Built Environment Workgroup

The U.S. healthcare sector is engaged in the largest building boom in forty years for new construction, major additions, and renovations. At the same time, rising and volatile energy costs, looming climate protection regulation, and a growing interest in healthier, energy efficient, high performance building practices is creating the impetus for a transformation of healthcare design, construction, operations and maintenance. Working in partnership with the other GHSI work groups, the Built Environment Work Plan is designed to organize and develop information, resources and tools to address high priority areas of concern with a focus on integrative health-based design and evidence based design practices. Participating healthcare systems in GHSI will have access to an array of tools and "best practices" to implement strategies that will augment patient safety, workplace safety, and maximize the sector's environmental performance, while reducing healthcare's eco-footprint.

Project Components

• Evidence-Based Design Database
  The GHSI is working with the Center for Health Design (CHD) to construct a "best practices" database for sustainable and evidence based design in healthcare design and construction. The database will include 170 design practices that Kaiser Permanente has adopted, along with best practice examples from CHD's Pebble Research Projects and Practice Greenhealth's Green Guide for Healthcare (GGHC) registered projects that have developed over the last several years. The case studies will capture positive outcomes that cut across patient safety, workers safety and environmental sustainability. Participants will be able to easily access these "best practices" with accompanying research, business case, "how to" guidance, and contact information. The database will also have a wiki capacity so that GHSI organizations will be able to share their own best practice information and build a learning network. The database will pursue alignment and integration with other GHSI products.
   
  The new beta version of RIPPLE is now live and available for public testing. RIPPLE is an open source, searchable database containing useable and relevant information to help you to learn more about evidence based design. As the database grows, you will be able to compare design decisions made by multiple health systems and see the results of those decisions. In addition, you can interact with your colleagues to discuss ways to use this information and leverage current and anticipated exemplary practices to design your hospital of the future.
• Energy Efficient, High Performance Hospitals Toolkit
  U.S. hospitals consume more than three times the energy of office buildings and currently spend over $5 billion annually on energy. In addition, regulations to reduce carbon emissions are beginning to occur at the state level and are likely to become national in the next few years. GHSI will identify, coordinate and disseminate critical tools, resources, design strategies, and "best practices" to assist hospitals to improve energy performance, reduce energy and operational costs, and improve environmental performance. GHSI will, for example, disseminate design tools such as the ASHRAE Advanced Energy Design Guide for Healthcare Facilities (anticipated 2009) and educational programs such as Practice Greenhealth's Clean Energy Exchange Program, which facilitates education programs for healthcare institutions to both reduce energy procurement costs as well as purchase a greater percentage of renewable energy for their facilities.
• Materials Data Tool
  The Healthy Building Network (HBN) is developing an on-line tool called Pharos which will allow users to choose from over 500 products and building materials used in the built environment. The data base will cover a broad spectrum of building materials and rates products on safety and sustainability criteria throughout their lifecycle. In cooperation with the GHSI, HBN will prioritize building materials and products that are used extensively in the healthcare sector as they build the PHAROS data tool for beta testing in 2008. The data base will allow participants to learn from other product users as well as rate products and materials they have used in their own healthcare facilities.
• Materials Educational Fact Sheets
  GHSI will organize and develop information, resources and tools which address the high priority areas of concern today in health care materials. All fact sheets and other materials developed through this process would be posted to the GHSI website and made available and accessible to anyone and everyone. Product data would be incorporated into the Pharos database, along with lists of products that have already been screened.  View fact sheets
• Green Guide for Healthcare (GGHC)
  The GGHC is a quantifiable sustainable design toolkit to assist hospitals in designing and operating high performance healing environments. More than 150 hospital projects nationwide have used the GGHC as their design framework, while the U.S. Green Building Council is using the GGHC as its framework document to launch a LEED for Healthcare later in 2008. The GGHC will continue to evolve new design innovations that support major reductions in healthcare's ecological footprint and will share best practices across a growing network of innovating hospitals. The GGHC will also unveil a new operations section in 2008 to link sustainable design and operations into a comprehensive vision for the 21st century hospital.  View GGHC (3.2 MB pdf)
• Energy Impact Calculator (EIC)
  The EIC was designed and developed to address healthcare professionals' understanding of the health impacts and costs of their facility's energy use and to enable energy purchasers to make business decisions on energy efficiency projects and renewable energy purchases based on a realistic understanding of energy's true costs. Based on EPA and other peer-reviewed data, this easy to use and fully transparent spreadsheet calculates energy's health impacts such as premature deaths, chronic bronchitis, asthma attacks and hospital ER visits on a per kWh/year basis. Users enter their electric utility North American Electric Reliability Corporation (NERC) region and either the number of hospital beds or the kilowatt hours a facility uses, and on a single page will also see displayed healthcare facilities' dollar costs for these incidents, and the external societal costs. For example a typical 200 bed hospital in the coal-powered Midwest using a 7,000,000 kWh year, generates $998,617/year in negative societal public health impacts, and $119,572 per year in direct health care costs. This information can change what constitutes the "best price" on energy purchases. The tool will help health care executives better understand their direct energy costs as well as related social and health care costs, and will aid them in their energy purchase decisions. Go to the Environmental Impact Calculator found on Practice Greenhealth's website.

Outcomes and Benefits

• A shared online database of Best Practices
  for health and evidence-based design in healthcare capital projects, including 170 design practices that Kaiser Permanente has adopted, along with case studies from CHD's Pebble Research Projects and Practice Greenhealth's Green Guide for Healthcare (GGHC) construction and operations registered projects, and wiki interfaces.
• Access to cutting-edge materials selection tool
  including Pharos database which allows its users to choose from over 500 products, building materials and their attributes used in the built environment.
• Design strategies to improve energy performance
  by as much as 30%, over current standards, in new hospitals and major additions through "integrated building design" and resources such as the ASHRAE Energy Design Guide for Healthcare Facilities.
• Training curriculum
  to improve energy performance in existing hospitals.
• How-to guidance and best practices
  for taking advantage of new additions/renovations to improve energy savings performance throughout the facility/complex — e.g. through central plant redesign and upgrades.
• Case studies demonstrating improved energy savings
  in a new hospital design and construction, existing hospital upgrades, and reduced operating costs. The case studies will be targeted to key decision makers including executives, facility managers, architects and engineers.
• Access to Practice Greenhealth's Clean Energy Exchange Program
  to reduce energy procurement costs as well as purchase a greater percentage of renewable energy for their facilities.
• Access to the Calculator Energy Impact (EIC)
  to further the understanding of the health impacts and true costs of energy and to enable health facilities/systems to make better business decisions on energy efficiency projects and renewable energy purchases.