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More hospitals are going "green"

Some believe the move toward environmentally friendly construction could extend to physician offices and other health facilities, because it might save more than the Earth.

By Katherine Vogt — Posted June 20, 2005

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Waterless urinals. State-of-the-art ventilation systems. Recycled flooring. These are just a few things that hospitals and other health care entities are using as they adopt "green" building principles to construct facilities in an environmentally friendly way.

Proponents say that such construction and design tactics not only are the right thing to do for the Earth, but might also lead to cost savings through operating efficiencies and may help improve the care of patients by creating higher-quality facilities with cleaner air, better water and more.

Though the up-front costs can be more expensive than traditional building techniques, and therefore may scare away crowds in a financially pinched industry like health care, many observers still expect to see a surge in new projects as more leaders learn about it.

Indeed, the U.S. Green Building Council, which certifies that building projects have met certain green-building standards, says just two health care entities have its Leadership in Energy and Environmental Design certification but 32 more are in the process of applying for it.

"This is huge. Everyone who is doing anything with construction right now is talking about green," said Dale Woodin, deputy executive director for the American Society for Healthcare Engineering, a division of the American Hospital Assn.

Green building is not a new idea, and it has been established for some time in other industries. But observers say it has only recently started to penetrate the health care sector. Woodin said it is catching on at a time when there is unprecedented growth in hospital construction projects.

The trend likely goes beyond hospitals to other health care facilities.

Though he couldn't provide any statistical evidence, Woodin said he believes that medical offices, clinics and other health care facilities are embracing the concept as well. "My sense is that the lessons learned at hospitals are also being tracked at other facilities," he said.

Metropolitan Hospital in Grand Rapids, Mich., is seeking LEED certification for its 208-bed, 500,000-square-foot facility slated to open in 2007. Leaders said the hospital would require all buildings constructed on its 170-acre campus -- including physician offices -- to get the designation.

Jarrad Pitts, the hospital's construction manager, said green building makes sense for Metropolitan because its core beliefs hold that the environment of care aids in the healing process.

"Also, as a hospital we see our role in the community as being substantial. So how we impact the environment is important to us," he added.

The new Metropolitan Hospital plans to have several unusual features, including a vegetation-covered roof to provide additional insulation, protection from ultraviolet rays and reduced storm runoff; extra windows and glass areas to enhance natural daylight and reduce electricity use; and landscaping techniques that provide shade in paved areas.

Finding construction dollars

The whole project is expected to cost about $150 million. Though some of the special measures, such as the roof, will cost the hospital a little extra, Pitts said that much of price tag is comparable to what it would be if traditional building techniques were being used.

"If it's done correctly and you apply the [techniques] that make the most sense to your project, the premium should be minimal or nothing really," he said.

But any additional expense may be hard for health care entities to swallow because of declining reimbursements and other financial pressures. "To add even a dollar to a construction project -- it's a hard dollar to find. So it's a challenge," Woodin said.

Woodin said there may be more of a surge in green building after more data become available about its potential for long-term savings. To that end, several organizations are studying green building in health care and helping to develop standards and educational resources.

In January 2002, the American Society for Healthcare Engineering crafted a statement outlining some of the principles of green building in health care, providing guidance on site design, materials and products, construction practices and more.

But there was little in the way of a roadmap for Boulder (Colo.) Community Foothills Hospital when it set out to become the first LEED-certified hospital in the nation, a designation the 60-bed facility secured in late 2003. Since then, the hospital has been flooded with inquiries from other health care leaders around the world.

"It kind of took us by surprise how much people wanted this information," said Kai Abelkis, the hospital's environmental coordinator.

The $75 million satellite campus has a smorgasbord of eco-friendly features, including an onsite recycling program, an energy-efficient power plant, xeriscaping -- plants selected for minimal water use -- on the grounds, and charging stations for electric cars in the parking lots. The facility was built using salvaged and recycled materials as well as sustainable products such as linoleum.

Abelkis said it's difficult to estimate whether the green measures added significantly to the overall price tag. He said some projections calculate the extra costs to be about 2% to 3% on top of a traditional project. "But we're getting paid back in air quality, in our water efficiency ... and because we built a better-quality hospital," he said.

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