Over the past several years, the green construction and operations movement has seen phenomenal growth. In fact, the U.S. Green Building Council’s (USGBC) Leadership in Energy and Environmental Design (LEED) registrations have grown by more than 50 percent per year. While adoption of LEED skyrockets, the USGBC has continued to improve its rating systems with the incremental launch and implementation of LEED 2009 this year.
Health care facilities, particularly hospitals, are complex and require a number of unique considerations in their design, construction and operations policies. These facilities have strict indoor air quality requirements and consume a significant amount of energy due to 24-hour-per-day, seven-day-per-week operation and water use because of the various cleaning and infection control issues. They also generate millions of tons of solid waste that include toxic and other bio-hazardous materials.
This presents a challenge, but also an opportunity to make a significant difference in a large percentage of construction and renovation projects, while also improving the operations of these facilities.
Because of the complexities involved, greening the health care industry can be a daunting and difficult task. However, with a good understanding of the tools available, those involved in the design, construction and operation of health care facilities can realize the potential that exists as health care becomes one of the largest green markets in the United States.
New day dawning
A new day is dawning on the world of green building and sustainable facility operations. The USGBC has produced what is by far the best third-party independent verification tool for determining if a building is in fact green and to what degree. Now officially more than 8 years old, the LEED rating system has proven to be a formidable tool for creating facilities that reduce energy, water and resource use while creating healthier places for all.
LEED provides a measurable, verifiable and repeatable method for achieving the green movement’s goal of “market transformation,” revolutionizing the process by which buildings are designed, constructed and operated. However, LEED still has much room for improvement.
Much of the success in the adoption of LEED and sustainable practices in general is largely due to the ability of the rating system to adapt to changes in the marketplace and improvements in technology over time. If LEED and the green building movement are going to thrive in a volatile and continually changing marketplace, there must be continued evolution and adaptation. In the past, there wasn’t a schedule for this ongoing improvement, but now there is.
The new Le Bonheur Children’s Medical Center campus, under construction in Memphis, Tenn., will have sustainable features such as green space, native plants and drip irrigation.
Until now, each individual rating system was developed and improved upon using timelines that were independent from the others and, for the most part, development decisions were made in a vacuum. These rating systems include but are not limited to the following:
- LEED for New Construction and Major Renovations (LEED-NC), which is the original commercial rating system;
- LEED for Existing Buildings: Operations and Maintenance (LEED-EB O&M), which is the recently revised and improved rating system that addresses the large number of existing buildings already in operation;
- LEED for Commercial Interiors (LEED-CI), which serves the tenant improvement market;
- LEED for Core and Shell (LEED-CS), which is for developments in building cores and shells; and
- LEED for Schools, which is LEED-NC adapted for the K-12 school market.
These rating systems were developed with the same five core credit categories (e.g., sustainable sites, water efficiency, energy and atmosphere, materials and resources, and indoor environmental quality) with many of the prerequisites and credits sharing the same intents, paths for compliance and performance thresholds.
At the same time, there were some major differences between them. For instance, each of these rating systems requires a different point total to reach certified, silver, gold or platinum levels. Also, many of the rating systems have credits with the same title and intent but require a different threshold of performance for compliance.
A good example of this is demonstrated in the materials and resources section of the rating system under the Regional Materials credit 5.1 of LEED-NC and LEED-CI, where the following discrepancies can be found:
• LEED-NC Regional Materials Credit 5.1 requires using “building materials or products that have been extracted, harvested or recovered, as well as manufactured, within 500 miles of the project site for a minimum of 10 percent (based on cost) of the total materials value.”
• LEED-CI Regional Materials Credit 5.1 requires using “a minimum of 20 percent of the combined value of construction and division 12 (furniture) materials and products that are manufactured regionally and within 500 miles.”
Though such differences may be appropriate, they also can be confusing to some users of LEED.
LEED’s new generation
LEED 2009, the name of the most recent and ongoing release of LEED rating systems, exemplifies the stated goals of the USGBC to further reduce perceived or real barriers to entry relating to complexity and costs. Three main pieces of the current LEED improvement cycle focus on LEED rating system updates and revisions, revision and advancement of the LEED certification process and an updated LEED online tool, which is called LEED online v3.
The new Le Bonheur Children’s Medical Center was designed to capture maximum natural light in staff areas, patient rooms, playrooms and family spaces.
Notable advancements in the rating systems themselves include the following revisions:
LEED prerequisite/credit alignment and harmonization. A structure was developed to consolidate, align and update all existing LEED rating systems into their “most effective common denominator,” providing a pool of prerequisites/credits for all LEED rating systems. A scrub of the existing credit interpretation rulings (CIRs) was conducted and necessary precedent-setting and clarifying language has been incorporated into the prerequisites and credits.
