Sustainable Healthcare Architecture

ROBIN GUENTHER, FAIA, LEED AP, a principal with Perkins + Will in New York City, is a leader in the design of sustainable, high-performance healing environments.GAIL VITTORI, LEED Fellow, co-director of the Center for Maximum Potential Building Systems in Austin, Texas, is a pioneer in green building protocols, policies, and prototypes.

• Foreword xiiiAcknowledgments xvKey Sustainability Indicators and Infographic xviiPART 1 CONTEXT 1CHAPTER 1 DESIGN AND STEWARDSHIP 3INTRODUCTION 3THE CASE FOR STEWARDSHIP 4SUSTAINABLE DEVELOPMENT 7THE PROFESSION OF ARCHITECTURE 7THE ETHICAL CHALLENGE FOR DESIGNERS 10ECOLOGICAL DESIGN 10CLEANER PRODUCTION 11THE PATRICK H. DOLLARD DISCOVERY HEALTH CENTER 12LIFE CYCLE THINKING 14CRADLE-TO-CRADLE DESIGN 16LIVING BUILDINGS 17ESSAYLIVING BUILDINGS AND A RESTORATIVE FUTURE by Jason F. McLennan 18CONCLUSION—THE NEXT GENERATION 21CHAPTER 2 THE BUILT ENVIRONMENT AND HUMAN HEALTH 23INTRODUCTION 23THE GLOBAL IMPACTS OF THE BUILT ENVIRONMENT 24CLIMATE CHANGE AND PUBLIC HEALTH 25ESSAYWHERE WE HEAL: THE IMPORTANCE OF HEALTHCARE BUILDINGS TOOUR HEALTH AND THE PLANET’S by Aaron Bernstein, MD 27URBAN PLANNING AND PUBLIC HEALTH 28SPRAWL AND AIR QUALITY 31SMART GROWTH AND HEALTHY CITIES 32ACTIVE DESIGN 33ESSAYACTIVE DESIGN: CONVERGING DESIGN EFFORTS TO PROMOTE ENVIRONMENTAL SUSTAINABILITY AND ADDRESS TODAY’S LEADING CAUSES OF DEATHby Karen K. Lee, MD and Joyce S. Lee 34AIR POLLUTION 36WATER POLLUTION AND SCARCITY 38GAVIOTAS HOSPITAL 40INDOOR AIR QUALITY 41CONCLUSION—THE FUTURE 41CHAPTER 3 ENVIRONMENT AND MEDICINE 45INTRODUCTION 45THE STATE OF HEALTH IN THE WORLD 46ENVIRONMENTAL HEALTH 47ECOLOGICAL MEDICINE 49PROTEA HEALTH 52HEALTHCARE AND THE ENVIRONMENT 54ESSAYTRANSFORMING HEALTHCARE by Gary Cohen 55THE PRECAUTIONARY PRINCIPLE 59MEDICINE’S ROLE IN ENVIRONMENTAL IMPROVEMENT 59CONCLUSION 60CHAPTER 4 NATURE AND HEALING 65INTRODUCTION 65THE TRADITION OF NATURE AND HEALING 66THE THERAPEUTIC SPA MOVEMENT 66NATURE RECONSIDERED 67BIOPHILIA 68BIOPHILIC DESIGN PRINCIPLES 69URBANIZATION AND NATURE 70LANDSCAPE PERCEPTION 70HEALING LANDSCAPE 70SIDNEY AND LOIS ESKENAZI HOSPITAL AND HEALTH CAMPUS 72SUSTAINABLE LANDSCAPE 78CONCLUSION 79PART 2 ACTUALIZING THE VISION 81CHAPTER 5 IMPROVING PERFORMANCE 83INTRODUCTION 83TOOLS AND METRICS 84LESSONS LEARNED FROM PIONEERS 95POST OCCUPANCY EVALUATION—PROVIDENCE NEWBERG MEDICAL CENTER 96POST OCCUPANCY EVALUATION—DELL CHILDREN’S MEDICAL CENTER OF CENTRAL TEXAS 97RESOURCE EFFICIENCY 98ESSAYENERGY STAR®: IT’S NOT JUST A SCORE; IT’S A GOAL AND A STRATEGY by Clark Reed 101LEGACY SALMON CREEK 104ENERGY END USE MONITORING 105ESSAYTARGETING 100! by Heather Burpee and Joel Loveland 105THE TOXIC-FREE HOSPITAL 119ESSAYTHE PBT-FREE CHALLENGE by Tom Lent 121TOOLS FOR DESIGNERS AND SPECIFIERS TO DE-SELECT TOXICANTS 124VISUALIZING THE PATH AHEAD 125CONCLUSION 126CASE STUDIES01 Dell Children’s Medical Center of Central Texas, Austin, TX 12702 OHSU Center for Health and Healing, Portland, OR 13103 Peace Island Medical Center, Friday Harbor, San Juan Island, WA 13404 Sherman Hospital, Elgin, IL 13705 Kiowa County Memorial Hospital, Greensburg, KS 13906 Kohinoor Hospital, Mumbai, India 14107 The Dyson Centre for Neonatal Care, Royal United Hospital, Bath, England 14408 St. Mary’s Hospital Sechelt Addition, Sechelt, BC, Canada 14609 New Karolinska Solna University Hospital, Stockholm County, Sweden 14810 UCSF Medical Center at Mission Bay, San Francisco, CA 15111 Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA 154CHAPTER 6 MEASURING VALUE 161INTRODUCTION 161HEALTHCARE AND THE TRIPLE BOTTOM LINE 162THE ECONOMICS OF SUSTAINABLE HEALTHCARE 163ESSAYLEED CERTIFIED HOSPITALS: PERSPECTIVES ON CAPITAL COST PREMIUMS AND OPERATIONAL BENEFITS by Breeze Glazer, Robin Guenther, and Gail Vittori 166TRADING CAPITAL COST FOR OPERATIONAL SAVINGS 174CROSSING THE CAPITAL-OPERATIONS CHASM: PROVIDENCE HEALTH & SERVICES 175CAN SUSTAINABLE HOSPITALS BEND THE HEALTH CARE COST CURVE? 