Cover Story
Going Green
By Carmen Peota
Hospitals and clinics are embracing sustainable design.
Enter the atrium of SMDC Health System’s First Street building, and you probably won’t guess that the four-story 250,000-square-foot medical office building is one of Minnesota’s “greenest.” There are no solar panels, wind turbines, or prairie-grass rooftops. The most striking feature is what lies beyond the southeast-facing wall of glass: Lake Superior.
The picture-postcard view of the lake will likely distract you from the fact that few lights are on in the atrium because sunlight floods the space, that walls are covered with paint instead of vinyl, and that the air you’re breathing is cleaner than that in most public buildings.
|
A wall of windows flanks the lobby and patient waiting areas in SMDC’s First Street building, letting in light and a stunning view of Lake Superior.
Photo courtesy of SMDC Health System
Gold Standard
SMDC Health System’s First Street building was the first health care facility in Minnesota to earn Leadership in Energy and Environmental Design (LEED) Gold-certification. Here are some of the things SMDC did to make the building environmentally friendly and to earn the designation:
- Maximized use of natural daylight to minimize use of artificial lighting.
- Installed energy-efficient systems to ensure that the building uses less energy and less water than a clinic of comparable size.
- Used low-VOC-emitting building materials and furnishings.
- Used wood from sustainably managed forests.
- Purchased construction materials from manufacturers and suppliers within a 500-mile radius.
- Ensured that more than 15 percent of construction materials contain recycled content.
- Recycled more than two-thirds of construction waste.
- Removed more than 2,200 truckloads of rock from the site and reused it as fill for area highways.
Fairview Health Services will apply what it has learned as it pursues LEED certification for the new University of Minnesota Children’s Medical Center it plans to build on its Riverside campus in Minneapolis.
Rendering courtesy of Fairview Health Services
Environmental Guinea Pig
It was only a month before groundbreaking when Fairview Health Services decided to pursue LEED certification for its Bass Lake Clinic in Maple Grove. At the time, Raymond Piirainen, director of real estate, sat down with the guidelines to see if getting the 26 credits for basic certification was feasible. He realized that Fairview would get 16 of the credits simply by following standard construction practices. “So you’re two-thirds of the way toward the goal. The next eight credits were the ones to focus on,” he says.
They ended up with a 6,100-square-foot facility that has a white roof to help keep it cool in the summer, special parking spaces for bicycles and fuel-efficient vehicles, plantings that require little water, and low-emitting interior finishes. More than 50 percent of the contractors’ waste materials were recycled, and upgraded mechanical and electrical systems provide higher air quality and reduce utility costs.
Piirainen says the experience has been useful. “Every one of our projects now uses the Bass Lake Clinic as a learning model. It’s an environmental guinea pig.”
Last year, Ridgeview Medical Center in Waconia won an H2E Environmental Leadership Award, which is given to health care organizations for outstanding environmental performance.
Photo courtesy of Ridgeview Medical Center
Solving Puzzles
When Ridgeview Medical Center CEO Bob Stevens asked facilities services director Todd Wilkening to lead a sustainable practices initiative back in 2001, Wilkening saw the challenge as a chance to solve a puzzle. “I like Rubik’s cubes,” he says.
Using U.S. Green Building Council guidelines as its bible, the Waconia-based hospital and clinic system has since attempted to weave sustainability into the design, construction, and operations of its facilities (it now has 17). It has opted for low-emitting materials such as Marmoleum (a product similar to linoleum), it recycles, and it looks for ways to cut energy consumption.
Wilkening says that sometimes requires considering something new—they’re looking at a geothermal system for a hospice in Chaska—and sometimes reconsidering the old. For example, they installed high-efficiency chillers and improved piping to get better performance out of an old power plant. “Sometimes if you look at what you’ve got, you can improve on that without having to expand,” he says, noting that that effort saved the organization $3 million.
Park Nicollet wanted to take advantage of the view of its neighboring wetland when adding on to Methodist Hospital in St. Louis Park.
Photo courtesy of Park Nicollet Health Services
Inspired by a Wetland
A wetland was the impetus for Park Nicollet Health Services to begin thinking about sustainability as it was designing an addition to Methodist Hospital in St. Louis Park in 2003. The organization wanted to capitalize on the natural beauty of the area adjacent to the hospital property. So it oriented the 209,000-square-foot building that houses its heart and vascular centers toward the wetland and added big windows to help patients feel connected to the outdoors. The idea was that the building, which provides ambulatory services, would be calming for patients and enhance healing, says Duane Spiegle, vice president of real estate and support
services.
