Green guide for healthcare and sustainability.ppt

Green guide for healthcare

2. environmentalhealth
Healthcare’s
primary mission
to protect health
=
sustainabilityDesign &
operation of our
facilities
=
opportunities for
improvement
overview

3. Protect the immediate
health of building
occupants.
Protect the health of the
surroundinglocal
community.
Protect the health of the
global community
and natural resources.
1
2
3
overview
strategies
2001 ASHE Green Healthcare
Construction Guidance Statement

4. 4
Three goals of “healing environments”
Reduce stress of the building’s occupants
Improve Safety
Contribute to Ecological Health
•Connection to nature (daylight/ views)
•Choice & Control (light and ventilation)
•Social Support (program areas)
•Positive Distractions (views/ program)
•Elimination of Environmental Stressors
(noise)
•Improved Indoor Air Quality
•Supportive Lighting Design/ Reduced Glare
•Healthier Materials
•Reduce Energy and Water Use
“Abetterbuildingis
onethatfacilitates
physical,mental,and
socialwell-beingand
productivebehaviorin
itsoccupants”
http://www.healthdesign.org

5. What is H2E?
H2E was jointly founded by the
American Hospital Association, the
U.S. Environmental Protection
Agency, Health Care Without
Harm, and the American Nurses
Association. To achieve our vision,
mission and goals, H2E is educating
health care professionals about
pollution prevention opportunities
and providing a wealth of practical
tools and resources to facilitate the
industry’s movement toward
environmental sustainability.

6. H2E Vision
H2E is based on a vision of a healthy health care system –a
system in which an environmentally aware and engaged health
care community is dedicated to the health of patients, workers,
their communities, and the global environment. We envision a
system where patients and staff interact in a healing environment
that embraces safer building products, clean air, reduced toxins,
safe working practices, energy and water efficiency, education,
and a commitment to public health demonstrated through waste
volume and toxicity reduction. We envision a system that
recognizes the link between our choices and our health, and are
working to make that system a reality by creating a national
movement for environmental sustainability in health care.

7. GGHC
But what does this do for the CEO?
1. Personnel shortages
2. Reimbursement
3. Malpractice Insurance
4. Government mandates
5. Physician-Hospital Relations
6. Capacity
7. Care for the uninsured
8. Patient Safety
9. Technology
10. Patient Satisfaction

8. How green is my facility?
benchmark
overview
strategies

9. Sponsors
Convener
sponsors
Center for Maximum Potential Building
Systems,www.cmpbs.org
Hospitals for a Healthy Environment,
www.h2e-online.org
NYS Research and Energy
Development Authority,
www.nyserda.org
Merck Family Fund, www.merckff.org

10. steering
committee
overview
contributors
Gail Vittori (Convener), CMPBS; Austin, TX
Mike Gallivan, Turner Construction; Boston, MA
Robin Guenther, AIA Guenther5 Architects; New York NY
Tom Lent, Healthy Building Network; Berkeley, CA
Robert Loranger, New England Medical Ctr; Boston, MA
Brendan Owens, US Green Building Council; Washington DC
Clark Reed, US EPA Energy Star; Washington DC
Greg RobertsAIA, Watkins Hamilton Ross; Houston, TX
Kim Shinn PE, TLC Engineers; Nashville, TN
Scott Slotterback, Kaiser Permanente; Oakland, CA
Al Sunseri PhD, ASHE; Chicago, IL
Walt Vernon PE, Mazzetti & Associates; San Francisco, CA
Janet Brown, Hospitals for a Healthy Environment; New York, NY
Steve Guttmann PE, Guttmann & Blaevoet; San Francisco, CA
Jamie Harvie PE, Institute for a Sustainable Future; Duluth, MN
Craig Kneeland, NYSERDA; Albany, NY
Ray Pradinuk AIBC, Stantec Architecture; Vancouver, BC
Alan Traugott, CJL Engineering; Moon Turnpike, PA

