6 Reasons Going Green Is a Bright Idea


Eco-friendly building is a whole lot easier and more affordable than it used to be, and that's just the tip of the iceberg.

What if I told you that you could increase the real estate value of your facility and save about 50 percent on utility costs for, well, as long as you're performing surgery there - and all you had to do was spend 2 to 5 percent more on construction and materials to reap those benefits? Would you do it?

Of course you would. And those are just two of the many reasons to go green when building your facility. Healthcare construction has long been behind residential and other commercial development when it comes to green building, but it's easier than ever to use eco-friendly methods and materials and to build conservation into your new surgical center. Here's a look at the six reasons to go green.

1 Health and comfort
Buildings have long been made with insulation and wood composite products that contain known carcinogens - materials that are outlawed in many European countries, I might add. Combine that with standard paint, excessive artificial lighting (which is also expensive), non-operable windows, over-dependence on air conditioning and super-insulated buildings, and it's no wonder healthcare workers start suffering from "sick building syndrome." The phenomenon is well-documented, and the California Healthy Building Study showed that comfortable, healthy staff will have better attitudes, more positive work experiences and fewer sick days, all of which lead to improved patient care and a 25 to 50 percent greater retention rate.

Avoid building materials such as medium-density fiberboard, which usually contains the wood preservative formaldehyde, a known carcinogen. Specify to your design team that you want substitute materials that are healthy, such as those made of straw or bagasse instead of wood. The Green Guide for Healthcare (www.gghc.org) establishes minimum guidelines for indoor air quality, which can be adversely affected by air conditioning systems and furnishings or permanently installed building materials with potentially hazardous chemicals. It also encourages you to use natural light and reduce noise pollution.

Preventing daily exposure to low levels of pollutants is easily done during building, and preferable to dealing with the eye and nose irritation, headaches, fatigue and itchy skin prevalent in sick buildings. After all, the last thing a healthcare facility should do is make people sick.

2 Utility efficiency
By taking the cross-discipline approach set out in the Green Guide for Healthcare, you can save money and the environment.

  • Energy efficiency. Energy is a significant part of an operating budget, and it's getting more expensive every year. Incorporate exterior shading methods to minimize the amount of solar heat gain in the summer while providing sufficient natural light. This, combined with the installation of a solar panel electrical generation system, can reduce electricity usage by 50 percent or more. Verify that building systems, from light bulbs to OR tables, are operating according to their intent by periodically testing building, medical and office equipment to ensure it meets the minimum EnergyStar standards (EnergyStar is a government program that offers businesses and consumers energy-efficient solutions).
  • Water conservation. Choose capital equipment in labs, central sterile, laundry, the OR and procedure rooms that will reduce water use. Have your architect design the physical space to decrease water runoff around the facility.
  • Materials and resources. Reduce the use of materials that pollute the immediate or greater environment. Instead, use recycled, recyclable and locally made materials to reduce transportation and pollution. For cleaning and maintenance, use methods and solutions that are low in waste and toxicity.

One Facility on the Cutting Edge

It's easy to think that talk of green building saving you green is just that, but the Oregon Health and Science University's Center for Health and Healing, described by officials as "a super green building delivered within a conventional building budget," is proof that you can realize tangible results.

The Center for Health and Healing has integrated "significant energy and water savings ' into a design that emphasizes the health and comfort of patients, visitors and employees," says the university. "In contrast to conventional building designs that seek to seal nature out and then rely heavily on mechanical assistance, this building's design and engineering team have harvested natural resources."

For example, rainwater that falls on the building is reused in toilets and landscaping, and daylight is fully leveraged for lighting. The sun's energy is captured both through a "Trombe wall" solar collector and photovoltaic cells located on south facade sunscreens. A Trombe wall is a sun-facing wall built from material that can act as a thermal mass (such as stone, concrete, adobe or water tanks), combined with an air space, insulated glazing and vents to form a large solar thermal collector.

Other energy-saving features include a range of passive and active systems such as

  • a large-scale, on-site micro-turbine plant that generates about 35 percent of the building's electricity;
  • natural ventilation;
  • displacement ventilation;
  • radiant cooling; and
  • the first use of chilled beams to replace air conditioning in a large building in the United States.