Park Nicollet then became concerned that its building was encroaching on the wetland, which filters water before it enters Minnehaha Creek. So it began working with the local watershed district, which offered funding for small rain gardens—depressions filled with selected plants that capture and filter run off from its parking lot.
Spiegle says Park Nicollet has since incorporated many more sustainable design concepts into its building projects. They’re adding several acres of green space by replacing an asphalt parking lot with a five-story parking structure. They’re installing devices to cut down on water and energy use, and they’re trying to buy sustainable products from local manufacturers when they can.
Park Nicollet is currently pursuing LEED certification for a three-story addition to its cancer center on the north campus. The most obviously green feature of the new addition will be an 1,800-square-foot turf roof, seeded with plants that require little maintenance, to help filter
rainwater.
Spiegle estimates the additional cost for pursing LEED will be $500,000 to $600,000, plus consultant fees associated with handling the copious paperwork. He expects the payback to be several years out. But, he says, a return on investment is part of, but not the determining factor, in the decision to go green. “We think it’s important in being a community player and
citizen.” —C.P. |
If it weren’t for the dozen or so clear glass plaques hanging in the lobbies and corridors, you might not realize that 75 percent of the wood used in the building came from sustainably managed forests, that the building uses 35 percent less water and 32 percent less energy than clinics of comparable size, or that 42 percent of the materials used in its construction were manufactured within 500 miles of Duluth. Nor will you realize that 5,700 tons of construction waste were recycled while it was being built.
Such efforts are the reason why last year the U.S. Green Building Council, a nonprofit dedicated to promoting sustainable design, gave the First Street building its Leadership in Energy and Environmental Design (LEED)-Gold certification. The designation is a sort of gold star for steps taken by the architect, owner, and builder to minimize a building’s negative environmental impact. The First Street building was the first health care facility in Minnesota to achieve LEED certification (only a dozen buildings in the state have the designation at any level), and it was among the first 10 health care facilities in the United States to earn the designation.
Certifiably Green
For SMDC, the discussion about LEED certification was launched in 2003 with a proposal from the facilities management department that clean indoor air be a primary goal for the new building, which would house the cancer and digestive disorders centers as well as the breast health, pediatric, internal medicine, and ob/gyn departments. Problems with air circulation and moisture infiltration are common in older medical facilities and something facilities management staff at SMDC had to deal with on occasion, according to Harvey Anderson, vice president of facilities for SMDC.
Anderson was concerned that airborne dust and other particulate matter, molds, and off-gassing chemicals from adhesives, finishes, and fabrics were harmful to patients, particularly cancer patients whose immune systems were compromised or who were suffering nausea and other side effects of treatment. And he hoped that by selecting certain materials and equipment and paying attention to construction methods and ventilation, they could improve air quality.
Around the country, many other health care organizations were starting to make such sustainable design choices based on the belief that buildings could affect their occupants’ health. They were noting that a growing body of evidence coming from environmental health research was beginning to show the health effects of various chemicals. Formaldehyde, which is present in many pressed-wood and other products, was known to cause burning, watery eyes, nausea, and difficulty breathing for some people exposed at high levels. And, according to the Environmental Protection Agency, evidence from animal studies showed that it may cause cancer. Concern was growing about whether volatile organic compounds (VOCs), a group of chemicals emitted by a wide array of products, were also carcinogenic.
As committee members learned what LEED certification entailed, “it just took off,” Anderson says of pursuing the designation. SMDC saw it as a way to improve the health of patients, staff, and the community. “Why would we not want to do it?” he says. “We’re in health care. It meets our mission statement.”
But SMDC was about to discover that going after LEED certification involved a huge commitment. To earn the designation, the architects, engineers, contractors, and SMDC’s own facilities management staff would have to work together to earn points or credits in six categories: sustainable sites, water efficiency, energy and atmosphere, materials and resources, indoor environmental quality, and innovation. They would need to consider recycling their construction materials, using low-emitting materials, reducing energy and water usage, limiting light pollution, and avoiding use of materials such as PVC and formaldehyde, among myriad other things. And they would have to take into account factors such as the geology of the area, Duluth’s climate, and the budget. SMDC even hired a consultant to ensure that it got every credit it could.
