Dell Children's Medical Center in Austin, Texas, is the first hospital ever to achieve LEED (Leadership in Energy and Environmental Design) Platinum Certification status from the U.S. Green Building Council. The facility, which opened in June 2007, was built on the site of the city's old Mueller Municipal Airport, and 47,000 tons of airport runway material was reused in its construction. Here's a look at some of the other eco-friendly features that helped turn a green hospital platinum.

Coming soon: LEED for Healthcare
The very specialized and highly regulated nature of the healthcare industry has made it difficult for most healthcare facilities to achieve LEED (Leadership in Energy and Environmental Design) certification. In response to those challenges, the U.S. Green Building Council has been working on a LEED for Healthcare rating system that, once approved, should make LEED more accessible to healthcare facilities.

The LEED for Healthcare rating system would be similar to other LEED rating systems, with its own set of prerequisites, credits and resources for building owners and project managers to follow in order to achieve certification. But would differ in several significant ways:

• Health-based approach. Many of the credits focus not only on the building's environmental impact, but also the health of the people who use the building and the community at large. For example, there are stronger restrictions for developing a healthcare facility on a brownfield (potentially contaminated) site than there are for other types of buildings addressed in LEED.
• Acknowledgement of industry constraints. One of the reasons it's been so difficult for healthcare facilities to certify under other LEED rating systems is the amount of regulations and codes these building types must adhere to. LEED for Healthcare takes steps to address these constraints. For example, credits for energy consumption take into consideration the higher energy loads in 24-hour operational facilities, and water credits are written to allow for maximum efficiency while acknowledging the sanitation requirements of medical equipment and instruments.
• Integrative design. Additional credits will focus on integrative design, which involves casting a wider net when bringing stakeholders to the table to plan a new facility. For health care, this means involving building managers and owners, architects and engineers, doctors, nurses and members of the larger community that will be served by the facility.
• Healing atmosphere. Designs for healthcare facilities should focus on creating places of respite that provide access to nature and other features that will help with healing, decrease patient stays and reduce stress for staff members who often work long shifts.

— Deon Glaser, ASLA

Ms. Glaser is manager of LEED Technical Development for the U.S. Green Building Council in Washington, D.C.

Getting Started With LEED and the Green Guide
Building a green surgical facility means much more than just installing energy-saving LED lights in your ORs and recycling bins in the hallways. It encompasses everything from site selection to waste management to operations and maintenance. In a field that's already highly regulated, the thought of heaping another set of guidelines onto your building project may have you running for the hills. But since your ultimate goal is to promote the health of your patients and the well-being of your community, it goes without saying that building a healthy, earth-friendly facility is the first step toward achieving that goal.

Fortunately, you don't have to go it alone. There are two comprehensive resources available to assist your green building project from start to finish: The U.S. Green Building Council's (USGBC) LEED (Leadership in Energy and Environmental Design) Green Building Rating System and the Green Guide for Health Care.

Understanding LEED. This is a voluntary, third-party certification system for the design, construction, operation and maintenance of green buildings. There are 6 LEED rating systems in effect: New Construction and Major Renovations; Existing Buildings: Operations and Maintenance; Commercial Interiors; Core and Shell Development; Schools; and Homes. Each rating system focuses on 6 areas of human and environmental health performance.

1. Site Selection: location of the site, brownfield redevelopment, public transportation access, construction practices, pollution control, stormwater management.

2. Water Efficiency: water use reduction, wastewater technology, water-efficient landscaping.

3. Energy and Atmosphere: energy performance and savings, use of renewable energy, refrigerant management, energy systems commissioning.

4. Materials: reuse of existing materials and structures, recycled content, use of regional and rapidly renewable materials.

5. Indoor Environmental Quality: no smoking policies, good ventilation, low-emitting materials, daylighting, controllable lighting and heating systems.

6. Innovation in Design: innovative strategies used in the project but not covered in LEED.

Ultimately, the decision to seek certification rests with you, and you've got to base that decision on what's best for your facility, its users and your potential patients. The biggest advantage of being LEED-certified is the validation that all the steps you took in the design and building process did, in fact, yield the results you were hoping for. Having a third party evaluate your project lets you, your patients and your community know that you've successfully achieved the strategies necessary to create a healthy, earth-friendly surgical facility.

The Green Guide for Health Care. If you're planning to build a new surgical facility or overhaul an existing one, start by checking out the Green Guide for Health Care (www.gghc.org) to get a solid idea of what it means to go green from a building design and operations perspective.

The Green Guide, a project of Health Care Without Harm and the Center for Maximum Potential Building Systems, is the first voluntary, green building best practices toolkit customized for the healthcare sector.

Established in 2002, the Green Guide was an early response to the healthcare industry's unique challenges in implementing sustainable building practices, addressing the continuum of high-performance healing environments from planning and design to construction and operations. Just as the Green Guide borrowed its structure and rating system from LEED, with permission, the LEED for Healthcare rating system currently under development uses the Green Guide as a reference document.

From its inception, the Green Guide was structured to provide facilities with a self-certifying toolkit of best practices rather than an independent, third-party certification system, as with LEED. GGHC released a revised Operations section in December 2008, and a Version 3 of the Green Guide is currently in development. Going forward, the Green Guide will continue to provide a strategic leading edge with a vision to contribute to a regenerative healthcare industry by 2030.

— Deon Glaser, ASLA

Green Got You Down? LEED APs Can Help
Architects, engineers and other building professionals with the acronym "LEED AP" (LEED Accredited Professional) after their name have passed a test to demonstrate their "thorough understanding of green building practices and principles and the LEED Rating System." According to the U.S. Green Building Council, there are more than 75,000 credentialed building professionals who can help you navigate the LEED certification system. The Green Building Certification Institute has more information about the accreditation program on their Web site (www.gbci.org), including a searchable directory of LEED APs.