Commercial Architecture September 2017 - 12

FEATURE

healthy hospitals

scape, and natural materials such as wood and stone are
used to bring colors, and textures into the building itself.
The winter garden lobby is filled with daylight, contains
several distinct planted areas, and showcases a vertical
pier clad in birch bark."
Another area of research is examining the links between indoor air quality and a variety of health and performance markers, such as cognitive function, Papiez
said. "Over the past few years, the Harvard School of
Public Health, Boston, has shown significant improvements to cognitive performance through improvements
to indoor air quality, including increased ventilation
rates, decreased carbon dioxide levels, and decreased
VOC levels (Environmental Health Perspectives, 2015).
While this research has focused on non-healthcare environments, the impact on human ability to cognate and
make important decisions could likely translate to other
building typologies.
"The importance of indoor air quality for human
wellness was one of the reasons WakeMed pursued LEED
for Healthcare on its North Hospital project in Raleigh,
NC. EwingCole worked with WakeMed to select building materials, furniture, and furnishings that met lowVOC emission standards and were free of hazardous
compounds. While most LEED programs offer guidance
on VOC emissions, LEED for Healthcare takes a more
holistic look at the indoor environment. The newest versions of LEED, LEED v4, have built on this approach for
all programs," Papiez said.
"One of the most direct outcomes from effective daylighting is shorter patient stays, as proven by studies for
some time now," Guillot added. "Daylighting saves on

At WakeMed North Hospital, EwingCole was commissioned to convert a 110,000-sq.-ft. outpatient clinic in Raleigh, NC, into a 61-bed, 242,000-sq.-ft.
community hospital. With conversion to a full hospital, mechanical systems delivery was collected into one new central energy plant that houses the
hospital's generators, chillers, and hot-water boilers in one location. Photo: Brian Strickland, courtesy EwingCole

energy when coupled with effective shading strategies. I
would suggest that looking at the clinician workplace in

building, according to the U.S. Energy Information Ad-

ther testing and application, the economic pressures,

both the inpatient and outpatient setting will have com-

ministration," Guillot observed.

risk adversity, and regulatory requirements that ham-

parable results on effectiveness and overall engagement

"Water conservation can help health systems save dol-

of the healthcare teams. This is the next frontier in my

lars invisibly, but also become visible amenities on cam-

mind. Hospitals will typically push staff areas to the cen-

pus through landscape design. This decreases the strain

"Rethinking a healthcare system's standard presents

ter of floor plates-farthest from natural light. Locating

on water supplies and reduces the needs to treat and re-

an opportunity to use materials from sustainable sources,

these functions closer to windows and access to daylight-

lease the water. Clinically, infection control can be im-

including looking at supply chains," Guillot said.

ing is part of an overall sustainable/wellness strategy for

proved through the use of water conserving, such as low-

all, not just patients.

splash hand-washing stations," he said.

per the progress of large healthcare systems will likely
diminish," Papiez said.

"Ideas like regenerative design or salutogenic design-
design that focuses on human health and wellbeing-

"The conversation in hospitals has typically been how

Further, green-roof strategies can routinely reduce

should be at the core of the design process," he added.

to reduce steps for caregivers. It is important to provide

runoff by 50%. These roofs can soften the hard-edged,

"Spaces that encourage physical activity and build mobil-

effective care at the right time and to lean out waste, but

glare-producing of visible roofscapes of healthcare cam-

ity through access to public transportation or walking

what if we also could build an environment that pro-

puses and contribute to the overall sense of wellbeing,"

paths are all things that contribute to a sustainable and

motes healthy activity and mobility into the lives of ev-

Guillot commented.

regenerative environment."

ery employee, patient, and family member to promote
healthy behaviors?" Guillot asked.
OTHER RESOURCES

As much progress as has been made toward greener,
more sustainable and environmentally friendly health-

STANDARDS AND CERTIFICATIONS

care facilities, much opportunity still exists for improve-

Additionally, there is a growing body of standards to

ment in that area.

guide hospital administrators and design professionals. "A

Energy isn't the only resource to consider when making

"In our experience, only a few healthcare systems

commitment to sustainability should begin with holistic

a hospital or any other building green and sustainable.

are regularly pushing the boundary on system-wide

sustainability standards but also require measurement of

"Hospitals are huge consumers of one of our most pre-

sustainability topics like incorporation of renewable

performance over time after project completion," Papiez

cious resources: water. Large U.S. hospitals averaged

energy sources and material selection for environmen-

commented. "LEED and other sustainability metrics can

about 43 million gallons and $200,000 [annually] per

tal and human health. As these strategies undergo fur-

be successfully coupled with these broader strategies as

COMMERCI A L A RCHI T EC T URE

SEPTEMBER 2017

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