One goal is to reduce confusion among those who might not be sure which rating system is the most appropriate for their given project and another is to make the credits themselves more uniform from one system to the next. This alignment or harmonization of rating systems will include technical and market-based fixes to credits that currently need improvement or revision.
The USGBC has always offered CIRs for questions on the intent or path to compliance for credits that might not be completely clear. Consequently, the massive number of existing CIRs will be integrated into the coming changes based on volume or interpretations associated with any particular credit or prerequisite.
Predictable development cycle. LEED will move into a predictable development cycle that will help drive continuous improvements in LEED and allow stakeholders in the market to participate more fully in LEED’s future growth and development.
Knowing when to expect a change in the rating system will make it possible to more fully interact with the USGBC and communicate up-to-the-minute market trends that may be relevant to the improvement of LEED.
Transparent environmental/human impact credit weighting. LEED has undergone a scientifically grounded re-weighting of credits, which will reflect more accurately a credit-point impact on the environment and human health, whether positive or negative.
The transparent environmental/human impact credit-weighting procedure is a very important step in LEED’s evolution. How do users know where to focus their greening efforts related to the environmental or health impacts they expect to gain? What sections or credits in the rating system have the greatest impact on lives? Is there a crisis relating to the environment or human health that needs to be prioritized above all others? This aspect of LEED 2009 and its future will help answer these questions.
Regionalization. Incentives will be provided through LEED innovation and design style bonus points that will add value to credits that are considered most important for defined geographical regions. Project teams may select bonus points from a list of eligible credits driven by chapters, regional councils and the LEED steering committee.
For health facilities professionals who have worked on hospital projects across the country, the benefits are clear. For instance, facilities in the Southwest United States might be more interested in conserving water in buildings than those involved in greening facilities in the Northwest. Conversely, a project in Seattle might not call for the same HVAC requirements as a project in Phoenix. Adding additional opportunities to the LEED rating system to address these differences from region to region will definitely be a welcome improvement.
As the green movement grows and becomes easier to apply, it is important that health care continues to push the industry forward, raising the bar on building performance and environmental impact.
Health care benefits
While health care becomes greener, it has the potential to position itself as a driving force behind the incorporation of green building into all mainstream construction and design practices.
Hospitals operate 24 hours a day, seven days a week, which means that the potential reduced energy consumption achieved through green practices such as building commissioning, energy modeling and an integrated design approach will have a significant impact.
Moreover, LEED-certified hospitals will enjoy even more of the benefits than would a typical LEED building, including lower energy and water costs, reduced waste output and improved indoor air quality.
With its new revisions, there has never been a better time to explore LEED.
| Sidebar - Health care LEED on its way |
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There are many resources available to help tackle sustainability initiatives in the health care industry. Though not a rating system, the first “quantifiable” guide to enhancing health care facilities is the Green Guide for Healthcare™ (GGHC). The GGHC’s structure is familiar to those who have used the United States Green Building Council’s (USGBC) Leadership in Energy and Environmental Design (LEED) rating system. Until the launch of the GGHC reference document in 2003, health facilities professionals interested in greening a health care facility could only rely on LEED for New Construction (LEED-NC), a rating system initially created for the office building market. A significant difference between GGHC and LEED-NC is that GGHC includes operational prerequisites and credits, much like the LEED for Existing Buildings (LEED-EB) rating system. In the near future, however, the question of whether to pursue LEED-NC certification in conjunction with LEED-EB certification versus following the recommendations of the GGHC will be much easier. The USGBC, in close collaboration with the GGHC, will soon launch LEED for Healthcare, a specific rating system for the health care industry, including patient care facilities, medical offices, assisted living facilities and medical education and research centers. This new rating system will incorporate design, construction and operational requirements, much like the GGHC document. The LEED for Healthcare rating system represents four years of collaboration between the GGHC and USGBC. The GGHC has helped to streamline the LEED for Healthcare’s development schedule by aligning it with the LEED-NC rating system’s organizational structure and by conducting public comment periods and a robust pilot program. For more on the progress of the LEED for Healthcare rating system, check out the USGBC’s Web site at www.usgbc.org. |
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James D. Qualk is vice president of Nashville, Tenn.-based Smith Seckman Reid’s SSRCx facilities commissioning subsidiary. He can be reached at jqualk@ssr-inc.com. |
This article first appeared in the April 2009 issue of HFM.
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