undertook sustainable design.

The EPA designed the Energy Star Program to encourage builders to design more efficient buildings, and as of 2002 over 800 hospitals had signed up for the program. Even small changes in a building's structure can have marked effects on profits and environmental efficiency. Kaiser Permanente-Northern California, a non-profit healthcare insurance provider, upgraded their lighting in 129 buildings, resulting in a 23% reduction in electrical COSTS.

Columbia/HCA in Nashville, Tennessee implemented lighting upgrades in 100 buildings at $27 million with an annual savings of $7.8 million.

Sustainable green buildings need to be the future of health care facilities.

By using organic materials and improving the quality of life inside the buildings, healthcare facilities can not only save millions of dollars and improve patient care, but also make a difference for future generations.

BY BYEONG EON PARK

DESIGN ARCHITECT

DMR ARCHITECTS