Healthcare Design - December 2013 - 40

R RESEARCH | 12.13
To LEED or not to LEED?
Adelante Healthcare studied two of its community health centers-
one LEED-certified and one not-to determine the impact of certification
By Deborah Wingler and Ellen Taylor

Context
Prior research surrounding LEED certification has
primarily focused on financial savings related to
energy efficiencies and capital cost premiums
in office and acute care environments. However,
many research papers cite the U.S. Green Building
Council definition of green buildings as "ones that
have significantly reduced or eliminated negative
impacts on the environment and the occupants."
Unfortunately, the focus on more easily quantifiable measurements, such as water and energy use,
provides minimal insight into the indoor environmental quality (IEQ) and its effect on occupants.
Alone, this focus isn't compelling enough for many
providers, especially smaller clinic-based healthcare
organizations, to commit to the process of attaining
third-party certification for green design.
Addressing this narrow view, research conducted
in 2013 by Guy Newsham and colleagues, in association with the National Research Council Canada,
identified areas in need of further investigation, such
as the measurable impact green buildings have on
occupant health and well-being, job satisfaction,
and satisfaction with the environment for factors
including speech privacy, noise, light, access to
windows, thermal comfort, and air quality. A report
prepared by the Institute for Innovation in Large
Organizations for Practice Greenhealth further
suggests the next generation business case should
address areas like the economic benefit of staff
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HCDmagazine.com 12.13

outcomes that are linked to turnover and recruitment, and the community benefit of improved public
perception that can boost philanthropic support for
an organization. Doing so, the report states, would
create a business case that's "more persuasive for
hospital executives and boards, especially in nonprofits that need to demonstrate community benefit
to governmental funding."
The concept
In response to this, Adelante Healthcare decided
to conduct an extended business case focused on
what's often called the triple bottom line, using the
factors of people, planet, and profit to create the
study's framework. However, these factors were then
expanded to include outcomes through both direct
and indirect measures related to the mission, vision,
and goals of the organization in the areas of staff,
community, stewardship, and influence.
For the study, Adelante Healthcare decided to
compare the Mesa facility to another of its newest
outpatient clinics. Adelante Healthcare Surprise
opened in December 2011 in Surprise, Ariz., and
influenced the design of Mesa, which opened in
November 2012. Both facilities were built using
evidence-based design (EBD) principles, such as
decentralized nurses' stations, natural daylight in
public areas, the use of art as a positive distraction,
and culturally relevant design. They both also offer
similar comprehensive services through a medical
home model of care. However, Adelante Healthcare
Mesa is unique to the organization in its incorporation of sustainable initiatives to earn a LEED Platinum

Adelante Healthcare opened
the nation's first LEEDPlatinum community health
center in Mesa, Ariz., and
decided to conduct research
to help determine the impact
of LEED certification.

Deborah Wingler

Ellen Taylor

DUSTIN REVELLA (ADELANTE HEALTHCARE MESA)

In November 2012, Adelante Healthcare, a system
of seven federally qualified healthcare facilities
serving the Phoenix metropolitan area and surrounding communities, opened the nation's first
LEED-Platinum community health center in Mesa,
Ariz. Driven by a commitment to provide sustainable healthcare, Adelante Healthcare sought to
understand the impact of LEED certification on the
organization by conducting research designed to
address gaps within current literature and develop
a baseline for further investigation on green building
within ambulatory environments. Adelante's initial
report regarding the investment and implementation
of sustainable building practices at Adelante Healthcare Mesa, a Pebble Project facility, was delivered
in an educational session at the Healthcare Design
Conference, held Nov. 16-19 in Orlando.
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