The most challenging aspect of the project, according to Anderson, was the issue of indoor air quality. That, he says, required multiple actions, including specifying that their contractor cover all ducts and pipes before they were installed to keep out dust, using low-VOC-emitting glues, paints, carpeting, and fabrics, and insisting that furniture arrive wrapped in blankets rather than cardboard (again, to minimize dust). The efforts proved worthwhile when the air was finally tested. The company they hired reported that the level of VOCs was the lowest they’d seen in any building. “There was no smell,” Anderson says. “That’s what our patients recognized the first day.”
Not Easy Being Green
Going green is a challenge for any organization, whether or not they’re using the LEED process to do it. But it’s especially challenging for health care organizations. That’s because clinics and hospitals are more complicated than other buildings, according to Amy Douma, an associate vice president of HGA Architects in Minneapolis. Hospitals have 24/7 operations and infection-control concerns, they generate medical waste, they have to conform to extensive codes, and they’re notorious energy hogs.
Douma points out that those characteristics are sometimes at odds with sustainability. Operating rooms typically exchange their air volume as often as 25 times an hour. Using daylight—a common green goal—is difficult in buildings that have lots of tiny rooms and long corridors built to meet strict fire codes. Concern about infection can make facilities staff squeamish about recycling and reusing waste water.
Such issues have made health care slower than other sectors to adopt sustainability, according to Rick Hintz, an architect who heads the Health Care Practice Group for Perkins and Will in Minneapolis. “Quite honestly, when it comes to health care as an industry, it’s been very slow to pick up on this,” he says, noting that sustainable design really took off a decade ago in the public and commercial building sectors.
Hintz says health care organizations, which are always squeezed for dollars, have perceived using sustainable materials and methods as being more expensive than opting for traditional ones. That may no longer be true. SMDC’s Anderson says the cost of many sustainable products is now comparable to that of traditional materials because of market demand, and articles in architectural publications say green buildings cost no more than others.
In fact, many say going green saves money. SMDC has forecasted spending 20 percent to 30 percent less on utilities in the new building than they might in a clinic of comparable size. Todd Wilkening, director of facilities services at Ridgeview Medical Center in Waconia, which adopted a sustainable building practices policy in 2001, says sustainability has been good for their bottom line. “If you just think about the obvious things—reduce, reuse, and recycle—whether it’s existing processes or new construction, it’s a no-brainer. It’s going to start saving you money.” To ensure each sustainability measure at Ridgeview makes business as well as environmental sense, Wilkening’s team does cost-benefit analyses, often working with vendors to determine the life-cycle cost of materials and equipment.
Fading Fad or Permanent Color?
A few years ago, building a green hospital or clinic might have been a novelty. But that is clearly changing. Last year, Fairview Health System’s Bass Lake Clinic became the second Minnesota health care facility to earn LEED certification, and Ridgeview won a Hospitals for a Healthy Environment (H2E) Leadership award. Currently, hospitals and clinics in St. Cloud, Minneapolis, St. Louis Park, and elsewhere are pursuing LEED certification or considering other ways to go green.
It is a trend, according to Perkins and Will’s Hintz. “Most health care providers know about this. They see what their competition is doing. It’s in the trade journals.”
Hintz thinks a lot of what is labeled green or sustainable design is what the building industry has been doing since the first energy crisis of the 1970s: developing energy-efficient windows and insulation, improving air-handling and heating and cooling systems, and reusing and recycling. “Now, it just happens to fall under the umbrella of green or sustainable design,” he says.
HGA’s Douma believes that even if the intensity of interest in green fades, its essence will stick around. The whole goal of LEED certification is market transformation—to permanently change the way buildings are constructed, she notes. “It’s not simply to have specific buildings that you point to and say, ‘These are the good examples.’ It’s to have everyone building this way.” She believes that’s happening. “We used to say, ‘We’ll pick that because it’s green.’ Now it’s the norm.”
Douma says the marketplace and individuals respond to green because it simply makes sense. “When you learn about it, you start asking, ‘Why wouldn’t we do this when it’s good for the people in the buildings as well as the environment as a whole?’” MM
Carmen Peota is managing editor of Minnesota Medicine.