The building features eco-roofs on terraces, water-efficient fixtures and appliances, and the use of sustainable and regional materials in construction. OHSU has reaped significant benefits, along with a platinum rating from the U.S. Green Building Council's Leadership in Energy and Environmental Design program:

  • 61 percent more energy efficiency than required by Oregon code and LEED standards;
  • 56 percent less potable water use than a comparable conventional building;
  • 100 percent on-site sewage treatment, reducing by 15,000 gallons each day the water that reaches city sewers; and
  • 1 percent of the solids that would normally be sent into the city sewer system from a conventional building.

The Center for Health and Healing is obviously much larger than the average surgical facility, but it only takes a few facilities to have a similar cumulative impact. "Conservation and care with our environment is a natural outgrowth of the mission to improve lives," says Peter Kohler, MD, the president of OHSU.

- Stephanie Wasek

These aren't the only areas where you can go green. The GGHC also provides credits for innovation in design. Don't be afraid to step outside the box and devise new and unique ways to conserve energy and materials, use safer materials or keep from harming the environment with your facility.

Nurses might have ideas for conserving electricity and housekeeping for conserving water, so it's important get input from all stakeholders, including owners, physicians, nurses, administrators, engineering/maintenance and housekeeping staff.

3 Governmental agency incentives
Seattle, Minneapolis, Austin (Texas), New York, Los Angeles, Atlanta and Portland (Ore.) are just a few of the growing number of cities offering incentives to build green. The rewards include tax breaks and credits, expedited entitlement processes (which can save months of waiting), $30,000 cash rebates and parking requirement reductions. Further, many states and local utility companies are providing rebates to encourage the use of these systems, effectively paying for as much as 40 percent of the installation cost. Determine what is available in your community and calculate these incentives into your financial analysis. These incentives play a large part in reducing the cost and time of constructing the facility.

4 Social and environmental responsibility
Whether you strive to be socially and environmentally responsible, or feel it's a nice bonus, the potential for green building to benefit society is without question. Commercial buildings in the United States comprise 35 percent of all energy use and contribute about the same percentage of pollution, according to the Rocky Mountain Institute. While decreasing energy use and pollution, we can also work toward eliminating our dependence on foreign oil.

Work with your consultant and architect to determine a sustainable site. That is, you pick a location that encourages development with greater density rather than destroying healthy farmland or natural environments; increases the rehabilitation of sites damaged by contamination; and maximizes landscape areas while reducing paved areas. During building, you also want to control erosion and discourage negative effects on water and air quality.

Finally, if you locate your facility near public transportation and encourage carpooling, you can minimize the use of vehicles (and the associated pollution) by staff and patients - while maximizing convenience.

5 Marketing edge
Outpatient surgery is showing no signs of slowing down, and consumer-directed healthcare is becoming more popular, which means you'll be facing increasing competition - and will have to take every chance you get to differentiate your facility. Building green is an opportunity to bill your center as state-of-the-art, healthy, socially conscious and so cutting edge that you (surgeon, staff and patient) shouldn't miss it.

6 Increased real estate value
Green building has entered the mainstream, lowering the cost of special materials and labor to the point that eco-friendly building typically costs only about 2 to 5 percent more than conventional construction. As this trend continues, and as more cities penalize those who don't build green, you can expect that the cost difference will become zero. The payback period on the added costs of materials and systems is about five to seven years. Further, green buildings are becoming prized possessions with a perception of superior quality and higher appraised values: Buildings with reduced energy needs, operating with a degree of self-sufficiency, producing fewer health risks and built with state-of-the-art systems will have a higher real estate value in the long run than "conventional" buildings.

Don't lose focus
Green building is still somewhat new, especially for healthcare, and you'll encounter plenty of detractors who say, "It costs too much," or "One building won't change the environment." But cost is no longer an issue, and the long-term rewards of improved patient care, staff retention, community support and long-term value are worth the effort. More people in healthcare are realizing it; given the rate of growth in green building, the next facility in your town is more likely to incorporate eco-friendly design into its construction. If you don't want to find yourself in the unenviable position of being behind the times, you only need to be willing to take the lead.

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