176THE SOCIAL VALUE OF SUSTAINABLE HEALTHCARE 177DELL CHILDREN’S MEDICAL CENTER OF CENTRAL TEXAS POST-OCCUPANCY EVALUATION 178THE LIVING BUILDING FINANCIAL STUDY 180CONCLUSION 183CHAPTER 7 LESSONS FROM HEALTH SYSTEMS 185UNITED KINGDOM’S NATIONAL HEALTH SERVICE 185GUY’S HOSPITAL TOWER, LONDON 191CASE STUDIES12 Mittal Children’s Medical Centre, London, United Kingdom 19313 The Bluestone Unit, Craigavon Area Hospital, Craigavon, Northern Ireland 19614 New South West Acute Hospital, Enniskillen, Northern Ireland 199SYSTEM PROFILE: Partners Healthcare 20215 The Lunder Building, Massachusetts General Hospital, Boston, MA 20916 Spaulding Rehabilitation Hospital, Boston, MA 212SYSTEM PROFILE: Providence Health & Services 215PROVIDENCE NEWBERG: Five Lessons Learned 21717 Providence Newberg Medical Center, Newberg, OR 21918 Providence St. Peter Hospital, Olympia, WA 221SYSTEM PROFILE: Gundersen Health System 22419 Gundersen LaCrosse Hospital Addition 228SYSTEM PROFILE: Kaiser Permanente 231KAISER PERMANENTE’S JOURNEY TO SUSTAINABILITY 23420 Small Hospital, Big Idea Competition 236PART 3 SUSTAINABLE HEALTHCARE TODAY 243CHAPTER 8 GLOBAL SURVEY 245CASE STUDIES21 Akershus University Hospital, Loreskøg, Norway 24522 Butaro Hospital, Burera District, Rwanda 25223 Deventer Ziekenhuis, Deventer, The Netherlands 257Trias Energetica 26024 First People’s Hospital, Shunde District, Foshan City, Guangdong Province, People’s Republic of China 26325 Hospital Universitario San Vincente de Paul, Rionegro, Colombia 26826 Khoo Teck Puat Hospital, The Republic of Singapore 27227 Portadown Health and Care Centre, Portadown, Northern Ireland 27828 REHAB Centre for Spinal Cord and Brain Injuries, Basel, Switzerland 28429 Reina Sofi a Foundation Alzheimer Centre, Ensanche de Vallecas, Madrid, Spain 29130 The New Royal Children’s Hospital, Melbourne, Victoria, Australia 29731 Rush University Medical Center, Chicago, IL 30432 Salam Centre for Cardiac Surgery, Soba (Khartoum), Sudan 31433 Santa Lucia University General Hospital, Cartagena, Spain 31534 St. Bartholomew’s and The Royal London Hospitals, London, England 32235 Swedish Medical Center, Issaquah, WA 329Ten Lessons Learned 33336 Ysbyty Aneurin Bevan (Aneurin Bevan Hospital), Ebbw Vale, Blaenau Gwent, Wales 335PART 4 VISIONING THE FUTURE 341CHAPTER 9 TOWARD A NEW LANGUAGE OF FORM 343INTRODUCTION 343THE DEVELOPMENT OF THE MODERN HOSPITAL 344RIKSHOSPITALET-RADIUMHOSPITALET MEDICAL CENTRE 348DOUBLING DAYLIGHT 351CASE STUDIES37 Martini Hospital, Groningen, The Netherland 36138 Arras Hospital Centre, Arras, Nord-Pas-de-Calais, France 36539 Pediatric and Cardiac Center of the Innsbruck University Clinic, Innsbruck, Austria 36840 Helsingør Psychiatric Clinic, Helsingør (Elsinore), Denmark 37141 Rhine Ordinance Barracks Medical Center Replacement, Kaiserslautern, Germany 37542 Ng Teng Fong General Hospital and Jurong Community Hospital, The Republic of Singapore 37843 Nanaimo Regional General Hospital Emergency Department Addition, Nanaimo, BC, Canada 38144 Seattle Children’s Bellevue Clinic, Bellevue, WA 38445 Pictou Landing Mi’Kmaq Community Health Centre, Trenton, Nova Scotia, Canada 38646 Kenya Women’s and Children’s Wellness Centre, Nairobi, Kenya 39047 Tata Medical Centre Cancer Hospital, Kolkata, India 39248 CBF [Centre pour le Bien-être des Femmes] Women’s Health Centre, Ouagadougou, Burkina Faso 395CHAPTER 10 CREATING THE TWENTY-FIRST-CENTURY HOSPITAL 399INTRODUCTION 399TWENTY-FIRST-CENTURY HEALTHCARE 401CONCLUSION 412CASE STUDIES49 The Ubuntu Centre, Zwide Township, Port Elizabeth, South Africa 41450 Jubilee Gardens Health Centre and Library, London, England 41751 Old Town Recovery Center, Portland, OR 41952 Waldron Health Centre, Lewisham, South London, England 42253 Mirebalais National Teaching Hospital, Mirebalais, Haiti 42654 Embassy Medical Center, Colombo, Sri Lanka 42955 All Ukrainian Health Protection Centre for Mothers and Children, Kiev, Ukraine 432INDEX 435