Sustainable Development: Hospitals size up the value proposition of going green

Amy Eagle

Health Facilities Management

September 9, 2014

Hospitals size up the value proposition of going green

Health systems are recognizing sustainability as central to their mission, a fact reflected in the design, construction and operations of health facilities. “Sustainability is fundamentally about health,” says Robin Guenther, FAIA, LEED AP, sustainable health care design leader with the New York office of Perkins+Will. For the health of patients, visitors, staff and the larger community, providers are working to create facilities with minimal negative environmental impact.
Looking to the future
“Looking at the future of health care, hospitals and health care systems are caring for the community,” says Paul Stein, chief operating officer, MaineGeneral Health, Augusta. With changing payment structures, providers are adopting a model of health management and preventive care. “We’re trying to change the way folks look at our health care system and facilities,” says Stein. Rather than places to come when you’re sick, health facilities should be seen as places to be well and become educated about health, he says. Sustainable features contribute to this impression.
They also create more of a healing environment for patients, visitors and staff, enabling everyone in the facility “to do what they’re there to do, better,” says Gail Vittori, LEED fellow, co-director of the Center for Maximum Potential Building Systems, Austin, Texas, and co-author, with Guenther, of Sustainable Healthcare Architecture (John Wiley & Sons Inc., 2013). Sustainable designs and operations increase human health, productivity and safety, says Barbara Hamilton, LEED Green associate, sustainability manager, Palomar Health, Escondido, Calif. Since the health system opened Palomar Medical Center in Escondido, a 288-bed facility designed as a pilot project for the Green Guide for Health Care, “patient satisfaction scores have gone up dramatically,” she says.
According to Mary Larsen, manager for environmental stewardship, Advocate Health Care, Downers Grove, Ill., ensuring the safety of the environment also can be a bottom line-driven decision. Advocate has realized more than $15 million in savings from energy-efficiency, reduced consumption and overall waste-minimization since 2008. “The more conservation of resources, the more money we have to invest in our health care ministry,” Larsen says.
Return on investment
“You can’t afford not to [have sustainable facilities],” says Mark Webb, senior vice president of facilities administration, University Health System, San Antonio, Texas. Last year, the health system opened a six-story clinical pavilion on its Robert B. Green Campus in San Antonio, earning a Gold rating from the U.S. Green Building Council’s LEED program. The clinical pavilion includes efficient equipment and building operating systems designed to use 33 percent less energy than required by code, reflective paving and roofing materials that reduce the heat-island effect and a system for harvesting condensate from the central energy plant for power generation and landscape irrigation, among other sustainability features. The health system expects to receive LEED Gold as well for similar measures taken in the design of the 10-story, 420-bed Sky Tower at University Hospital, which opened this April. For either project, “we didn’t do anything with a payback over three years,” says Webb.
MaineGeneral Health anticipates a similar payback period for sustainable features of the Alfond Center for Health, a 640,000-square-foot, 192-bed replacement hospital in Augusta, a LEED Gold project that was completed under budget. The hospital’s heat-recovery system is expected to pay for itself in a year and the high-performance exterior, which Stein says was designed to be “as efficient as possible,” within three years.
The geothermal heat pump system at Methodist Olive Branch (Miss.) Hospital, a 210,000-square-foot, 100-bed facility, was “a big cost” for Methodist Le Bonheur Healthcare, Memphis, Tenn., says Richard Kelley, PE, LEED AP BD+C, project manager, corporate facilities management. The system, which involved drilling 200 bore holes 300 feet deep, has a life-cycle cost estimated at upward of $600,000. But with energy savings projected to result in a five-year return on investment, “we could do it with a clear conscience,” Kelley says.
Through a combination of conservation and renewable energy production, Gundersen Health System, La Crosse, Wis., is working to become energy-independent by the end of 2014, a project that “saves the organization millions and millions of dollars every year,” says Kari Houser, director of facility planning, construction and project management. The system’s new hospital, the Legacy Building, opened in January in La Crosse. The 430,000-square-foot, 325-bed hospital is designed to operate at 115 kBtu per square foot per year, which the hospital calculates will save about $660,000 annually at today’s energy rates; this is compared with benchmark median hospitals in the region, which require 250 kBtu per square foot per year. The Legacy Building’s energy savings are due in large part to a geothermal heat pump system that comprises 150 wells each 400 feet deep. Over the 50- to 100-year life of the Legacy Building, energy, water and labor costs will only go up, making the hospital’s efficiency measures even more valuable, Houser notes. “We’re making decisions that will help reduce the cost of care,” she says.
On-site power generation protects against energy price uncertainty, says Ramé Hemstreet, vice president, national facilities services operations, Kaiser Permanente, Oakland, Calif., and the organization’s chief energy officer. “With power purchase agreements with solar developers, costs per kilowatt-hour are locked in for 15 to 20 years,” Hemstreet says. Kaiser Permanente has installed solar panels at 13 locations, ranging from hospitals to a distribution center, as part of a sustainable energy policy to reduce the organization’s greenhouse gas emissions by 30 percent by 2020, from a baseline established in 2008. Last year, these arrays generated 18 million kilowatt-hours of electricity. Hemstreet says the system has more than 100 sites in California alone that could be added to this portfolio, for an up to 50-megawatt increase in generation capacity. “It’s cost-effective and the right thing to do,” he says.
Sustainability can provide a variety of efficiencies, notes Jon Utech, senior director for Cleveland Clinic’s Office for a Healthy Environment. For example, the organization specified light-emitting diode lighting instead of compact fluorescent lights for a facility project currently in the planning phase, a higher first cost it expects to recoup through future operational savings on bulb replacement, maintenance costs and energy costs.