11. Steve Ashkin The Ashkin Group IN
additional
contributors
overview
contributors
Laura Brannen Hospitals for Healthy Env, NH
Kathy Gerwig Kaiser Permanente, CA
Robert Guerry, CHFM Duke Univ Med Center, NC
Steve Guttman, PE Guttman & Blaevoet, CA
Jamie Harvie, PE Inst for a Sustainable Future, MN
Tom Hicks US EPA Energy Star, DC
Wayne Klingelsmith FASHE
Athens Reg Medical Center, GA
Paul Matthew Lawrence Berkeley Lab, CA
Sue Rubin ASHE, IL
Dale Woodin ASHE, IL

12. ASHE Green Healthcare Construction
Guidance Statement (2002)
LEED® Green Building Rating System
Labs 21 Environmental Performance
Criteria
Australia Green Building Council’s
Green Star
New York City High Performance
Building Guidelines
Savings by Design Healthcare Model
(Pacific Gas & Electric)
AIA Guidelines for Healthcare
Construction
overview
contributors
reference
documents

13. TheGreenGuideforHealthCareseekstoreward
thoseorganizationsthatvoluntarilystewardthe
environmentintheinterestsofhumanhealth.
Italsocreatesincentiveforthehealthcareand
relatedindustriestochangetheirpractices,build
sustainableenvironments,andenhancetheiroverall
accountabilityandperformance.
industry
tool

14. The design and operation of health care buildings is
highly regulatedwith intense economic and life
safety oversight
Health care facilities are often multiple building
campusesof varying ages, conditions, systems
24/7 operationswith patients in place require intensive
coordination and redundancy of all services at all times.
Long ownershipmean owners realize life cycle
implications of their construction choices.
1
2
3
4
overview
design attributes

15. Operationalissues, such as mercury elimination,
have defined industry’s environmental stewardship
5
overview
operational attributes
The H2E is a voluntary
program designed to help
health care facilities
enhance work place safety,
reduce waste and waste
disposal costs and become
better environmental
stewards and neighbors.

16. 6
7
8
Construction frequently occurs within oradjacent
to occupied buildings(where health is fragile, or
steadiness of hand required)
overview
construction attributes
Infection Control Risk Assessment (ICRA) protocols
to minimize the impacts of construction on occupants
demonstrate leadership to the wider sustainable
building industry
Healthcare construction managerscan evolve a
rigorous, sustainable set of practices for the
healthcare industry that may inform wider
construction practice

17. construction
manual
1 –Integrated Design
2 –Sustainable Sites
3 –Water Efficiency
4 –Energy & Atmosphere
5 –Materials & Resources
6 –Indoor Environmental Quality
7 –Innovation
2 -2
1 -18
1 -7
3 -19
2 -24
2 -22
0 -4
11 -94
Section / Category Name Pre-Req. / Max. Total

18. operations
manual
1 –Integrated Operation
2 –Energy Conservation
3 –Water Conservation
4 –Chemical Management
5 –Waste Management
6 –Environmental Services
7 –Environmental Purchasing
8 –Innovation
4 -8
3 -18
1 -8
1 -5
1 -6
0 -9
0 -11
0 -7
10 -72
Section / Category Name Pre-Req. / Max. Total

19. Intent
Documentation
Health Issues
Reference Standards
Credit Goals
Technologies & Strategies
organization

20. INTEGRATED DESIGN
4 points
How do we ensure a connection to
health mission in the design
process?
How do we optimize the design
process to consider the facility’s
operations?
What protocols are necessary to
maintain healthy building
operations?
INTEGRATED OPERATIONS
8 points

21. integrated design
Integrated Design
Process
Environmental
Health Mission
Statement &
Program
2 prerequisites
Prereq 1
Prereq 2
prerequisites

22. integrated operations
Integrated O&M
Re-certification
Process
Outside Air
Introduction &
Exhaust
Environmental
Tobacco Smoke
4 prerequisites
Prereq 1
Prereq 2
Prereq 3
Prereq 4
prerequisites

