Going Green: 5 Ways to Build a Sustainable Hospital

The sustainability craze has reached the healthcare industry, as designers look to build new, state-of-the-art "green" facilities and existing hospitals upgrade their energy policies. Jeff Hull, director of architecture, construction, and real estate with Idaho based St. Luke's Health System discusses five steps the hospital design team took to increase sustainability of the new facility at St. Luke's Magic Valley in Twin Falls, Idaho.

1. Use existing materials before buying new ones. Before the Magic Valley facility was designed, the hospital realized there was a layer of basalt, or solid lava rock, five to seven feet under the topsoil of the construction site. In trying to establish a structure with basements and tunnels, the team realized workers would need to get through that rock. Instead of transporting the rock elsewhere, the team had a clever idea: Re-use the rock for landscaping and structural fill. The landscape team took the biggest boulders and used them to decorate the hospital campus. The rest of the material was run through a crushing and screening process and then used for structural fill underneath the hospital's paving and parking lots. "So everything we excavated was crushed, screened and reused on site, so we didn't import or export anything," Mr. Hull says. This approach decreased waste, saved money on additional materials and gave the campus a natural beauty by using the indigenous rock for decoration.

2. Install "green space."
Putting a public face on a hospital's "green" initiative can help spread awareness of environmental issues. In the case of Magic Valley, the public face came in the form of the hospital's rooftop gardens. "In a multi-story, multi-tier building, you can look out and see a roof below you," Mr. Hull says. The hospital replaced the roof's original white, reflective surfaces with rock and planted gardens to generate oxygen and reduce ultraviolet impact on the roof. The gardens also serve to remind the public of the importance of plant life and give patients a beautiful view from their hospital rooms.

The hospital also took an original approach to tree planting. In 2006, large quantities of appropriate-sized trees were hard to come by in the community, so the hospital bought slightly undersized trees and worked with the local community college to grow them. "The college's horticulture program accepted the trees and nurtured them as part of their class experience," he says. "This allowed [the trees] to grow significantly larger than the normal stock you could buy."

3. Increase natural light. "There's evidence that natural light accelerates the healing process," Mr. Hull says. "And the more natural light you can get into a space, the less generated light you need to produce." These two facts form the rationale for Magic Valley's emphasis on natural light. Traditionally, hospitals have been designed with windowed patient rooms and interior, windowless corridors linking departments. In Magic Valley, Mr. Hull says patient rooms were pulled apart to allow nursing areas and corridors to experience daylight. "The public moving through the facility is always on an exterior wall — a window wall — enjoying the access to the daylight," he says.

The hospital also regulates generated light usage with photo cells that measure the present daylight and need for generated light. If a room is deemed light enough without generated light, the lights will stay off. "Energy codes are requiring us to use less and less generated light in spaces," he says. "Once you get used to not having the lights on, you can get away with a lot less generated light."

4. Use technology to regulate energy use.
Magic Valley regulates generated light usage with computers that determine the amount of light in a room and, as a result, the amount of generated light required. The same principle is applied to the hospital's fan system. Because hospitals require a large volume of fresh air exchange, many hospitals use giant boxes that contain a large fan and a large coil. These devices require a lot of electricity to start up, so the hospital began looking into other options.

A Canadian firm introduced the idea of a "fan wall," or a wall of very small fans that require very little electricity to start. A computer keeps track of the requested temperature for each area of the hospital and adjusts the fan wall to keep temperatures on par.  "As the need changes, the quantity of fans [that are turned on] changes," he says. Because the computer rotates which fans are turned on first, the fans also wear out less quickly.

5. Expand recycling programs. During the design process, the construction manager approached construction waste management with a recycling focus. "When we first came to Twin Falls, this community didn't have much of a recycling program," Mr. Hull says. You could take aluminum cans to the recycling center and get a few pennies." To bulk up recycling, the hospital focused on recycling trim and scraps on used metal, plastic sheets used to wrap supplies, sheet rock and wood from containers. By working with the waste management companies on recycling education, the hospital was able to increase recycling efforts substantially.

Similar changes were applied to hospital culture. As any hospital administrator knows, strategy is relatively useless when it comes up against a negative and unyielding culture. The team worked hard to convince hospital employees that recycling was important. They introduced smaller containers for waste instead of large, trash-only cans in each department. "We have a pretty healthy recycling program now," Mr. Hull says.

Learn more about St. Luke's Health System.

Read more on hospital design and development:

-5 Ways Evidence-Based Design Adds Value to Hospitals

-5 Steps to Catch a Hospital Buyer's Eye

-8 Trends in Hospital Design and Development

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