23. ID Prerequisite 1:
Integrated Design Process
Use cross discipline decision making
starting early in the design process &
continuing throughout to maximize
interrelationships between systems.
Architects
Engineers
Interior Designers
Builders &
Contractors
Facility managers
Administrators
Medical Staff
Patients
Group
purchasing
organizations
Support services
Integrated design process
winning
solutions

24. ID Prerequisite 2:Establish a health
mission statement and environmental
health goalsfor governing the design process
& integrating sustainability strategies
IO Prerequisite 1: Create synergies among
staff early in the planning process by involving
decisionmakers who influence the
building’s operational output. Foster
connections between output systems in order
to optimize flows.
Professional
Consultants/
Facilities Managers
core credit
Managers
Administrators
Clinical Staff
Patients
Purchasers
Support Services
Infection Control
Quality Assurance

25. INNOVATION IN
DESIGN
Can our organization contribute newindustry leadership,
working protocols, operational initiatives, and engaging
strategies for an evolving environmental health dialog?
What new ideasdoes our project embody by building
upon these goals and principles?
4 points
Does our building design find new and creative waysto
support healing environments for our patients, and
supportive environments for our staff?

26. SS Credit 9 Connection to the
Natural World
sustainable sites
Atrium
Cafe
Library
Establish 5% of the
building program as
programmed places of
respiteeasily accessible
to patients, visitors, and
staff. Provide at least one
place of respite dedicated
to staff and separate from
patients and visitors.

27. fresh air
clean site
sustainable sites
Credit 10.1 & 10.2 Community
Contaminant Prevention (2)
Exceed by 10% NIH-CDC
Guidelines for Airborne
Effluent from Laboratories
Develop a policy for
containment and engineering
controls to manage fuel and
chemical storage.

28. Energy Star® compliant (highly
reflective) AND high emissivity
roofing (emissivity of at least 0.9
for 75% of area
OR
a "green" (vegetated) roof for at
least 50% of the roof area.
Combinations to collectively
cover 75% of the roof area.
Credit 7: Heat Island Effect: Roof
sustainable sites

29. WATER EFFICIENCY
7 points
WATER CONSERVATION
How can we conserve and protect
water supplies in rural and urban
environments?
Can we improve use efficiencies and
reduce potable water demand?
8 points

30. prerequisite
(Eliminate)
Potable Water
Use for
Equipment
Cooling
1
water efficiency
1 prerequisite
Do not use potable
water for once
through cooling for
any equipment.

31. •Credit 1: Water Efficient Landscaping (2)
•Credit 2: Innovative Wastewater Technologies (1)
•Credit 3: Potable Water Use Reduction (2)
•Credit 4: Process Water Efficiency (2)
Reduce potable water use
7 points
water efficiency
Black –as in LEED Green –modified from LEED Blue –new to GGHC

32. environmental
health
Use high efficiency
irrigation technologies,
employ xeriscape plantings
OR
Use captured rain or
recycled site water to
reduce irrigation needs.
Credit 1: Water Efficient
Landscaping (2):
Reduce potable water use by 50%, or
eliminate potable water usage
water efficiency &
conservation

33. environmental
health
Employ strategies that in
aggregate use less water
than the water use
baseline after meeting the
Energy Policy Act of 1992
fixture performance
requirements.
Const WE Credit 3 (2):
Ops WC Credit 2 (2):
Potable Water Use Reduction
Reduce potable water use by 10%
to 30%
Low consuming fixtures
Occupant sensor controls
water efficiency &
conservation

34. environmental
health
4.1 Document Baseline
process water usage
4.2 Reduce Process water
usage by
20% to 30%
Ops WC Credit 3: Process
Water Efficiency (3):
Reduce process water use by
20% to 40%
Const WE Credit 4: Process
Water Use Reduction (2).
water efficiency &
conservation

35. ENERGY & ATMOSPHERE
19 points
18 points
ENERGY EFFICIENCY
How does the hospital reduce energy
demand and environmental impacts
from fossil fuel use?
Does the facility utilize renewable
sources of energy?
Can healthcare entities conserve and
protect natural reserves as a
safeguard measure for human health?

36. Fundamental
Building Systems
Commissioning
1
Minimum Energy
Performance
2
CFC Reduction in
HVAC&R Equipment
3
3 prerequisites
ENERGY & ATMOSPHERE

37. New Construction: Model
anticipated energy performance
using DOE2.1E excluding
equipment loads.
Renovation or Additions:
Use results of DOE2.1E models
calibrated against actual usage
data.
Use EPA Energy Star™
TargetFinder and Statement of
Design Intent.
Credit 1: Optimize Energy
Performance (10):
Reduce energy demand &
preserve community supply by
10% to 45%
energy & atmosphere
energy conservation

38. Credits 2, 4 & 7 /Credits 2 & 4:
Reduce environmental health impactsby selecting refrigerants that
preserve the ozone layer and protect human health; support renewable
power sources that preserve environmental health
Credits 1 & 7 /Credits 3 & 4:
Reduce energy demand, increase payback and community health through
design energy efficiency measures and improved equipment efficiencies.
energy & atmosphere
energy conservation
credits
Credits 3, 5 & 6 /Credits 1 & 5:
Optimize ongoing performancewith commissioning, measurement, and
energy supply efficiency for even better rate of return.

39. Credits 2 & 5:
Reduce climate change impactsand impacts to
community resource infrastructurethrough support for
renewable power sources and emissions reduction reporting.
Prerequisite Credit 1 :
Reduce energy demandthrough design energy efficiency
measures and improved equipment efficiencies.
energy conservation
credits
Credits 1, 3 & 4:
Optimize ongoing performancewith commissioning,
measurement, and energy supply efficiency.

40. •Credit 1/ Construction: Optimize Energy Performance (8)
•Credit 1/ Operations: Optimize Energy Performance (10)
reduce energy demand
energy & atmosphere
energy conservation

41. energy & atmosphere
Credit 7:
Medical Equipment Efficiency
Use Energy Star ®
qualified products or
equipment in the top 25
th
percentile for at least 75%
(based on quantities, not
costs) of new equipment
that is not building
systems related, and at
least 30% of all such
equipment

42. prerequisite
Prereq 2: Mercury Elimination
Switches, thermostats, gauges
Low-mercury lamps
Medical devices
Dental amalgam separators
Demolition protocol
materials & resources

43. materials & resources
2.1Divert 50% from landfills and
incineration.
2.2Divert 75% from landfills and
incineration.
Calculate by weight
or volume.
Credit 2: Construction Waste
Management (2):
Divert construction, demolition and
land clearing debris
Waste management plan
salvage
recycle

44. Reduce total waste volume by
30-50% below 1998 volumes.
Utilize alternative waste
treatment technologies to
reduce reliance on incineration
for medical waste.
WM Credit 1 & 2: Waste reduction
Reduce total and regulated medical
waste disposal in landfills and
incinerators
Waste management plan
Reduce use of
disposables
Reduce packaging
Recycle
waste management

45. EP Credit 3: Electronics Purchase &
Take Back
Electronics purchasing policy:
•Toxics disclosure
•Take Back –no landfill,
incineration or export
environmental purchasing

46. ES Credit 4: Environmentally
Preferable Cleaning Policy
•Sustainable floor care
systems
•Levels of required
disinfection
•GreenSeal GS-37 cleaning
products
environmental services

47. What: Peer-to-peer forum to discuss GGHC
Who: Health care project participants:
-Health care system facility planners
-Contracted design teams (architects, engineers,
interior designers, etc)
-GGHC (GGHC Coordinator & Steering committee)
-Notvendor reps
Where: online at www.GGHC.org
gghc forum basics
overview
forum

49. Green Guide
for Health Care
www.gghc.org
Download the 2.2

50. For More Information
Clark Reed, EPA
[email protected]
202/343-9146
Janet Brown, H2E
[email protected]
413/253-0254